In their excellent overview of currently available biologic compounds that are in use or under investigation for Crohn’s disease (CD), Sandborn and Faubion (Gut 2004;53:1366–73) reconfirm the unique standing of infliximab. They also note the ongoing discussion concerning the increased occurrence of lymphoproliferative disorders in patients who received infliximab.

Recently, we followed a 61 year old patient with a 31 year history of relapsing CD. Initial treatment was with steroids but after 10 years a right sided hemicolectomy necessitated discontinuation of steroids. Five years before the present admission, the patient relapsed with multiple rectovesicular fistulas. Non-Hodgkin lymphoma was absent in the histologic material. Because of a poor response to conventional treatment, including azathioprine (100–200 mg/day), infliximab was added 22 months before the current admission. Total infliximab …