Open AccessSevere Henoch-Schönlein purpura with infliximab for ulcerative colitis
Author(s) -
Yang Song,
Yanhong Shi,
Chao He,
Changqin Liu,
Junshan Wang,
Yujie Zhao,
Yanmin Guo,
Rui Wu,
Xiaoyue Feng,
Zhanju Liu
Publication year - 2015
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v21.i19.6082
Subject(s) - medicine , infliximab , ulcerative colitis , dermatology , inflammatory bowel disease , vasculitis , purpura (gastropod) , palpable purpura , colectomy , henoch schonlein purpura , adverse effect , gastroenterology , disease , ecology , biology
Infliximab (IFX) is an anti-tumor necrosis factor chimeric antibody that is effective for treatment of autoimmune disorders such as Crohn's disease and ulcerative colitis (UC). IFX is well tolerated with a low incidence of adverse effects such as infections, skin reactions, autoimmunity, and malignancy. Dermatological manifestations can appear as infusion reaction, vasculitis, cutaneous infections, psoriasis, eczema, and skin cancer. Here, we present an unusual case of extensive and sporadic subcutaneous ecchymosis in a 69-year-old woman with severe UC, partial colectomy and cecostomy, following her initial dose of IFX. The reaction occurred during infliximab infusion, and withdrawal of IFX led to gradual alleviation of her symptoms. We concluded that Henoch-Schönlein purpura, a kind of leukocytoclastic vasculitis, might have contributed to the development of the bruising. Although the precise mechanisms of the vasculitis are still controversial, such a case highlights the importance of subcutaneous adverse effects in the management of UC with IFX.