Journal article
A Case Report of Takayasu’s Arteritis and Ulcerative Colitis in a Pediatric Patient with Chronic Recurrent Multifocal Osteomyelitis Successfully Treated with Infliximab: Diagnostic Clues in Disease Associations and Immune Dysregulation
Case reports in rheumatology, v 2019(2019), pp 1-11
2019
PMID: 31285932
Abstract
Background
. Takayasu’s arteritis with comorbid chronic recurrent multifocal osteomyelitis and ulcerative colitis is rare in the pediatric population. Treatment with anti-TNF alpha agents such as infliximab has been a successful treatment strategy in adults and can be used effectively in the pediatric population.
Case Presentation.
We present the case of a 15-year-old Caucasian girl with a history of chronic recurrent multifocal osteomyelitis and ulcerative colitis presenting with hypertensive emergency secondary to Takayasu’s arteritis with middle aortic syndrome. She was treated with corticosteroids and methotrexate and ultimately required infliximab infusions of 15 mg/kg every 4 weeks to successfully control her symptoms and normalize her inflammatory markers.
Conclusions
. In this case, we discuss the use of infliximab in an adolescent patient with chronic recurrent multifocal osteomyelitis, ulcerative colitis, and Takayasu’s arteritis. The significance of this case is determined by the unique occurrence of all three conditions in a pediatric patient, the important consideration of vasculitis in the differential of a pediatric patient presenting with hypertensive emergency, the need for vigilance for detecting diagnostic clues, signs, and symptoms, knowledge of disease associations when evaluating a patient with a predisposition for autoinflammatory conditions, and the use of increasing doses of infliximab to control symptoms.
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Details
- Title
- A Case Report of Takayasu’s Arteritis and Ulcerative Colitis in a Pediatric Patient with Chronic Recurrent Multifocal Osteomyelitis Successfully Treated with Infliximab: Diagnostic Clues in Disease Associations and Immune Dysregulation
- Creators
- Viveka Clare De Guerra - Women & Children's Hospital of BuffaloHumaira Hashmi - Western New York Pediatric Gastroenterology, 166 Washington Avenue, Batavia, NY 14020, USABree Kramer - Women & Children's Hospital of BuffaloRula Balluz - Women & Children's Hospital of BuffaloMary Beth Son - Boston Children's HospitalDeborah Stein - Boston Children's HospitalAlicia Lieberman - Strong Memorial HospitalMahmoud Zahra - Women & Children's Hospital of BuffaloRabheh Abdul-Aziz - Women & Children's Hospital of Buffalo
- Publication Details
- Case reports in rheumatology, v 2019(2019), pp 1-11
- Number of pages
- 11
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Other Identifier
- 991022051416404721