• ADVERSE DRUG REACTIONS
• CARDIOVASCULAR COMPLICATIONS
• ULCERATIVE COLITIS

• Adult
• Female
• Humans
• Male
• Middle Aged
• Atrioventricular Block/chemically induced
• Atrioventricular Block/epidemiology
• Bradycardia/chemically induced
• Bradycardia/epidemiology
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/chemically induced
• Colitis, Ulcerative/drug therapy
• Colitis, Ulcerative/epidemiology
• Coronary Artery Disease/epidemiology
• Coronary Artery Disease/drug therapy
• Double-Blind Method
• Hypertension/epidemiology
• Hypertension/drug therapy
• Incidence
• Severity of Illness Index
• Sphingosine 1 Phosphate Receptor Modulators/adverse effects
• Sphingosine 1 Phosphate Receptor Modulators/therapeutic use
• Sphingosine 1 Phosphate Receptor Modulators/administration & dosage
• Sphingosine-1-Phosphate Receptors
• Randomized Controlled Trials as Topic
• Multicenter Studies as Topic
• Clinical Trials, Phase II as Topic
• Clinical Trials, Phase III as Topic

• Pfizer Inc.

• DADA2
• adenosine deaminase 2 (ADA2)
• anti-TNF-α
• infliximab
• leukocytoclastic vasculitis
• pericarditis

Infliximab (IFX) is an anti-tumor necrosis factor alpha (TNF-α) agent that is widely used for the management of a variety of autoimmune and inflammatory diseases, including Crohn's disease (CD). As a result of its increasing administration, new complications have emerged. Hemorrhagic pericardial effusion, secondary to IFX therapy, is a rare but life-threatening complication.

A 27-year-old man was diagnosed with CD (Montreal A2L3B1) 6 years prior. After failing to respond to mesalazine and methylprednisolone, he took the first dose of IFX 300 mg based on his weight (60 kg, dose 5 mg/kg) on December 3, 2018. He responded well to this therapy. However, on January 21, 2019, 1 wk after the third injection, he suddenly developed dyspnea, fever, and worsening weakness and was admitted to our hospital. On admission, computed tomography scan of the chest revealed a large pericardial effusion and a small right-side pleural effusion. An echocardiogram showed a large pericardial effusion and normal left ventricular function. Then successful ultrasound-guided pericardiocentesis was performed and 600 mL hemorrhagic fluid was drained. There was no evidence of infection and the concentrations of TNF-α, IFX, and anti-IFX antibody were 7.09 pg/mL (reference range < 8.1 pg/mL), < 0.4 μg/mL (> 1.0 μg/mL), and 373 ng/mL (< 30 ng/mL), respectively. As the IFX instruction manual for injection does mention pericardial effusion as a rare adverse reaction (≥ 1/10000, < 1/1000), so we discontinued the IFX. Monitoring of the patient’s echocardiogram for 2 mo without IFX therapy showed no recurrence of hemorrhagic pericardial effusion. Follow-up visits and examinations every 3 to 6 mo until April 2021 showed no recurrence of CD or pericardial effusion.

This is a case of hemorrhagic pericardial effusion following treatment with IFX. It is a rare but life-threatening complication of IFX. Early recognition helps prevent the occurrence of hemorrhagic pericardial effusion and minimize the impact on the natural evolution of the disease.

• Hemorrhagic pericardial effusion
• Pericardial complication
• Infliximab
• Crohn's disease
• Anti-tumor necrosis factor alpha
• Case report

Inflammatory bowel disease (IBD) is a chronic condition of the bowel that can be further categorized into ulcerative colitis and Crohn’s disease. Rarely, this condition can be associated with pericarditis, which can be an extraintestinal manifestation of the disease or drug-induced. This review aims to determine the pathogenesis and management of pericarditis in IBD. In this review, the goal is to elucidate the pathogenesis of pericarditis in IBD and determine if pericarditis is an extraintestinal manifestation of IBD or a complication of current drug therapy used to manage IBD. Additionally, this review intends to explain the first-line management of pericarditis in IBD and explore the role of biologicals in attenuating pericarditis. An electronic search was conducted to identify relevant reports of pericarditis in IBD, and a quality assessment was conducted to identify high-quality articles according to the inclusion criteria. Full-text articles from inception to November 2020 were included, while non-English articles, gray literature, and animal studies were excluded. The majority of studies suggest that pericarditis arises as a complication of drug therapy by 5-aminosalicylic acid derivatives such as sulfasalazine, mesalamine, and balsalazide, and it occurs due to IgE-mediated allergic reactions, direct cardiac toxicity, cell-mediated hypersensitivity reactions, and humoral antibody response to therapy. Drug cessation or the initiation of a corticosteroid regimen seems to be the most effective means of managing pericarditis in IBD due to drug therapy or an extraintestinal manifestation.

• crohn’s disease
• extraintestinal manifestations
• inflammatory bowel disease
• pericarditis
• ulcerative colitis

• Adverse drug reaction
• Class effect
• Pleuropericarditis
• Tumor necrosis factor inhibitors
• VigiBase

• Crohn's disease
• inflammatory bowel disease
• pericardial effusion
• pericarditis

• adverse event
• drug-related
• inflammatory bowel disease
• infliximab
• paediatric
• pericarditis

Introduction. Antitumor necrosis factor (TNF) alpha agents are commonly used biologic therapies for a wide variety of rheumatic and inflammatory diseases. Here, we present a case of hemorrhagic pericarditis as a consequence of infliximab and review the literature on pericardial complications stemming from this drug class. Methods. For the literature review, search terms using versions of antitumor necrosis factor alpha AND pericardial effusion OR pericarditis OR pleuropericarditis OR cardiac tamponade were used. Results. Pericarditis is a rare but serious complication of anti-TNF based therapy, and hemorrhagic fluid is even more rare, with only one additional case reported. It is likely that this complication was secondary to a robust immune response to very high titer anti-infliximab antibodies. Providers should be aware that this complication can occur and that abnormal elevations in procalcitonin may accompany this unusual finding.

• Adalimumab
• Anti-tumor necrosis factor
• Autoimmune disease
• Certolizumab pegol
• Complications
• Golimumab
• Infliximab
• Infusion reactions

Thirty-eight cases of listeriosis over a 12-year period from inpatients at a tertiary care hospital in China were reviewed. We found a high prevalence of healthcare-associated cases that did not cluster in time and space.

Background. Listeriosis is an emerging infectious disease associated with high mortality. There are few published reports from East Asia and developing countries. Our goal was to describe the clinical characteristics and outcomes of patients diagnosed with Listeria monocytogenes at a tertiary care hospital in Beijing, China.

Methods. Peking Union Medical College Hospital (PUMCH), an 1800-bed hospital, consists of 2 campuses that house different medical departments. We retrospectively reviewed all culture-proven cases of listeriosis occurring at PUMCH between 1999 and 2011. Point estimates and 95% confidence intervals are presented.

Results. There were 38 patients with listeriosis: 5 neonatal, 8 maternal, and 25 nonmaternal. The median age of the adult nonmaternal patients was 47 (range, 18–79) years with a female predominance (72%). Forty percent (n = 10) had an underlying rheumatic disease. Forty-four percent of cases (n = 11) were healthcare-associated infections occurring a median of 20 (range, 3–44) days after hospital admission. Only 2 of the 11 healthcare-associated cases clustered in space and time. One healthcare-associated case occurred in a patient receiving KHI-272 therapy, an oral, irreversible dual EGFR/HER2 inhibitor. The neonatal and maternal listeriosis cases were similar to those reported in the literature.

Conclusions. Nonclustered healthcare-associated cases of L. monocytogenes occurred at a large tertiary care hospital in Beijing, China. The source of these infections is unclear. Although rare, in the setting of immunosuppression, Listeria should be considered in the differential diagnosis of healthcare-associated infections, even in the absence of a point-source outbreak.

• Effusive–constrictive pericarditis
• Infliximab
• Pericardial effusion
• Rheumatoid arthritis
• TNF-inhibitor therapy

• Anti-Inflammatory Agents/adverse effects
• Anti-Inflammatory Agents/therapeutic use
• Antibodies, Monoclonal/adverse effects
• Antibodies, Monoclonal/therapeutic use
• Crohn Disease/complications
• Crohn Disease/drug therapy
• Humans
• Infliximab
• Male
• Middle Aged
• Pericarditis/chemically induced
• Pericarditis/diagnosis

• Aged
• Anti-Bacterial Agents/therapeutic use
• Antirheumatic Agents/adverse effects
• Antirheumatic Agents/therapeutic use
• Arthritis, Rheumatoid/complications
• Arthritis, Rheumatoid/drug therapy
• Drug Therapy, Combination
• Etanercept
• Female
• Gram-Positive Bacteria/isolation & purification
• Humans
• Immunoglobulin G/adverse effects
• Immunoglobulin G/therapeutic use
• Meropenem
• Metronidazole/therapeutic use
• Opportunistic Infections/diagnosis
• Opportunistic Infections/drug therapy
• Opportunistic Infections/microbiology
• Penicillin G/therapeutic use
• Pericarditis/diagnosis
• Pericarditis/drug therapy
• Pericarditis/microbiology
• Receptors, Tumor Necrosis Factor/therapeutic use
• Risk Factors
• Thienamycins/therapeutic use

• Crohn Disease/complications
• Crohn Disease/therapy
• Endocarditis, Bacterial/etiology
• Endocarditis, Bacterial/therapy
• Enterococcus faecalis/isolation & purification
• Female
• Humans
• Middle Aged