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...
| Publicado en: | BMJ Case Reports Vol. 14; no. 5; pp. 1 - 5 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
BMJ Publishing Group
May2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150978559&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150978559 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1757790X B755 jtl: BMJ Case Reports issn: 1757790X maglogo: N pubinfo: dt: May2021 vid: 14 iid: 5 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 150978559 10.1136/bcr-2021-241744 150978559 ppf: 1 ppct: 4 formats: tig: 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 refInfo: holdings: @attributes: islocal: N |
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