Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis

Infliximab, a monoclonal antibody targeting tumor necrosis factor-alpha (TNF-α), is widely used in treating inflammatory bowel diseases (IBD), including ulcerative colitis (UC). While generally well-tolerated, infliximab is associated with rare but significant adverse effects, including autoimmune h...

Full description

Saved in:
Bibliographic Details
Main Authors: Gerolamo Bevivino, Patrizio Scarozza, Michela Di Fonzo, Giulia Zerboni, Federico Iacopini
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1548321/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850228586108157952
author Gerolamo Bevivino
Patrizio Scarozza
Michela Di Fonzo
Giulia Zerboni
Federico Iacopini
author_facet Gerolamo Bevivino
Patrizio Scarozza
Michela Di Fonzo
Giulia Zerboni
Federico Iacopini
author_sort Gerolamo Bevivino
collection DOAJ
description Infliximab, a monoclonal antibody targeting tumor necrosis factor-alpha (TNF-α), is widely used in treating inflammatory bowel diseases (IBD), including ulcerative colitis (UC). While generally well-tolerated, infliximab is associated with rare but significant adverse effects, including autoimmune hemolytic anemia (AIHA). This report describes the case of a 54-year-old male diagnosed with UC, who developed hemolytic anemia secondary to infliximab therapy after 1 year of treatment. During the infusion preceding the onset of anemia, the patient experienced a severe infusion reaction characterized by urticaria, bronchospasm, chills, fever, and pulsating headache. Laboratory findings confirmed hemolytic anemia with a positive direct and negative indirect Coombs tests. The patient responded well to corticosteroid therapy (prednisone at 1 mg/kg/day for 30 days) and stopping anti-TNF-α, with hemoglobin levels improving from 7.2 g/dL at presentation to 14.6 g/dL after 1 month. AIHA should be considered an uncommon but serious complication of infliximab therapy, necessitating careful monitoring, especially in patients treated for gastrointestinal indications. This case underscores the importance of recognizing and managing infusion-related complications of biologic therapies.
format Article
id doaj-art-cf02d96db35e47b28068891a6ff592c4
institution OA Journals
issn 2296-858X
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-cf02d96db35e47b28068891a6ff592c42025-08-20T02:04:29ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15483211548321Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitisGerolamo BevivinoPatrizio ScarozzaMichela Di FonzoGiulia ZerboniFederico IacopiniInfliximab, a monoclonal antibody targeting tumor necrosis factor-alpha (TNF-α), is widely used in treating inflammatory bowel diseases (IBD), including ulcerative colitis (UC). While generally well-tolerated, infliximab is associated with rare but significant adverse effects, including autoimmune hemolytic anemia (AIHA). This report describes the case of a 54-year-old male diagnosed with UC, who developed hemolytic anemia secondary to infliximab therapy after 1 year of treatment. During the infusion preceding the onset of anemia, the patient experienced a severe infusion reaction characterized by urticaria, bronchospasm, chills, fever, and pulsating headache. Laboratory findings confirmed hemolytic anemia with a positive direct and negative indirect Coombs tests. The patient responded well to corticosteroid therapy (prednisone at 1 mg/kg/day for 30 days) and stopping anti-TNF-α, with hemoglobin levels improving from 7.2 g/dL at presentation to 14.6 g/dL after 1 month. AIHA should be considered an uncommon but serious complication of infliximab therapy, necessitating careful monitoring, especially in patients treated for gastrointestinal indications. This case underscores the importance of recognizing and managing infusion-related complications of biologic therapies.https://www.frontiersin.org/articles/10.3389/fmed.2025.1548321/fullinfliximabhemolytic anemiaulcerative colitisautoimmune disorderscase report
spellingShingle Gerolamo Bevivino
Patrizio Scarozza
Michela Di Fonzo
Giulia Zerboni
Federico Iacopini
Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
Frontiers in Medicine
infliximab
hemolytic anemia
ulcerative colitis
autoimmune disorders
case report
title Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
title_full Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
title_fullStr Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
title_full_unstemmed Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
title_short Case Report: Hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
title_sort case report hemolytic anemia secondary to infliximab treatment in a patient with ulcerative colitis
topic infliximab
hemolytic anemia
ulcerative colitis
autoimmune disorders
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1548321/full
work_keys_str_mv AT gerolamobevivino casereporthemolyticanemiasecondarytoinfliximabtreatmentinapatientwithulcerativecolitis
AT patrizioscarozza casereporthemolyticanemiasecondarytoinfliximabtreatmentinapatientwithulcerativecolitis
AT micheladifonzo casereporthemolyticanemiasecondarytoinfliximabtreatmentinapatientwithulcerativecolitis
AT giuliazerboni casereporthemolyticanemiasecondarytoinfliximabtreatmentinapatientwithulcerativecolitis
AT federicoiacopini casereporthemolyticanemiasecondarytoinfliximabtreatmentinapatientwithulcerativecolitis