November 12, 2014
Notes: Chou, Ting-Ywan
Reiter, Russel J
Yeh, Diana Y
J Pineal Res. 2013 Dec 12. doi: 10.1111/jpi.12112.
Author Address: Medical Imaging Department, Cardinal Tien Hospital, New Taipei City, Taiwan; School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
Reference Type: Journal Article
Record Number: 4635Author: Clayton, H., Flatz, L., Vollenweider-Roten, S., Schoepfer, A., Gilliet, M. and Conrad, C.
Title: Anti-TNF therapy in the treatment of psoriasis in a patient with acute-on-chronic pancreatitis
Short Title: Anti-TNF therapy in the treatment of psoriasis in a patient with acute-on-chronic pancreatitis
Alternate Journal: Dermatology
ISSN: 1421-9832 (Electronic)
Accession Number: 24192530
Keywords: Acute Disease
Immunoglobulin G/*therapeutic use
Immunosuppressive Agents/*therapeutic use
Receptors, Tumor Necrosis Factor/*therapeutic use
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
Abstract: BACKGROUND: Psoriasis is accepted as a multisystemic disease with several important systemic manifestations. Thus, underlying comorbidities have to be taken into account in the choice of treatment. OBJECTIVE: To explore the role of anti-TNF therapy in the treatment of psoriasis in a patient with acute-on-chronic pancreatitis. METHODS: Here, we present the case of a 75-year-old patient with severe psoriasis also suffering from chronic alcohol-induced pancreatitis with recurrent acute flares. A recent life-threatening episode of acute pancreatitis and ischemic liver precluded the reintroduction of methotrexate. Cyclosporine was also excluded as it has been reported to induce acute pancreatitis. Thus, an anti-TNF treatment was initiated in close collaboration with a gastroenterologist. RESULTS: A year after starting anti-TNF therapy the patient continues to show complete clinical remission of his psoriasis. No side effects, particularly no bacterial infections, were reported. No relapses of the patient’s underlying chronic pancreatitis were observed throughout the entire treatment with regular clinical and laboratory monitoring, suggesting that chronic pancreatitis is not per se a contraindication for anti-TNF therapy. CONCLUSION: This case study opens the way for further questioning on the role of TNF in the pathogenesis of chronic and acute pancreatitis and the use of anti-TNF therapy in its treatment.