title: Efficacy of Adalimumab in a Girl with Refractory Intestinal Behcet's Disease.
abstract: We describe our experience with a juvenile patient who had refractory intestinal Behcet's disease that responded to adalimumab, a fully humanized antibody against soluble TNF-α and its receptor. The patient, a 13-year-old girl, presented with oral aphthous ulcers, vulvar pain, and rashes on the lower extremities. She gradually developed a low-grade fever, abdominal pain, diarrhea, and hematochezia. Lower gastrointestinal endoscopy revealed ulcers in the terminal ileum, consistent with intestinal Behcet's disease. Methylprednisolone pulse therapy was initiated, after which the symptoms transiently improved, but, during the corticosteroid taper, the abdominal pain recurred. The symptoms resolved soon after the administration of adalimumab. Of importance, the dose of corticosteroids was successfully reduced without exacerbation during 8 months of observation. This is the first reported case in which adalimumab was used for pediatric gastrointestinal Behcet's disease. Adalimumab is a good choice for intestinal Behcet's disease refractory to conventional treatment.
authors.affiliation: Department of Pediatrics, Tokyo Women's Medical University, No. 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Kaji
authors.affiliation: Department of Pediatrics, Tokyo Women's Medical University, No. 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan ; Institute of Rheumatology, Tokyo Women's Medical University, No. 10-22, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kishi
authors.affiliation: Department of Pediatrics, Tokyo Women's Medical University, No. 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan ; Institute of Rheumatology, Tokyo Women's Medical University, No. 10-22, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Miyamae
authors.affiliation: Department of Pediatrics, Tokyo Women's Medical University, No. 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Nagata
authors.affiliation: Institute of Rheumatology, Tokyo Women's Medical University, No. 10-22, Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
authors.affiliation: Fujikawa Pediatrics Clinic, No. 7-29-2, Ooi, Shinagawa-ku, Tokyo 140-0014, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujikawa