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CASE REPORT
A 53-year-old man with dyspnoea, respiratory failure, consistent with infliximab-induced acute interstitial pneumonitis after an accelerated induction dosing schedule
  1. Rymon Rofaiel1,
  2. Sonny Kohli2,
  3. Marco Mura3,
  4. Seyed M Hosseini-Moghaddam1
  1. 1Medicine, Western University, London, Canada
  2. 2Critical care, Oakville-Trafalgar Memorial Hospital, Oakville, Ontario, Canada
  3. 3Internal Medicine, London Health Sciences Centre Victoria Hospital, London, Ontario, Canada
  1. Correspondence to Dr Seyed M Hosseini-Moghaddam, seyed.hosseini{at}lhsc.on.ca

Summary

A 53-year-old man with ulcerative colitis (UC) suffered fatal acute interstitial pneumonitis (AIP) post completing an accelerated infliximab induction course. This is the first case reported in this setting. A literature review found four similar cases of infliximab-induced interstitial lung disease in the setting of treating patients with UC using standard infliximab regimens had successful treatment of the subjects post infliximab discontinuation. Unfortunately, the patient we are presenting, who had an accelerated infliximab induction course, did not survive. Although a prior small trial along more recent new small studies continue to show a benefit in reducing the need for early colectomy with the accelerated infliximab induction regimen as salvage therapy, it should be used cautiously until more safety data are available. Further larger trials are required to investigate rare side effects that may be associated with this regimen such as rapidly progressive lung toxicity as seen in this patient.

  • Mechanical ventilation
  • Respiratory system
  • Ulcerative colitis
  • Interstitial lung disease
  • Mechanical ventilation
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Footnotes

  • Contributors RR obtained patient’s next of kin consent, collected data and completed initial and final draft of manuscript including references and literature review.

    SK assisted in collecting data and images as well as peer-reviewed initial and final draft prior to submission.

    MM peer-reviewed initial and final draft of manuscript prior to submission.

    SMH-M peer-reviewed final draft of manuscript prior to submission.

  • Competing interests None declared.

  • Patient consent Consent obtained from next of kin.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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