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Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis

BACKGROUND: Outcome data regarding the use of tumor necrosis factor alpha inhibitors (anti-TNFα) in patients with inflammatory bowel disease (IBD) after liver transplant (LT) for primary sclerosing cholangitis (PSC) are scant. METHODS: We performed a retrospective chart review to investigate outcome...

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Autores principales: Parekh, Ravish, Abdulhamid, Ahmed, Trudeau, Sheri, Kaur, Nirmal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976998/
https://www.ncbi.nlm.nih.gov/pubmed/29862092
http://dx.doi.org/10.1155/2018/1015408
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author Parekh, Ravish
Abdulhamid, Ahmed
Trudeau, Sheri
Kaur, Nirmal
author_facet Parekh, Ravish
Abdulhamid, Ahmed
Trudeau, Sheri
Kaur, Nirmal
author_sort Parekh, Ravish
collection PubMed
description BACKGROUND: Outcome data regarding the use of tumor necrosis factor alpha inhibitors (anti-TNFα) in patients with inflammatory bowel disease (IBD) after liver transplant (LT) for primary sclerosing cholangitis (PSC) are scant. METHODS: We performed a retrospective chart review to investigate outcomes among a series of post-liver-transplant PSC/IBD patients receiving anti-TNFα therapy at Henry Ford Health System ((HFHS), Detroit, MI). RESULTS: A total of five patients were treated with anti-TNFα agents for IBD after LT for PSC from 1993 through 2015. Two patients were treated with adalimumab, and three were treated with infliximab. Three patients were hospitalized with severe posttransplant infections. Two patients developed posttransplant lymphoproliferative disease (PTLD); one of these patients died due to complications of PTLD. CONCLUSION: Anti-TNFα treatment following LT worsened the disease course in our patients with concurrent PSC/IBD and led to serious complications and surgical intervention. Larger studies are needed to evaluate the side effects and outcomes of the use of such agents in this patient population. Until then, clinicians should have a high threshold to use anti-TNFα therapy in this setting.
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spelling pubmed-59769982018-06-03 Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis Parekh, Ravish Abdulhamid, Ahmed Trudeau, Sheri Kaur, Nirmal Case Rep Gastrointest Med Case Report BACKGROUND: Outcome data regarding the use of tumor necrosis factor alpha inhibitors (anti-TNFα) in patients with inflammatory bowel disease (IBD) after liver transplant (LT) for primary sclerosing cholangitis (PSC) are scant. METHODS: We performed a retrospective chart review to investigate outcomes among a series of post-liver-transplant PSC/IBD patients receiving anti-TNFα therapy at Henry Ford Health System ((HFHS), Detroit, MI). RESULTS: A total of five patients were treated with anti-TNFα agents for IBD after LT for PSC from 1993 through 2015. Two patients were treated with adalimumab, and three were treated with infliximab. Three patients were hospitalized with severe posttransplant infections. Two patients developed posttransplant lymphoproliferative disease (PTLD); one of these patients died due to complications of PTLD. CONCLUSION: Anti-TNFα treatment following LT worsened the disease course in our patients with concurrent PSC/IBD and led to serious complications and surgical intervention. Larger studies are needed to evaluate the side effects and outcomes of the use of such agents in this patient population. Until then, clinicians should have a high threshold to use anti-TNFα therapy in this setting. Hindawi 2018-05-15 /pmc/articles/PMC5976998/ /pubmed/29862092 http://dx.doi.org/10.1155/2018/1015408 Text en Copyright © 2018 Ravish Parekh et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Parekh, Ravish
Abdulhamid, Ahmed
Trudeau, Sheri
Kaur, Nirmal
Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis
title Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis
title_full Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis
title_fullStr Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis
title_full_unstemmed Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis
title_short Tumor Necrosis Factor Alpha Inhibition for Inflammatory Bowel Disease after Liver Transplant for Primary Sclerosing Cholangitis
title_sort tumor necrosis factor alpha inhibition for inflammatory bowel disease after liver transplant for primary sclerosing cholangitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976998/
https://www.ncbi.nlm.nih.gov/pubmed/29862092
http://dx.doi.org/10.1155/2018/1015408
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