title: Refractory lymphocytic enterocolitis and tumor necrosis factor antagonist therapy.
abstract: OBJECTIVE
  Lymphocytic enterocolitis is a malabsorptive syndrome characterized by severe small-bowel villous abnormality and crypt hyperplasia and dense infiltrate of lymphocytes throughout the gastrointestinal tract.
  
  
  METHODS
  We present 2 patients with lymphocytic enterocolitis refractory to usual medical therapy who were treated with tumor necrosis factor antagonists.
  
  
  RESULTS
  Both patients had clinical improvement in diarrheal symptoms and intestinal histologic abnormalities.
  
  
  CONCLUSIONS
  Tumor necrosis factor-alpha antagonists such as infliximab or adalimumab may be a new treatment option for patients with severe refractory lymphocytic enterocolitis not responding to corticosteroids.
authors.affiliation: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Ghazaleh
authors.initials: G
authors.lastname: Aram
authors.forename: Theodore M
authors.initials: TM
authors.lastname: Bayless
authors.forename: Zong-Ming
authors.initials: ZM
authors.lastname: Chen
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Montgomery
authors.forename: Mark
authors.initials: M
authors.lastname: Donowitz
authors.forename: Francis M
authors.initials: FM
authors.lastname: Giardiello
mesh_terms: D000068879:Adalimumab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D046730:Colitis, Lymphocytic / Q000628:therapy*; D003106:Colon / Q000473:pathology; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D007155:Immunologic Factors / Q000627:therapeutic use*; D000069285:Infliximab; D007421:Intestine, Small / Q000473:pathology; D008853:Microscopy; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab