Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report.

Acute severe ulcerative colitis Case report Inflammatory bowel disease Infliximab Toxic megacolon Ulcerative colitis

Journal

World journal of clinical cases
ISSN: 2307-8960
Titre abrégé: World J Clin Cases
Pays: United States
ID NLM: 101618806

Informations de publication

Date de publication:
06 May 2021
Historique:
received: 09 01 2021
revised: 04 02 2021
accepted: 09 03 2021
entrez: 10 5 2021
pubmed: 11 5 2021
medline: 11 5 2021
Statut: ppublish

Résumé

Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitis associated with high levels of circulating tumor necrosis factor alpha, due to the intense inflammation and faster stool clearance of anti-tumor necrosis factor drugs. Dose-intensified infliximab treatment can be beneficial and is associated with lower rates of colectomy. The aim of the study was to present a case of a patient with ASUC and megacolon, treated with hydrocortisone and accelerated scheme of infliximab that was monitored by drug trough level. A 22-year-old female patient diagnosed with ulcerative colitis, presented with diarrhea, rectal bleeding, abdominal pain, vomiting, and distended abdomen. During investigation, a positive toxin for Infliximab accelerated infusions can be beneficial in ASUC unresponsive to the treatment with intravenous corticosteroids. Longitudinal studies are necessary to define the best therapeutic drug monitoring and treatment regimen for these patients.

Sections du résumé

BACKGROUND BACKGROUND
Acute severe ulcerative colitis (ASUC) is a complication of ulcerative colitis associated with high levels of circulating tumor necrosis factor alpha, due to the intense inflammation and faster stool clearance of anti-tumor necrosis factor drugs. Dose-intensified infliximab treatment can be beneficial and is associated with lower rates of colectomy. The aim of the study was to present a case of a patient with ASUC and megacolon, treated with hydrocortisone and accelerated scheme of infliximab that was monitored by drug trough level.
CASE SUMMARY METHODS
A 22-year-old female patient diagnosed with ulcerative colitis, presented with diarrhea, rectal bleeding, abdominal pain, vomiting, and distended abdomen. During investigation, a positive toxin for
CONCLUSION CONCLUSIONS
Infliximab accelerated infusions can be beneficial in ASUC unresponsive to the treatment with intravenous corticosteroids. Longitudinal studies are necessary to define the best therapeutic drug monitoring and treatment regimen for these patients.

Identifiants

pubmed: 33969111
doi: 10.12998/wjcc.v9.i13.3219
pmc: PMC8080733
doi:

Types de publication

Case Reports

Langues

eng

Pagination

3219-3226

Informations de copyright

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: The authors state that they have no conflicts of interest regarding this case report.

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Auteurs

Ana Lorena Sousa de Vasconcelos Garate (ALSV)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Thiara Barcelos Rocha (TB)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Luciana Rocha Almeida (LR)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Rodrigo Quera (R)

Inflammatory Bowel Disease Program, Gastroenterology, Medicine Department, Clínica Universidad de los Andes, Santiago 7550000, Chile.

Jaqueline Ribeiro Barros (JR)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Julio Pinheiro Baima (JP)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Rogerio Saad-Hossne (R)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil.

Ligia Yukie Sassaki (LY)

Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil. ligia.sassaki@unesp.br.

Classifications MeSH