Infliximab-Induced Lupus Causing Pericarditis: a Case Report and Review of the Literature

Excerpt

A 49-year-old woman presented with a 1-day history of sharp left-sided pleuritic chest pain radiating to the back and associated with shortness of breath. Her past medical history was significant for fistulizing Crohn’s disease (CD) diagnosed in 2011, status post hemicolectomy. She was on prednisone intermittently over the first few years after diagnosis and reportedly had never been on aminosalicylates (mesalamine or sulfasalazine), thiopurines such as azathioprine or 6-mercaptopurine, or methotrexate. At the time of presentation, she was not taking prednisone or any other corticosteroids. She was started on infliximab therapy a year prior to admission and had initially received infusions every 8 weeks prior to switching to every 6 weeks. Additionally, she had missed her most recent dose that was due 3 weeks prior due to insurance issues, so it had been 9 weeks since her last dose. She denied any preceding viral prodromal symptoms including fever, chills, myalgia, headache, cough, rhinitis, nausea, or vomiting and also denied any previous sick contacts or recent travel. …