Efficacy of thalidomide therapy in pediatric Crohn's disease with evidence of tuberculosis

World J Gastroenterol. 2017 Nov 21;23(43):7727-7734. doi: 10.3748/wjg.v23.i43.7727.


Aim: To evaluate the efficacy of thalidomide for treating troublesome cases of pediatric Crohn's disease (CD) with tuberculosis infection.

Methods: A retrospective study of clinical outcome among children treated with thalidomide was conducted. All patients had evidence of tuberculosis infection with a failure of anti-tuberculosis treatment for more than one year, and were subsequently diagnosed with CD. All the patients received thalidomide treatment with a starting dose of 1.2-2.5 mg/kg per day. Remission was defined as pediatric CD activity index less than or equal to 10.

Results: Ten patients with CD were treated with thalidomide at an average age of 7.2 years and followed up for a median of 22.2 mo. Clinical remission rate was 60% after 9-12 mo of thalidomide treatment. One patient with no response had an interleukin-10 receptor alpha gene mutation. Erythrocyte sedimentation rate, C-reactive protein and platelet count showed a dramatic decrease; hemoglobin level and weight improved significantly after thalidomide treatment when compared with the baseline values.

Conclusion: Thalidomide is an effective and safe drug for remission of CD in pediatric patients who have been treated for tuberculosis.

Keywords: Anti- tubercular treatment; Children; Inflammatory bowel disease; Intestinal tuberculosis; Thalidomide.

MeSH terms

  • Adolescent
  • Antitubercular Agents / therapeutic use
  • Blood Sedimentation / drug effects
  • Body Weight / drug effects
  • C-Reactive Protein / analysis
  • Child
  • Child, Preschool
  • Crohn Disease / blood
  • Crohn Disease / complications
  • Crohn Disease / drug therapy*
  • Female
  • Follow-Up Studies
  • Hemoglobins / analysis
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Platelet Count
  • Remission Induction / methods
  • Retrospective Studies
  • Severity of Illness Index
  • Tertiary Care Centers / statistics & numerical data
  • Thalidomide / therapeutic use*
  • Treatment Outcome
  • Tuberculosis / blood
  • Tuberculosis / complications*
  • Tuberculosis / drug therapy


  • Antitubercular Agents
  • Hemoglobins
  • Immunosuppressive Agents
  • Thalidomide
  • C-Reactive Protein

Supplementary concepts

  • Pediatric Crohn's disease