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Infliximab and adalimumab-induced thrombocytopenia in a woman with colonic Crohn’s disease
  1. Antonio Salar1,
  2. Xavier Bessa2,
  3. Eduard Muñiz3,
  4. David Monfort4,
  5. Carlos Besses5,
  6. Montserrat Andreu6
  1. 1Department of Clinical Haematology, Hospital del Mar, Universitat Autonoma de Barcelona, Spain
  2. 2Department of Gastroenterology, Hospital del Mar, Universitat Autonoma de Barcelona, Spain
  3. 3Servei de Immunologia del Banc de Sang i Teixits, Barcelona, Spain
  4. 4Department of Gastroenterology, Hospital del Mar, Universitat Autonoma de Barcelona, Spain
  5. 5Department of Clinical Haematology, Hospital del Mar, Universitat Autonoma de Barcelona, Spain
  6. 6Department of Gastroenterology, Hospital del Mar, Universitat Autonoma de Barcelona, Spain
  1. Correspondence to:
    Dr Antonio Salar
    Department of Clinical Hematology, Hospital del Mar, Passeig Maritim 25–29, 08003 Barcelona, Spain; asalar{at}imas.imim.es

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We report here a case of drug-related thrombo-cytopenia associated with infliximab and later with adalimumab in a patient with Crohn’s disease. A 42-year-old woman was diagnosed with colonic Crohn’s disease with perianal fistula lesions (Perianal Disease Activity Index (PDAI)  = 11). She was treated with metronidazole and azathioprine. After 2 months the patient remained symptomatic and three infusions with infliximab (monoclonal antibody against tumour necrosis factor α (TNFα)) at a dose of 5 mg/kg were administered at 0, 2 and 6 weeks. The symptoms decreased and improvement was noted (PDAI = 2). Maintenance therapy with infliximab every 8 weeks was started. After three additional infusions, a routine blood count showed thrombocytopenia of 44×109/l (fig 1) with normal haemoglobin, white blood cell count and coagulation tests. Pseudo-thrombocytopenia …

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