ABSTRACT
Behçet's disease is a chronic inflammatory disease characterized by recurrent oral aphthae and systemic manifestations. Gastrointestinal involvement is rare. We report a case of ileocolitis secondary to Behçet's successfully treated with tumor necrosis factor-alpha antibody (infliximab) therapy. To our knowledge this is the second reported case of Behçet's ileocolitis successfully treated with anti-tumor necrosis factor therapy.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Behcet Syndrome/drug therapy , Colitis/drug therapy , Gastrointestinal Agents/therapeutic use , Ileitis/drug therapy , Tumor Necrosis Factor-alpha/immunology , Adult , Behcet Syndrome/pathology , Colitis/pathology , Colonoscopy , Female , Humans , Ileitis/pathology , InfliximabSubject(s)
Amyloid/ultrastructure , Colitis/complications , Colitis/pathology , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/pathology , Intestinal Mucosa/ultrastructure , Aged , Colonoscopy , Diarrhea/etiology , Diarrhea/pathology , Female , Humans , Intestinal Mucosa/pathologyABSTRACT
BACKGROUND: Pioglitazone is an oral hypoglycemic agent in the thiazolidinedione class. Only one case of hepatotoxicity related to this agent has previously been reported. OBJECTIVE: To report the clinical course of a patient with hepatitis after therapy with pioglitazone. DESIGN: Case report. SETTING: A community hospital. PATIENT: A 49-year-old diabetic man taking pioglitazone, 30 mg/d. INTERVENTION: Discontinuation of pioglitazone therapy. MEASUREMENTS: Serum aminotransferase and bilirubin levels, standard blood tests for causes of hepatitis and cirrhosis other than drug toxicity, and liver biopsy. RESULTS: After 6 months of pioglitazone therapy, significant hepatic dysfunction developed. Blood tests excluded viral, metabolic, and autoimmune disorders. Liver biopsy showed mixed hepatocellular-cholestatic injury compatible with drug toxicity. After treatment with pioglitazone was discontinued, liver enzyme values returned to normal. CONCLUSION: Patients receiving pioglitazone may develop serious liver injury and should be observed for evidence of hepatitis.
