[Pneumocystis pneumonia during infliximab treatment for active Crohn's colitis]. / Pneumocystis-pneumonie tijdens behandeling met infliximab voor actieve Crohn-colitis.
Ned Tijdschr Geneeskd
; 149(41): 2290-5, 2005 Oct 08.
Article
en Nl
| MEDLINE
| ID: mdl-16240855
ABSTRACT
A 51-year-old man with Crohn's disease for 22 years presented with a dry cough, dyspnoea, fever and diarrhoea. He had steroid-resistant Crohn's disease. Because of nausea complaints, azathioprine was switched to methotrexate with concomitant infliximab induction therapy. During infliximab therapy, symptoms occurred for which the patient was hospitalised and Pneumocystis pneumonia (PCP) was diagnosed by examination of bronchoalveolar lavage fluid; it was successfully treated with co-trimoxazole and prednisolone. The exacerbation of the Crohn's colitis diminished. This is the first Dutch case history of PCP during combination therapy with prednisolone, methotrexate and infliximab. Infliximab treatment has been associated with an increased risk for infectious complications. For patients with Crohn's disease, one should consider giving PCP prophylaxis for the duration of lymphocytopenia on an individual basis, weighing the adverse effects ofco-trimoxazole against the risk of PCP. A CD4-cell count < 0.2 x 10(9)/l or a lymphocyte count < 0.6 x 10(9)/l may be used as a guide.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neumonía por Pneumocystis
/
Fármacos Gastrointestinales
/
Enfermedad de Crohn
/
Anticuerpos Monoclonales
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
/
Male
/
Middle aged
Idioma:
Nl
Revista:
Ned Tijdschr Geneeskd
Año:
2005
Tipo del documento:
Article