Severe Attack of Henoch-Schönlein Purpura With Neurological Involvement During Adalimumab Treatment for Crohn's Disease

J Crohns Colitis. 2020 May 21;14(4):538-542. doi: 10.1093/ecco-jcc/jjz164.

Abstract

Tumour necrosis factor-α [TNF-α] inhibitors have revolutionised the management of chronic inflammatory conditions. A number of cutaneous adverse events have been reported with TNF inhibition, including vasculitis. Most reactions are mild and rarely warrant treatment withdrawal. Here we describe a patient with Crohn's disease treated with adalimumab in whom severe multivisceral Henoch-Schönlein purpura developed, including neurological involvement, requiring definitive TNF blocker withdrawal.

Keywords: Crohn’s disease; Henoch-Schönlein purpura; adalimumab; endoscopy; pathology.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab / administration & dosage
  • Adalimumab / adverse effects*
  • Administration, Intravenous
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy*
  • Dose-Response Relationship, Drug
  • Electromyography / methods
  • Endoscopy, Gastrointestinal / methods
  • Female
  • Gastrointestinal Hemorrhage* / diagnosis
  • Gastrointestinal Hemorrhage* / etiology
  • Glucocorticoids / administration & dosage*
  • Humans
  • IgA Vasculitis* / diagnosis
  • IgA Vasculitis* / etiology
  • IgA Vasculitis* / physiopathology
  • IgA Vasculitis* / therapy
  • Peripheral Nervous System Diseases* / diagnosis
  • Peripheral Nervous System Diseases* / etiology
  • Severity of Illness Index
  • Skin / pathology
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors / administration & dosage
  • Tumor Necrosis Factor Inhibitors / adverse effects
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Tumor Necrosis Factor Inhibitors
  • Adalimumab