Effective use of switching biologics for ulcerative colitis complicated with pyoderma gangrenosum and primary sclerosing cholangitis.

Although prednisolone, granulocyte/monocyte apheresis, calcineurin inhibitor and anti-tumour necrosis factor (TNF) therapy are generally used, no treatment strategy for inflammatory bowel disease complicated with pyoderma gangrenosum (PG) has been established yet. Herein, we present the case of a 29...

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Publicado en:BMJ Case Reports Vol. 14; no. 5; pp. 1 - 5
Autores principales: Iwahashi, Kenta, Kuroki, Yuichiro, Takano, Yuichi, Nagahama, Masatsugu
Formato: Journal Article
Publicado: BMJ Publishing Group May2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2021
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      pub: BMJ Publishing Group
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        10.1136/bcr-2021-241744
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        atl: Effective use of switching biologics for ulcerative colitis complicated with pyoderma gangrenosum and primary sclerosing cholangitis.
      aug:
        au:
          Iwahashi, Kenta
          Kuroki, Yuichiro
          Takano, Yuichi
          Nagahama, Masatsugu
        affil: Gastroenterology, Showa University Fujigaoka Hospital, Yokohama, Japan.
      sug:
      ab: Although prednisolone, granulocyte/monocyte apheresis, calcineurin inhibitor and anti-tumour necrosis factor (TNF) therapy are generally used, no treatment strategy for inflammatory bowel disease complicated with pyoderma gangrenosum (PG) has been established yet. Herein, we present the case of a 29-year-old man with ulcerative colitis (UC) complicated with primary sclerosing cholangitis. When UC relapsed and PG developed, prednisolone and granulocyte/monocyte apheresis were used; however, their therapeutic effects were deemed insufficient. After 2 weeks, adalimumab (ADA) induced remission; however, his UC and PG relapsed 20 weeks later. As a result of switching to infliximab, since a loss of response to ADA was deemed to have occurred, remission was reintroduced and subsequently maintained for 40 weeks. We conclude that anti-TNF-α antibodies might be selected as the first choice when PG and UC are refractory to treatment, and a switch to anti-TNFs should be considered when the effect is still insufficient.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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