al 1 recently published their experience with infliximab for induction and maintenance of remission in 6 patients with intestinal Behc ¸et's disease (BD). Other reports have also shown the efficacy of infliximab in inducing remission in intestinal BD. [2][3][4][5][6][7] However, many of these patients were receiving co-therapies. It is possible that alternate antitumor necrosis factor (anti-TNF) agents may have different efficacy, just as etanercept has not been shown to be efficacious in Crohn's disease. Therefore, the response of BD to other anti-TNF agents given as monotherapy would be of interest. We describe a patient with steroid-dependent immunosuppressive-refractory intestinal BD who has maintained complete remission on adalimumab monotherapy.
A 30-year-old Caucasian female was diagnosed with BD according to the International Study Group criteria based on her long history of recurrent painful oral and genital ulcers, arthralgias, and papulopustular skin lesions. She had required intermittent courses of corticosteroids in the past. She presented with severe abdominal pain, diarrhea, and passage of blood per rectum. Sedimentation rate and C-reactive protein were significantly elevated. Colonoscopy revealed 6 deep punched-out ulcers in the cecum and ascending colon (Fig. 1a,b). The terminal ileum was normal. Biopsies revealed nonspecific chronic in-