REVIEWS
IMAJ | volume 25
Journal 12, December 2023
pages: 836-840
New-onset Blepharitis and Anti-TNF-Alpha Therapy in Patients with Crohn’s Disease: A Case Series and Literature Review
1 Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Petah Tikva, Israel
2 Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, affiliated with the Hebrew University of Jerusalem, Israel
3 Department of Gastroenterology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
4 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
5 Pediatric Gastroenterology Institute, Dana–Dwek Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
6 Pediatric Gastroenterology and Nutrition Institute, Rambam Health Care Campus, Haifa, Israel
7 School of Medicine, Tel Aviv University, Tel Aviv, Israel
Summary
Anti-tumor necrosis factor-alpha (anti-TNFα) medications are the most frequently used biologicals to treat inflammatory bowel disease (IBD). Little is known about the ocular side effects of this drug category. We present a case series of six young patients with Crohn disease (CD) and no previous ophthalmologic manifestations who developed blepharitis after commencing treatment with anti-TNFα therapy. Six otherwise healthy patients with CD, with no history of allergies or prior ocular complaints, developed blepharitis at a median of 7.5 months after the initiation of anti-TNFα therapy. All ophthalmic findings were treated topically. The ocular symptoms of two of the patients resolved shortly after discontinuation of the anti-TNFα treatment. The other four presented with relapsing-remitting symptoms. Blepharitis is a common ocular disease in the general population and an extra-intestinal manifestation in patients with IBD. It may be an adverse effect of anti-TNFα therapy in this patient population.