Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature

Detalhes bibliográficos
Autor(a) principal: Grillo, Thais Gagno [UNESP]
Data de Publicação: 2021
Outros Autores: 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]
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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spelling 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
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