title: Review of pulmonary adverse effects of infliximab therapy in Crohn's disease.
abstract: BACKGROUND
  Anti-inflammatory therapies are the mainstay for the treatment of inflammatory bowel disease (IBD) in children and adults, including biologics such as infliximab. While there is extensive literature on the general side effects of therapy with infliximab, the data on pulmonary adverse effects remains sparse. This article summarizes the literature related to pulmonary adverse effects of Infliximab therapy in Crohn's Disease.
  
  
  METHODS
  Published reports of specific pulmonary complications during ongoing therapy with infliximab in patients with IBD were included in the review. A wide variety of infectious and non-infectious complications have been reported with the use of infliximab therapy in IBD.
  
  
  CONCLUSIONS
  It is important to carefully evaluate respiratory signs and symptoms in patients with IBD, especially those receiving biologic therapies. Besides infectious complications, other non-infectious pulmonary adverse effects associated with the use of infliximab should be considered in patients with IBD. Further, it is important to differentiate primary pulmonary involvement of IBD from pulmonary adverse effects of infliximab therapy. An algorithm for assessing patients with IBD presenting with pulmonary symptoms is provided as a guide for clinicians for medical decision-making.
authors.affiliation: a Pediatric Gastroenterology, The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Dhiren
authors.initials: D
authors.lastname: Patel
authors.affiliation: a Pediatric Gastroenterology, The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan , Wayne State University School of Medicine , Detroit , MI , USA.
authors.forename: Shailender
authors.initials: S
authors.lastname: Madani
authors.affiliation: b Department of Emergency Medicine , Wayne State University , Detroit , MI , USA.
authors.forename: Shraddha
authors.initials: S
authors.lastname: Patel
authors.affiliation: c Pulmonology, Allergy/Immunology, Cystic Fibrosis and Sleep Medicine (PACS) Division, Department of Pediatrics, Children's Healthcare of Atlanta , Emory University School of Medicine , Atlanta , GA , USA.
authors.forename: Lokesh
authors.initials: L
authors.lastname: Guglani
mesh_terms: D000328:Adult; D000465:Algorithms; D002648:Child; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab / Q000009:adverse effects* / Q000627:therapeutic use; D008171:Lung Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000209:etiology
chemical_list: D005765:Gastrointestinal Agents; D000069285:Infliximab
keywords: Adverse effects; Crohn’s Disease; Inflammatory Bowel Disease; Infliximab; Ulcerative Colitis; interstitial lung disease; tumor necrosis factor