Transient menorrhagia without adalimumab discontinuation in a patient with Crohn's disease

摘要

Menstrual disorders are listed as possible rare side effects during infliximab or adalimumab administration but very few case reports regarding the management of such menstrual side effects exist.1A 32-year-old woman with ileal Crohn's disease was switched to adalimumab because of an allergic reaction during infliximab maintenance therapy. The patient was started on adalimumab but during the third dose of adalimumab induction scheme the patient developed severe menorrhagia lasting four days. In detail, the patient had to use approximately three times more pads daily as opposed to her previous 'normal' menstruation days. Menorrhagia resolved spontaneously in the fourth day and the patient was advised to continue adalimumab use and to use oral contraceptives in case of menorrhagia relapse. In next menstruations the patient had no recurrence of menorrhagia.Inflammatory bowel disease, and more specially Crohn's disease have been related to menstrual abnormalities. These abnormalities are encountered either in the panel of disease extraintestinal manifestations or as the presenting or triggering factor of relapsing Crohn's disease.2