title: Angioedema associated with Crohn's disease: response to biologics.
abstract: A 46-year-old female patient with terminal ileum Crohn's disease and ankylosing spondylitis presented with recurrent angioedema and urticaria. Investigations ruled out hereditary angioedema, and environmental or food allergen triggers. She was diagnosed with chronic idiopathic urticaria with angioedema, and was treated with a trial of intravenous immunoglobulin immunotherapy, danazol, prednisone and hydroxyzine. Due to ongoing bowel and arthritic complaints, she was started on infliximab infusions and within 2 treatments, she had complete resolution of the angioedema and urticaria, as well as of the bowel and arthritic symptoms. Unfortunately she developed allergic reactions to the infliximab and was switched to another anti-tumor necrosis factor (TNF)-α agent, adalimumab. Since then, she has had no further angioedema or urticaria, and her Crohn's disease has been quiescent. This is the first known case report of chronic idiopathic urticaria with angioedema coexistent with Crohn's disease that was successfully treated with anti-TNF-α agents.
authors.affiliation: Department of Gastroenterology, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada. flavio.habal@uhn.ca
authors.forename: Flavio
authors.initials: F
authors.lastname: Habal
authors.forename: Vivian
authors.initials: V
authors.lastname: Huang
mesh_terms: D000799:Angioedema / Q000188:drug therapy / Q000209:etiology*; D002908:Chronic Disease; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014581:Urticaria / Q000188:drug therapy / Q000209:etiology
chemical_list: D016756:Immunoglobulins, Intravenous; D014409:Tumor Necrosis Factor-alpha