Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.12998/wjcc.v9.i33.10382 http://hdl.handle.net/11449/230038 |
Resumo: | Background Anti-tumor necrosis factor agents were the first biologic therapy approved for the management of Crohn's disease (CD). Heart failure (HF) is a rare but potential adverse effect of these medications. The objective of this report is to describe a patient with CD who developed HF after the use of infliximab. Case Summary A 50-year-old woman with a history of hypertension and diabetes presented with abdominal pain, diarrhea, and weight loss. Colonoscopy and enterotomography showed ulcerations, areas of stenosis and dilation in the terminal ileum, and thickening of the intestinal wall. The patient underwent ileocolectomy and the surgical specimen confirmed the diagnosis of stenosing CD. The patient started infliximab and azathioprine treatment to prevent post-surgical recurrence. At 6 mo after initiating infliximab therapy, the patient complained of dyspnea, orthopnea, and paroxysmal nocturnal dyspnea that gradually worsened. Echocardiography revealed biventricular dysfunction, moderate cardiac insufficiency, an ejection fraction of 36%, and moderate pericardial effusion, consistent with HF. The cardiac disease was considered an infliximab adverse effect and the drug was discontinued. The patient received treatment with diuretics for HF and showed improvement of symptoms and cardiac function. Currently, the patient is using Conclusion This reported case supports the need to investigate risk factors for HF in inflammatory bowel disease patients and to consider the risk-benefit of introducing infliximab therapy in such patients presenting with HF risk factors. |
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Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literatureAnti-tumor necrosis factor therapyCase reportCrohn's diseaseHeart failureInflammatory bowel diseaseInfliximabBackground Anti-tumor necrosis factor agents were the first biologic therapy approved for the management of Crohn's disease (CD). Heart failure (HF) is a rare but potential adverse effect of these medications. The objective of this report is to describe a patient with CD who developed HF after the use of infliximab. Case Summary A 50-year-old woman with a history of hypertension and diabetes presented with abdominal pain, diarrhea, and weight loss. Colonoscopy and enterotomography showed ulcerations, areas of stenosis and dilation in the terminal ileum, and thickening of the intestinal wall. The patient underwent ileocolectomy and the surgical specimen confirmed the diagnosis of stenosing CD. The patient started infliximab and azathioprine treatment to prevent post-surgical recurrence. At 6 mo after initiating infliximab therapy, the patient complained of dyspnea, orthopnea, and paroxysmal nocturnal dyspnea that gradually worsened. Echocardiography revealed biventricular dysfunction, moderate cardiac insufficiency, an ejection fraction of 36%, and moderate pericardial effusion, consistent with HF. The cardiac disease was considered an infliximab adverse effect and the drug was discontinued. The patient received treatment with diuretics for HF and showed improvement of symptoms and cardiac function. Currently, the patient is using Conclusion This reported case supports the need to investigate risk factors for HF in inflammatory bowel disease patients and to consider the risk-benefit of introducing infliximab therapy in such patients presenting with HF risk factors.Department of Internal Medicine São Paulo State University (Unesp) Medical SchoolDepartment of Pathology São Paulo State University (Unesp) Medical SchoolInflammatory Bowel Disease Program Digestive Disease Center ClínicaUniversidad de los AndesDepartment of Internal Medicine São Paulo State University (Unesp) Medical SchoolDepartment of Pathology São Paulo State University (Unesp) Medical SchoolUniversidade Estadual Paulista (UNESP)Digestive Disease Center ClínicaUniversidad de los AndesGrillo, Thais Gagno [UNESP]Almeida, Luciana Rocha [UNESP]Beraldo, Rodrigo Fedatto [UNESP]Marcondes, Mariana Barros [UNESP]Queiróz, Diego Aparecido Rios [UNESP]da Silva, Daniel Luiz [UNESP]Quera, RodrigoBaima, Julio Pinheiro [UNESP]Saad-Hossne, Rogerio [UNESP]Sassaki, Ligia Yukie [UNESP]2022-04-29T08:37:18Z2022-04-29T08:37:18Z2021-11-26info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article10382-10391http://dx.doi.org/10.12998/wjcc.v9.i33.10382World Journal of Clinical Cases, v. 9, n. 33, p. 10382-10391, 2021.2307-8960http://hdl.handle.net/11449/23003810.12998/wjcc.v9.i33.103822-s2.0-85120964335Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengWorld Journal of Clinical Casesinfo:eu-repo/semantics/openAccess2024-09-03T13:15:04Zoai:repositorio.unesp.br:11449/230038Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462024-09-03T13:15:04Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
title |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
spellingShingle |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature Grillo, Thais Gagno [UNESP] Anti-tumor necrosis factor therapy Case report Crohn's disease Heart failure Inflammatory bowel disease Infliximab |
title_short |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
title_full |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
title_fullStr |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
title_full_unstemmed |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
title_sort |
Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature |
author |
Grillo, Thais Gagno [UNESP] |
author_facet |
Grillo, Thais Gagno [UNESP] Almeida, Luciana Rocha [UNESP] Beraldo, Rodrigo Fedatto [UNESP] Marcondes, Mariana Barros [UNESP] Queiróz, Diego Aparecido Rios [UNESP] da Silva, Daniel Luiz [UNESP] Quera, Rodrigo Baima, Julio Pinheiro [UNESP] Saad-Hossne, Rogerio [UNESP] Sassaki, Ligia Yukie [UNESP] |
author_role |
author |
author2 |
Almeida, Luciana Rocha [UNESP] Beraldo, Rodrigo Fedatto [UNESP] Marcondes, Mariana Barros [UNESP] Queiróz, Diego Aparecido Rios [UNESP] da Silva, Daniel Luiz [UNESP] Quera, Rodrigo Baima, Julio Pinheiro [UNESP] Saad-Hossne, Rogerio [UNESP] Sassaki, Ligia Yukie [UNESP] |
author2_role |
author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (UNESP) Digestive Disease Center ClínicaUniversidad de los Andes |
dc.contributor.author.fl_str_mv |
Grillo, Thais Gagno [UNESP] Almeida, Luciana Rocha [UNESP] Beraldo, Rodrigo Fedatto [UNESP] Marcondes, Mariana Barros [UNESP] Queiróz, Diego Aparecido Rios [UNESP] da Silva, Daniel Luiz [UNESP] Quera, Rodrigo Baima, Julio Pinheiro [UNESP] Saad-Hossne, Rogerio [UNESP] Sassaki, Ligia Yukie [UNESP] |
dc.subject.por.fl_str_mv |
Anti-tumor necrosis factor therapy Case report Crohn's disease Heart failure Inflammatory bowel disease Infliximab |
topic |
Anti-tumor necrosis factor therapy Case report Crohn's disease Heart failure Inflammatory bowel disease Infliximab |
description |
Background Anti-tumor necrosis factor agents were the first biologic therapy approved for the management of Crohn's disease (CD). Heart failure (HF) is a rare but potential adverse effect of these medications. The objective of this report is to describe a patient with CD who developed HF after the use of infliximab. Case Summary A 50-year-old woman with a history of hypertension and diabetes presented with abdominal pain, diarrhea, and weight loss. Colonoscopy and enterotomography showed ulcerations, areas of stenosis and dilation in the terminal ileum, and thickening of the intestinal wall. The patient underwent ileocolectomy and the surgical specimen confirmed the diagnosis of stenosing CD. The patient started infliximab and azathioprine treatment to prevent post-surgical recurrence. At 6 mo after initiating infliximab therapy, the patient complained of dyspnea, orthopnea, and paroxysmal nocturnal dyspnea that gradually worsened. Echocardiography revealed biventricular dysfunction, moderate cardiac insufficiency, an ejection fraction of 36%, and moderate pericardial effusion, consistent with HF. The cardiac disease was considered an infliximab adverse effect and the drug was discontinued. The patient received treatment with diuretics for HF and showed improvement of symptoms and cardiac function. Currently, the patient is using Conclusion This reported case supports the need to investigate risk factors for HF in inflammatory bowel disease patients and to consider the risk-benefit of introducing infliximab therapy in such patients presenting with HF risk factors. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-11-26 2022-04-29T08:37:18Z 2022-04-29T08:37:18Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.12998/wjcc.v9.i33.10382 World Journal of Clinical Cases, v. 9, n. 33, p. 10382-10391, 2021. 2307-8960 http://hdl.handle.net/11449/230038 10.12998/wjcc.v9.i33.10382 2-s2.0-85120964335 |
url |
http://dx.doi.org/10.12998/wjcc.v9.i33.10382 http://hdl.handle.net/11449/230038 |
identifier_str_mv |
World Journal of Clinical Cases, v. 9, n. 33, p. 10382-10391, 2021. 2307-8960 10.12998/wjcc.v9.i33.10382 2-s2.0-85120964335 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
World Journal of Clinical Cases |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
10382-10391 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
repositoriounesp@unesp.br |
_version_ |
1810021378938634240 |