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Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study

Background: Vasculitis is an uncommon complication of biologics used to treat inflammatory bowel disease (IBD). This study describes a case series of vasculitis induced by anti-tumor necrosis factor (TNF) therapy in IBD patients. Methods: Retrospective assessments were performed using the medical re...

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Autores principales: Parra, Rogério Serafim, Chebli, Júlio Maria Fonseca, Chebli, Liliana Andrade, de Lima Junior, Sérgio Figueiredo, Lins Neto, Manoel Alvaro, de Medeiros, Terry Rocha, Faria, Francesca Maia, Feitosa, Marley Ribeiro, Nigro, Cintia Maura Caseiro, Féres, Omar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179457/
https://www.ncbi.nlm.nih.gov/pubmed/37176606
http://dx.doi.org/10.3390/jcm12093165
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author Parra, Rogério Serafim
Chebli, Júlio Maria Fonseca
Chebli, Liliana Andrade
de Lima Junior, Sérgio Figueiredo
Lins Neto, Manoel Alvaro
de Medeiros, Terry Rocha
Faria, Francesca Maia
Feitosa, Marley Ribeiro
Nigro, Cintia Maura Caseiro
Féres, Omar
author_facet Parra, Rogério Serafim
Chebli, Júlio Maria Fonseca
Chebli, Liliana Andrade
de Lima Junior, Sérgio Figueiredo
Lins Neto, Manoel Alvaro
de Medeiros, Terry Rocha
Faria, Francesca Maia
Feitosa, Marley Ribeiro
Nigro, Cintia Maura Caseiro
Féres, Omar
author_sort Parra, Rogério Serafim
collection PubMed
description Background: Vasculitis is an uncommon complication of biologics used to treat inflammatory bowel disease (IBD). This study describes a case series of vasculitis induced by anti-tumor necrosis factor (TNF) therapy in IBD patients. Methods: Retrospective assessments were performed using the medical records of adult IBD patients who underwent outpatient clinical follow-ups between January 2010 and December 2019 in order to identify patients with vasculitis caused by anti-TNF therapy. Results: There were 2442 patients altogether. Of these, 862 (35%) took anti-TNF medication. Five patients (0.6% of the overall patients; n = 3 (60%) Crohn’s disease; n = 2 (40%), ulcerative colitis) were identified as having leukocytoclastic vasculitis (LCV) due to anti-TNF therapy; these patients were white, female, and non-smokers. The mean age of LCV diagnosis was 32.2 years, and the mean IBD duration was 7.2 years. The mean time between the start of biologic therapy and LCV onset was 30.8 months. Most of the patients were using adalimumab (80%; n = 4). All the patients were in remission at the time of the LCV diagnosis, and the vasculitis affected the skin in all cases. Anti-TNF therapy was discontinued in the five abovementioned patients, and the response of LCV to the oral steroids was significantly positive. Remarkably, all five patients experienced complete remission from LCV within 4–12 weeks after starting prednisone therapy, and none of them had LCV recurrence in the follow-up period (a mean duration of 28 months). Conclusions: LCV is an unusual complication of anti-TNF therapy in the IBD setting. In this context, clinicians should have a high degree of suspicion of LCV in patients who develop an unexplained cutaneous rash.
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spelling pubmed-101794572023-05-13 Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study Parra, Rogério Serafim Chebli, Júlio Maria Fonseca Chebli, Liliana Andrade de Lima Junior, Sérgio Figueiredo Lins Neto, Manoel Alvaro de Medeiros, Terry Rocha Faria, Francesca Maia Feitosa, Marley Ribeiro Nigro, Cintia Maura Caseiro Féres, Omar J Clin Med Article Background: Vasculitis is an uncommon complication of biologics used to treat inflammatory bowel disease (IBD). This study describes a case series of vasculitis induced by anti-tumor necrosis factor (TNF) therapy in IBD patients. Methods: Retrospective assessments were performed using the medical records of adult IBD patients who underwent outpatient clinical follow-ups between January 2010 and December 2019 in order to identify patients with vasculitis caused by anti-TNF therapy. Results: There were 2442 patients altogether. Of these, 862 (35%) took anti-TNF medication. Five patients (0.6% of the overall patients; n = 3 (60%) Crohn’s disease; n = 2 (40%), ulcerative colitis) were identified as having leukocytoclastic vasculitis (LCV) due to anti-TNF therapy; these patients were white, female, and non-smokers. The mean age of LCV diagnosis was 32.2 years, and the mean IBD duration was 7.2 years. The mean time between the start of biologic therapy and LCV onset was 30.8 months. Most of the patients were using adalimumab (80%; n = 4). All the patients were in remission at the time of the LCV diagnosis, and the vasculitis affected the skin in all cases. Anti-TNF therapy was discontinued in the five abovementioned patients, and the response of LCV to the oral steroids was significantly positive. Remarkably, all five patients experienced complete remission from LCV within 4–12 weeks after starting prednisone therapy, and none of them had LCV recurrence in the follow-up period (a mean duration of 28 months). Conclusions: LCV is an unusual complication of anti-TNF therapy in the IBD setting. In this context, clinicians should have a high degree of suspicion of LCV in patients who develop an unexplained cutaneous rash. MDPI 2023-04-28 /pmc/articles/PMC10179457/ /pubmed/37176606 http://dx.doi.org/10.3390/jcm12093165 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Parra, Rogério Serafim
Chebli, Júlio Maria Fonseca
Chebli, Liliana Andrade
de Lima Junior, Sérgio Figueiredo
Lins Neto, Manoel Alvaro
de Medeiros, Terry Rocha
Faria, Francesca Maia
Feitosa, Marley Ribeiro
Nigro, Cintia Maura Caseiro
Féres, Omar
Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study
title Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study
title_full Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study
title_fullStr Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study
title_full_unstemmed Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study
title_short Leukocytoclastic Vasculitis Secondary to Anti-Tumor Necrosis Factor Therapy in Inflammatory Bowel Diseases: A Multicenter Retrospective Cohort Study
title_sort leukocytoclastic vasculitis secondary to anti-tumor necrosis factor therapy in inflammatory bowel diseases: a multicenter retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179457/
https://www.ncbi.nlm.nih.gov/pubmed/37176606
http://dx.doi.org/10.3390/jcm12093165
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