The efficacy and safety profile of anti-tumour necrosis factor (TNF) α agents has led to their increasing use in inflammatory bowel diseases (IBD). Infectious complications and immunogenicity are the main drawbacks of these drugs. Among the latter, drug-induced lupus erythematosus (DILE) has been reported among infliximab but not adalimumab-treated IBD patients. We read with interest the article by Sandborn and coworkers (Gut 2007;56:1232–9), in which no cases of DILE among patients in the CLASSIC-I trial were reported, suggesting that this was less likely with adalimumab than infliximab. We would, however, like to report two cases that suggest that this optimistic viewpoint may not be justified.

Case 1

A 29-year-old woman, with a history of autoimmune aortitis and steroid-dependent ileocolonic Crohn’s disease, started adalimumab because of persistent disease activity despite subcutaneous methotrexate, which was also maintained. …