scholarly journals Posterior Reversible Encephalopathy Syndrome following Ustekinumab Induction for Crohn’s Disease

2018 ◽  
Vol 12 (2) ◽  
pp. 521-527 ◽  
Author(s):  
Avantika Mishra ◽  
Darren N. Seril
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Human Monoclonal Antibody ◽  
Interleukin 12 ◽  
Cytokine Signaling ◽  
Acute Encephalopathy ◽  
Posterior Reversible Encephalopathy ◽  
Inflammatory Bowel ◽  
Reversible Encephalopathy

Biological agents are frequently used in the management of inflammatory bowel disease, and it is important to understand the potential adverse effects of these therapies. Ustekinumab is a human monoclonal antibody that interferes with interleukin-12 and -23 cytokine signaling and is approved for the treatment of moderate to severe Crohn’s disease. We report 2 cases of neurological adverse events, one of which is consistent with posterior reversible encephalopathy syndrome (PRES), in the setting of ustekinumab therapy for Crohn’s disease. The first patient had a seizure and classic neuroimaging features of PRES following induction with ustekinumab. The second patient presented with acute encephalopathy and atypical imaging findings concerning for PRES after ustekinumab induction. Both patients recovered fully following cessation of ustekinumab therapy. PRES associated with ustekinumab is uncommon, but must be a consideration in Crohn’s disease patients receiving this therapy who present with focal neurological symptoms or change in mentation.

scholarly journals Neurological manifestations related to Crohn’s disease: a boon for the workforce

2017 ◽  
Vol 7 (4) ◽  
pp. 291-297 ◽  
Author(s):  
Reza Nemati ◽  
Somayeh Mehdizadeh ◽  
Hooman Salimipour ◽  
Ehsan Yaghoubi ◽  
Zeinab Alipour ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Optic Neuropathy ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Ischemic Optic Neuropathy ◽  
Neurological Manifestations ◽  
Posterior Reversible Encephalopathy ◽  
Inflammatory Demyelinating Polyneuropathy ◽  
Reversible Encephalopathy

Abstract The neurological manifestations of Crohn’s disease and its prevalence are not well known. Here, we report five patients of confirmed Crohn’s disease with different neurological presentations. The neurological presentations include anterior ischemic optic neuropathy, myelopathy, posterior reversible encephalopathy syndrome, chronic inflammatory demyelinating polyneuropathy, and chronic axonal sensory and motor polyneuropathy. These manifestations should be kept in mind in the assessment of Crohn’s disease.

scholarly journals Posterior reversible encephalopathy syndrome following sepsis in a Crohn’s disease patient: A case report

2016 ◽  
Vol 4 (4) ◽  
pp. 103 ◽  
Author(s):  
Ioannis Papaconstantinou ◽  
Dionysios S Mantzos ◽  
Eirini Pantiora ◽  
Marios K Tasoulis ◽  
Sofia Vassilopoulou ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Disease Patient ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals Management of Crohn’s disease in an immunosuppressed COVID-19-positive patient: safety-driven prioritisation of nutritional therapy as a bridge to restarting immunosuppression

2021 ◽  
Vol 14 (3) ◽  
pp. e239404
Author(s):  
Clare Harris ◽  
Richard James Harris ◽  
Louise Downey ◽  
Markus Gwiggner
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Patient Safety ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Therapy ◽  
Interleukin 12 ◽  
Inflammatory Bowel ◽  
Term Maintenance

Active inflammatory bowel disease (IBD), combined immunosuppression and corticosteroid therapy have all been identified as risk factors for a poor outcome in COVID-19 infection. The management of patients with both COVID-19 infection and active IBD is therefore complex. We present the case of a 31-year-old patient with Crohn’s disease, on dual immunosuppression with infliximab and mercaptopurine presenting with inflammatory small bowel obstruction and COVID-19 infection. The case highlights the use of nutritional therapy, which remains underused in the management of adults with IBD, to manage his flare acutely. Following negative SARS-CoV-2 PCR testing and SARS-CoV-2 IgG testing confirming an antibody response, ustekinumab (anti-interleukin 12/23) was prescribed for long-term maintenance.

scholarly journals Gene Polymorphisms of NOD2, IL23R, PTPN2 and ATG16L1 in Patients with Crohn’s Disease: On the Way to Personalized Medicine?

Genes ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 866
Author(s):  
Peter Hoffmann ◽  
David Lamerz ◽  
Petra Hill ◽  
Marietta Kirchner ◽  
Annika Gauss
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Risk Allele ◽  
University Hospital ◽  
Interleukin 12 ◽  
Nucleotide Polymorphisms ◽  
Bowel Diseases ◽  
History Of ◽  
Inflammatory Bowel ◽  
Genetic And Environmental Factors

Genetic and environmental factors are involved in the pathogenesis of inflammatory bowel diseases (IBD). The study aimed at investigating the potential influence of single nucleotide polymorphisms (SNPs) NOD2 rs2066844, NOD2 rs2066845, NOD2 rs2066847, IL23R rs11209026, PTPN2 rs2542151, PTPN2 rs7234029, and ATG16L1 rs2241880 on the response to immunomodulatory therapies and disease course in Crohn’s disease (CD). This is an uncontrolled retrospective monocentric study including patients from the IBD outpatient clinic of Heidelberg University Hospital. Therapy responses and disease courses were related to genetic findings. 379 patients with CD were included. The presence of at least one PTPN2 rs7234029 risk allele was associated with nonresponse to anti-interleukin-12/23 treatment (89.9% vs. 67.6%, p = 0.005). The NOD2 rs2066844 risk allele was associated with a first-degree family history of colon cancer (12.7% vs. 4.7%, p = 0.02), the ATG16L1 rs2241880 risk allele with ileal CD manifestation (p = 0.027), and the IL23R rs11209026 risk allele with a higher rate of CD-related surgeries per disease year (0.08 vs. 0.02, p = 0.025). The results of this study underline the relevance of genetic influences in CD. The association of the PTPN2 rs7234029 risk allele with nonresponse to anti-interleukin-12/23 treatment in CD patients is a novel finding and requires further investigation.

scholarly journals A Case of Adalimumab-Induced Pneumonitis in a 45-Year-Old Man with Crohn’s Disease

2011 ◽  
Vol 18 (5) ◽  
pp. 262-264 ◽  
Author(s):  
James D Reid ◽  
Brian Bressler ◽  
John English
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Lung Injury ◽  
Tumour Necrosis ◽  
Human Monoclonal Antibody ◽  
Tumour Necrosis Factor Alpha ◽  
Necrosis Factor Alpha ◽  
Inflammatory Bowel ◽  
Factor Alpha ◽  
Necrosis Factor

Adalimumab is a human monoclonal antibody against tumour necrosis factor-alpha that has been associated with acute lung toxicity, mainly in patients with rheumatoid arthritis. Descriptions of similar patterns of lung injury in patients treated with adalimumab for inflammatory bowel disease are emerging in the literature. A case involving a 45-year-old man with Crohn’s disease who developed a nonbronchiolitis inflammatory nodular pattern of lung injury after starting adalimumab is reported.

scholarly journals Treatment of inflammatory bowel diseases: focusing on biologic agents and new therapies

2021 ◽  
Vol 64 (9) ◽  
pp. 605-613
Author(s):  
Hyo Yeop Song ◽  
Geom Seog Seo
Keyword(s):  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Biologic Agents ◽  
Janus Kinase ◽  
Interleukin 12 ◽  
New Therapies ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Background: The treatment of inflammatory bowel diseases has evolved with the development of anti-tumor necrosis factor agents. Despite the long-term effectiveness, many patients experience primary non-response, secondary loss of response, or intolerance. Therefore, the development of new drugs that act on different inflammatory pathways has become necessary. This review focuses on biologic agents and new therapies for the treatment of inflammatory bowel diseases.Current Concepts: Vedolizumab, a gut-selective agent that targets α4β7 integrin is effective in both ulcerative colitis and Crohn’s disease. Ustekinumab is a monoclonal antibody that binds to p40 subunit of interleukin-12/interleukin-23. Ustekinumab is available for the treatment of Crohn’s disease and ulcerative colitis. Tofacitinib is the first Janus kinase inhibitor approved for the treatment of ulcerative colitis. The advantage of tofacitinib is an oral prescription medicine and has rapid action.Discussion and Conclusion: Since vedolizumab, ustekinumab and tofacitinib are effective agents for the treatment of inflammatory bowel diseases, positioning of old and new biologic agents and small molecules should be determined. The safety and efficacy of novel and emerging drugs needs to be evaluated in patients with inflammatory bowel disease.

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