Cough and fever in a female with Crohn's disease receiving infliximab.

She had reported poor health status during the preceeding month. The patient had been diagnosed with Crohn’s disease 9 months earlier. Initially, the patient was treated with 32 mg?d methylprednisolone and 100 mg?d azathioprine, both taken orally. Azathioprine was discontinued 4 weeks later, due to hepatic damage, and was replaced by infliximab injections; the chimeric monoclonal immunoglobulin (Ig)-G1 antibody to tumour necrosis factor (anti-TNF)-a. Treatment was initially 5 mg?kg at 0, 2 and 6 weeks as an induction regimen, followed by a maintenance regimen of 5 mg?kg every 8 weeks, the latter one taken 10 days before admission. In total, the patient received six doses of anti-TNF-a over a period of 8 months. At the same time, she also received 16 mg?d of methylprednisolone orally. The patient also suffers from type II diabetes mellitus for which she was receiving glybenclamide orally, as well as arterial hypertension, which was controlled with an oral acetylcholine esterase inhibitor. The patient’s past medical history records showed acute hepatitis 40 yrs previously, hysterectomy with ovariectomy 25 yrs previously and cholecystectomy 5 yrs previously.