Tumour necrosis factor inhibitors in critical care: Case report with review of the literature

SummaryThis is a case report of a patient with Crohn's disease admitted to hospital with a typical flare. The main symptoms were abdominal pain and haemorrhagic diarrhoea. During the current admission she was commenced on her first course of Infliximab.The clinical benefits of monoclonal TNF-alpha inhibitors are described. The anxieties relating to infectious complications that may be, in part related to the TNF-alpha inhibition are also discussed. At present the impact of these agents on critical illness is unclear but as the use of these effective drugs increase it is inevitable there will be an increase in patients presenting with critical illness who are concurrently on this treatment. Some of the implications are outlined.