Serial cardiac magnetic resonance imaging confirmed the progressive resolution of pericardial inflammation over five years following infliximab discontinuation and initiation of anakinra.
Case Report
No
41-year-old woman with Crohn's disease who developed infliximab-induced systemic lupus erythematosus manifesting as acute recurrent pericarditis
Discontinuation of infliximab, initiation of colchicine, and subsequent addition of anakinra (interleukin-1 blockade)
Resolution of pericardial inflammation assessed by longitudinal cardiac magnetic resonance (CMR)surrogate
Longitudinal CMR is a valuable tool for tracking pericardial inflammatory activity and guiding the safe de-escalation of immunomodulatory therapy in biologic-induced autoimmune pericarditis.
Recurrent pericarditis is an uncommon extraintestinal manifestation of inflammatory bowel disease and may arise from biologic-induced autoimmunity. Anti–tumor necrosis factor (TNF) agents such as infliximab can trigger drug-induced lupus, with pericardial involvement representing a rare presentation. Cardiac magnetic resonance (CMR) enables precise evaluation of pericardial inflammation, guiding treatment strategies and supporting safe immunomodulatory tapering.
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Vaidehi Mendpara
Joseph El Roumi
Allan Klein
The International Journal of Cardiovascular Imaging
Cleveland Clinic
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Mendpara et al. (Mon,) conducted a case report in Infliximab-induced systemic lupus erythematosus with recurrent pericarditis (n=1). Anakinra and colchicine (following infliximab discontinuation) was evaluated on Pericardial inflammatory activity assessed by serial cardiac magnetic resonance. Serial cardiac magnetic resonance imaging confirmed the progressive resolution of pericardial inflammation over five years following infliximab discontinuation and initiation of anakinra.
www.synapsesocial.com/papers/69ba43584e9516ffd37a48ea — DOI: https://doi.org/10.1007/s10554-026-03639-3