Yellow fever vaccination during treatment with infliximab in a patient with ulcerative colitis: A case report

Abstract

We report the case of a 59-year-old patient who accidentally underwent live vaccination against yellow fever during continuous treatment with the TNF-α-antibody (AB) infliximab for ulcerative colitis. The clinical course showed fever of short duration and elevation of liver enzymes without further clinical complications. Yellow fever viremia was not detectable and protective antibodies were developed. A primary vaccination against yellow fever under infliximab has not been reported in the literature before, although vaccination is an important topic in IBD. Live vaccinations, like Stamaril^® against yellow fever, are contraindicated during TNF-α-AB treatment. Treatment regimens containing TNF-α-AB are of growing importance, not only in gastroenterology, but also in rheumatology and dermatology. We discuss this topic by presenting our case and reviewing the current literature.

Zusammenfassung

Wir berichten über einen 59-jährigen Patienten mit Colitis ulcerosa, der während einer Therapie mit dem TNF-α-Antikörper (AK) Infliximab gegen Gelbfieber geimpft wurde. Im klinischen Verlauf entwickelte der Patient Fieber und erhöhte Leberwerte ohne weitere Komplikationen. Virämie durch das Gelbfieber-Virus war nicht nachweisbar und der Patient entwickelte schützende Antikörper gegen Gelbfieber.

Eine erstmalige Impfung gegen Gelbfieber unter Infliximab wurde bisher nicht beschrieben, obwohl Impfungen ein wichtiges Thema sind, nicht nur in der Therapie chronisch entzündlicher Darmerkrankungen. Lebendimpfungen, wie Stamaril^® gegen Gelbfieber, sind kontraindiziert während einer TNF-α-AK-Therapie. Therapieregime mit TNF-α-AK sind von großer Bedeutung, nicht nur in der Gastroenterologie, sondern auch in der Rheumatologie und Dermatologie. Wir stellen unseren Fall und die aktuelle Literatur zum Thema vor.

Schlüsselwörter

chronisch entzündliche Darmerkrankung - Gelbfieberimpfung - Infliximab - Colitis ulcerosa

Key words

inflammatory bowel disease - yellow fever vaccine - infliximab - ulcerative colitis

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