{"id":6313,"date":"2021-02-03T08:56:52","date_gmt":"2021-02-03T08:56:52","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=6313"},"modified":"2022-06-09T11:54:24","modified_gmt":"2022-06-09T10:54:24","slug":"a-complex-case-of-adalimumab-induced-pleuropericarditis-in-a-patient-with-underlying-ulcerative-colitis-2021","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2021\/02\/03\/a-complex-case-of-adalimumab-induced-pleuropericarditis-in-a-patient-with-underlying-ulcerative-colitis-2021\/","title":{"rendered":"A Complex Case of Adalimumab Induced Pleuropericarditis in a Patient with Underlying Ulcerative Colitis (2021)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nJournal article<\/p>\n<p><strong>Author(s):<\/strong><br \/>\n*Abbasi A, *Day S, Subahani M, *Townson G<\/p>\n<p><strong>Citation:<\/strong><br \/>\n<span class=\"has-inline-color\">Asploro Journal of Biomedical and Clinical Case Reports, <\/span>2021 Jan; 4(1) p.16-21<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nIntroduction: Adalimumab is an anti-tumour necrosis factor (anti-TNF) monoclonal antibody and an important part of the treatment regime for autoimmune conditions including inflammatory bowel disease. We present a case of adalimumab induced pleuropericarditis and discuss the diagnosis challenges we faced.<br \/>\nCase History: A 22-year-old male presented to the emergency department with 3 days history of headache, malaise, fever and right-sided chest pain. He was diagnosed with ulcerative colitis 8 months ago but failed to respond to mesalazine, requiring high dose steroids to induce disease remission. His mesalazine was stopped after 4 months and he was initiated on adalimumab 2 months prior to the current presentation. At presentation, he had a temperature of 38.7 \u00b0C (101.6 \u00b0F) but no other physical signs. His inflammatory markers were raised, and the chest x-ray was clear. He was started on empirical intravenous antibiotics on suspicion of the underlying infective process. On day 4 the patient developed a new pleural rub and crepitations on both lung bases. An urgent echocardiogram and computed tomography scan of the thorax abdomen and pelvis revealed pleural effusion and a 1.8 cm diameter pericardial effusion. Extensive investigation including virology screen, autoimmune screen and pleural fluid analysis were normal.<br \/>\nDiagnosis, Management and Outcome: This case was discussed in a multidisciplinary meeting. A diagnosis of pleuropericarditis secondary to adalimumab was made. Adalimumab and antibiotics were stopped, and he was started on a course of oral steroids. The patient responded well to the treatment and his symptoms resolved.<br \/>\nConclusion: Rare drug toxicity should be part of differential diagnosis, especially in young patients with unusual presentation. An early multidisciplinary approach is crucial for a positive outcome. The patient should be actively involved in decision making to improve long term outcome.<\/p>\n<p><a href=\"https:\/\/asploro.com\/a-complex-case-of-adalimumab-induced-pleuropericarditis-in-a-patient-with-underlying-ulcerative-colitis\/\">Link to full-text<\/a> [no password required]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): *Abbasi A, *Day S, Subahani M, *Townson G Citation: Asploro Journal of Biomedical and Clinical Case Reports, 2021 Jan; 4(1) p.16-21 Abstract: Introduction: Adalimumab is an anti-tumour necrosis factor (anti-TNF) monoclonal antibody and an<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2021\/02\/03\/a-complex-case-of-adalimumab-induced-pleuropericarditis-in-a-patient-with-underlying-ulcerative-colitis-2021\/\">Read more <span class=\"screen-reader-text\">A Complex Case of Adalimumab Induced Pleuropericarditis in a Patient with Underlying Ulcerative Colitis (2021)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[200],"tags":[979,982,221,981,983,876],"class_list":["post-6313","post","type-post","status-publish","format-standard","hentry","category-staff-publication","tag-979","tag-adalimumab","tag-gastroenterology","tag-inflammatory-bowel-disease","tag-pleuropericarditis","tag-ulcerative-colitis"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6313","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=6313"}],"version-history":[{"count":1,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6313\/revisions"}],"predecessor-version":[{"id":6314,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/6313\/revisions\/6314"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=6313"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=6313"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=6313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}