Francesc Vidal, MD, PhD; Ramón Fontova, MD, PhD; Cristóbal Richart, MD, PhD
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Vidal F., Fontova R., Richart C.; Severe Neutropenia and Thrombocytopenia Associated with Infliximab. Ann Intern Med. 2003;139:W-63. doi: 10.7326/0003-4819-139-3-200308050-00021-w4
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Published: Ann Intern Med. 2003;139(3):W-63.
TO THE EDITOR:
Background: Infliximab, a monoclonal anti–tumor necrosis factor (TNF)-α antibody, has recently been approved for treatment of rheumatoid arthritis (1, 2). To date, therapy with this drug has been associated with few adverse events (3-5).
Objective: To describe a patient who developed severe neutropenia and thrombocytopenia after administration of infliximab.
Case Report: A 60-year-old woman had developed rheumatoid arthritis in her forties. She had received many drugs, including nonsteroidal anti-inflammatory drugs, steroids, chloroquine, cyclophosphamide, and methotrexate (up to 15 mg/wk), with good hematologic tolerance but poor clinical results. The disease progressed markedly, and by the beginning of 2001, the patient required assistance with activities of daily living. She was receiving indomethacin, 150 mg/d, and 6-methylprednisolone, 12 mg/d; treatment with immunosuppressive drugs had been discontinued several months before. In June 2001, intravenous infliximab was started (after 1-month pretreatment with methotrexate, 7.5 mg/wk) at doses of 3 mg/kg of body weight at weeks 0, 2, and 6, and every 8 weeks thereafter. Following the second dose of infliximab, the patient improved markedly. Blood cell counts, assessed before each dose of infliximab, remained normal.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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