Open AccessA Patient with KL-6 Elevation with Anti-TNFα Who Could Receive Long-Term Use without Interstitial Pneumonia after Class Switch of Anti-TNFα
Author(s) -
Takuya Masuda,
Atsushi Yoshida,
Fumiyoshi Ueno,
Shintaro Hara,
Haruaki Nabeta,
Shotaro Umezawa,
Mayuki Shirai,
Yoshihide Morikawa,
Toshio Morizane,
Yutaka Endo,
Toshifumi Hibi
Publication year - 2019
Publication title -
inflammatory intestinal diseases
Language(s) - English
Resource type - Journals
eISSN - 2296-9403
pISSN - 2296-9365
DOI - 10.1159/000497778
Subject(s) - medicine , adalimumab , infliximab , tumor necrosis factor alpha , interstitial lung disease , rheumatoid arthritis , discontinuation , tnf inhibitor , inflammatory bowel disease , gastroenterology , refractory (planetary science) , ulcerative colitis , lung , disease , physics , astrobiology
A 40-year-old man with refractory ulcerative colitis (UC) was treated with tumor necrosis factor α inhibitor (anti-TNFα), infliximab. One month later, the chest computed tomography and laboratory test showed noninfectious interstitial lung disease (ILD) and elevation of serum Krebs von den Lungen-6 (KL-6). Fortunately, ILD disappeared after the discontinuation with anti-TNFα. Two and a half years after his first UC treatment, he was treated again with another anti-TNFα, adalimumab, for relapse and he had a second ILD. This course suggested anti-TNFα induced ILD. The characteristics of anti-TNFα-induced ILD in inflammatory bowel disease (IBD) are not well understood. We summarized and investigated the characteristics of such patients based on a literature review including 15 cases. It suggested that anti-TNFα-induced ILD in IBD might be rare and tends to have a better outcome compared with ILD in rheumatoid arthritis.