Diffuse Autoimmune Enteropathy and Colopathy in an Adult Patient Successfully Treated With Adalimumab and a Review of the Literature.
Autoimmune enteropathy (AIE) is a rare disease that causes intractable diarrhea not responsive to a gluten free diet and must be distinguished from refractory sprue. It is associated with circulating autoantibodies against goblet cells and enterocytes. AIE mainly involves the small intestines, with very few cases reported in adults. Because of the paucity of cases, the epidemiology of the disease remains unclear, and treatment is based on the cases found in the literature. Of the 35 adult cases reported, only 4 involved the colon. Because of the low number of cases, there have been no clear recommendations on treatment modalities with most reports heavily emphasizing steroids as the mainstay of treatment. We present the case of adult female patient who developed postpartum AIE and colopathy with profuse diarrhea successfully treated with adalimumab and a review of the literature. To the best of our knowledge, this case is only the fourth case of a tumor necrosis factor alpha antagonist being used in the treatment of AIE and the first case of adalimumab being used.
Departments of 1Medicine and 2Pathology, University of Toledo Medical Center, Toledo, OH; and 3Department of Medicine, Division of Gastroenterology, University of Toledo Medical Center, Toledo, OH.
Syed Shafae
SS
Hasan
Nauman Saleem
NS
Siddiqui
Sri Krishna
SK
Chaitanya Arudra
Luis
L
de Las Casas
Basil
B
Akpunonu
Ali
A
Nawras
D015746:Abdominal Pain / Q000209:etiology; D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D016884:Polyendocrinopathies, Autoimmune / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D012810:Sigmoid Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology
D000893:Anti-Inflammatory Agents; D000068879:Adalimumab