Journal List > Korean J Gastroenterol > v.61(1) > 1007107

Jang, Park, Kim, Jo, Jo, Ahn, Seo, and Hong: A Case of Crohn's Disease Having Normal Delivery after Infliximab Treatment during Early Pregnancy

Abstract

Infliximab is a chimeric IgG1 monoclonal antibody to tumor necrosis factor (TNF)-α used in the treatment of steroid refractory or dependent Crohn's disease (CD). Patients with active CD are more likely to experience stillbirth, preterm labor, or small for gestational aged babies. The safety of administering infliximab in pregnant patients is not well documented. A 25-year-old woman, who was diagnosed with small bowel CD three years ago, was admitted to our hospital due to the aggravation of abdominal pain. She had been treated with mesalazine, azathioprine and intermittent steroid for three years. After admission, she did not respond to steroid therapy, we decided to try infliximab. After the administration of infliximab, epigastric pain was relived and Crohn's disease activity index score decreased significantly. However after the fourth infusion of infliximab, the patient became aware that she was ten gestational weeks old pregnancy state After then, infliximab was stopped and maintained by mesalazine. The patient gave birth to a healthy baby via normal vaginal delivery without the recurrence of CD. This case suggests that infliximab administration is safe during the early period of pregnancy. Thus, we report this case with a review of literature.

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Fig. 1.
Colonoscopic and microscopic findings of sigmoid colon. (A) It showed aphthous ulceration 35 cm from anal verge. (B) Microscopically it showed chronic inflammation and granuloma (H&E, ×400).
kjg-61-37f1.tif
Fig. 2.
Capsule endoscopy. It showed segmental longitudinal ulcerations on the jejunum (A) and ileum (B).
kjg-61-37f2.tif
Fig. 3.
Crohn's disease activity index (CDAI) score and infliximab treatment. LNMP, last normal menstrual period; NSVD, normal spontaneous vaginal delivery.
kjg-61-37f3.tif
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