症例報告瘻孔を有するCrohn病に対する抗TNF-α製剤(infliximab)の2使用経験

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Case 1. A 25-year-old woman, who had been performed appendectomy as initial diagnosis of acute appendicitis, presented entero-cutaneous fistula at a site of postoperative drainage. She was diagnosed as Crohn disease by re-evaluation of the lower gastrointestinal tract thereafter. The fistula was closed by triple infusion of infliximab at dose of 5mg/kg. Case 2. A 38-year-old man had been performed operation of resection of bowel and stoma because of fistulating Crohn disease in 2000. The abscess developed beside the stoma on Jan 2005 and it was revealed to be originated from the fistula at the sigmoid colon in the stoma. The fistula was successfully treated by triple infusion of infliximab at dose of 5 mg kg after drainage of the abscess. However, the fistula recurred on Jun 2005 and since the infliximab has been given bimonthly as a maintenance therapy. Imfliximab was new treatment for Crohn disease. We should observe the treatment because of the recurrence of fistula.