Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 14, 2012; 18(34): 4787-4790
Published online Sep 14, 2012. doi: 10.3748/wjg.v18.i34.4787
Angioedema associated with Crohn's disease: Response to biologics
Flavio Habal, Vivian Huang
Flavio Habal, Vivian Huang, Department of Gastroenterology, University Health Network, University of Toronto, Toronto ON M5G 2C4, Canada
Author contributions: Habal F managed the patients and provided case data and photographs, as well as editing; Huang V completed the literature review and hypothesis generation, and wrote the paper.
Correspondence to: Flavio Habal, MD, Department of Gastroenterology University Health Network, University of Toronto, 200 Elizabeth Street, Toronto ON M5G 2C4, Canada. flavio.habal@uhn.ca
Telephone: +1-416-3405023 Fax: +1-416-5955251
Received: December 15, 2011
Revised: May 31, 2012
Accepted: June 15, 2012
Published online: September 14, 2012
Abstract

A 46-year-old female patient with terminal ileum Crohn’s disease and ankylosing spondylitis presented with recurrent angioedema and urticaria. Investigations ruled out hereditary angioedema, and environmental or food allergen triggers. She was diagnosed with chronic idiopathic urticaria with angioedema, and was treated with a trial of intravenous immunoglobulin immunotherapy, danazol, prednisone and hydroxyzine. Due to ongoing bowel and arthritic complaints, she was started on infliximab infusions and within 2 treatments, she had complete resolution of the angioedema and urticaria, as well as of the bowel and arthritic symptoms. Unfortunately she developed allergic reactions to the infliximab and was switched to another anti-tumor necrosis factor (TNF)-α agent, adalimumab. Since then, she has had no further angioedema or urticaria, and her Crohn’s disease has been quiescent. This is the first known case report of chronic idiopathic urticaria with angioedema coexistent with Crohn’s disease that was successfully treated with anti-TNF-α agents.

Keywords: Angioedema; Anti-tumor necrosis factor-α; Biologics; Crohn’s disease; Cytokines; Inflammatory bowel disease; Infliximab; Urticaria