Acute Psychosis in an Adolescent Treated With Infliximab for Crohn's Disease

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To the Editor: Infliximab is a monoclonal antibody against tumor necrosis factor-α (TNF-α) and has been shown to be 81% more efficacious than placebo in Crohn’s disease patients who have had an inadequate response to conventional therapy. While there are case reports of suicide attempts after treatment with infliximab for inflammatory bowel diseases, and reports of anti-TNF-α treatment leading to psychosis in elderly patients with rheumatologic disorders, to our knowledge, this is the first case of a pediatric patient with Crohn’s disease who developed acute psychosis after treatment with infliximab.

Case report. A 15-year-old white male high school honors student, with a history of Crohn’s disease since age 12 years and a history of obsessive-compulsive disorder and attention-deficit disorder, received his first 3 infliximab infusions over a 2-month period for treatment of poorly controlled Crohn’s disease.