Sari I, Birlik M, Gonen C, Akar S, Gurel D, Onen F, Akkoc N. Cytomegalovirus colitis in a patient with Behcet’s disease receiving tumor necrosis factor alpha inhibitory treatment. World J Gastroenterol 2008; 14(18): 2912-2914 [PMID: 18473420 DOI: 10.3748/wjg.14.2912]
Corresponding Author of This Article
Professor Nurullah Akkoc, MD, Dokuz Eylul Universitesi Tip Fakultesi Ic hastaliklari ABD Immunoloji-Romatoloji BD 35340 Inciralti, Izmir 35340, Turkey. nurullah.akkoc@deu.edu.tr
Article-Type of This Article
Case Report
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Ismail Sari, Merih Birlik, Servet Akar, Fatos Onen, Nurullah Akkoc, Division of Rheumatology, Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir 35340, Turkey
Can Gonen, Division of Gastroenterology, Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir 35340, Turkey
Duygu Gurel, Department of Pathology, Dokuz Eylul University School of Medicine, Izmir 35340, Turkey
Author contributions: Sari I and Birlik M wrote the paper; Sari I and Akar S drafted the article; Sari I, Gonen C and Gurel D collected and assembled the data; Onen F and Akkoc N critically revised the article for important intellectual content; Akkoc N finally approved the article.
Correspondence to: Professor Nurullah Akkoc, MD, Dokuz Eylul Universitesi Tip Fakultesi Ic hastaliklari ABD Immunoloji-Romatoloji BD 35340 Inciralti, Izmir 35340, Turkey. nurullah.akkoc@deu.edu.tr
Telephone: +90-232-4123781
Fax: +90-232-2792739
Received: January 28, 2008 Revised: April 9, 2008 Published online: May 14, 2008
Abstract
Anti-tumor necrosis factor alpha (TNF-α) inhibitors are effective in the treatment of various inflammatory rheumatic conditions. Increased risks of serious infections are the major issues concerning the long-term safety of these agents. We present a case of a young male Behcet’s patient whose disease was complicated by cytomegalovirus (CMV) colitis. Colitis started 10 d after the third Infliximab dose and responded to the cessation of TNF blocking treatment and administration of ganciclovir. Tumor necrosis factor alpha and interferon gamma act at several levels in combating viral infections. CMV infections should be kept in mind and included in the differential diagnosis of severe gastrointestinal symptoms in patients receiving anti-TNF agents.
