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Metadados | Descrição | Idioma |
---|---|---|
Autor(es): dc.contributor | Universidade Estadual Paulista (Unesp) | - |
Autor(es): dc.contributor | Clin Univ Los Andes | - |
Autor(es): dc.creator | Sousa de Vasconcelos Garate, Ana Lorena [UNESP] | - |
Autor(es): dc.creator | Rocha, Thiara Barcelos [UNESP] | - |
Autor(es): dc.creator | Almeida, Luciana Rocha [UNESP] | - |
Autor(es): dc.creator | Quera, Rodrigo | - |
Autor(es): dc.creator | Barros, Jaqueline Ribeiro [UNESP] | - |
Autor(es): dc.creator | Baima, Julio Pinheiro [UNESP] | - |
Autor(es): dc.creator | Saad-Hossne, Rogerio [UNESP] | - |
Autor(es): dc.creator | Sassaki, Ligia Yukie [UNESP] | - |
Data de aceite: dc.date.accessioned | 2022-02-22T00:59:24Z | - |
Data de disponibilização: dc.date.available | 2022-02-22T00:59:24Z | - |
Data de envio: dc.date.issued | 2021-06-25 | - |
Data de envio: dc.date.issued | 2021-06-25 | - |
Data de envio: dc.date.issued | 2021-05-06 | - |
Fonte completa do material: dc.identifier | http://dx.doi.org/10.12998/wjcc.v9.i13.3219 | - |
Fonte completa do material: dc.identifier | http://hdl.handle.net/11449/210285 | - |
Fonte: dc.identifier.uri | http://educapes.capes.gov.br/handle/11449/210285 | - |
Descrição: dc.description | 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 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 Clostridium difficile and colonic dilatation of 7 cm consistent with megacolon were observed. She was treated with oral vancomycin for pseudomembranous colitis and intravenous hydrocortisone for severe colitis, which led to the resolution of megacolon. Due to the persistent severe colitis symptoms, infliximab 5 mg/kg was prescribed, monitored by drug trough level (8.8 mu g/mL) and fecal calprotectin of 921 mu g/g (< 30 mu g/g). Based on the low infliximab trough level after one week from the first infliximab dose, the patient received a second infusion at week 1, consistent with the accelerated regimen (infusions at weeks 0, 1, 2 and 6). We achieved a positive clinical and endoscopic response after 6 mo of therapy, without the need for a colectomy. CONCLUSION 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. | - |
Descrição: dc.description | Sao Paulo State Univ Unesp, Med Sch, Dept Internal Med, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazil | - |
Descrição: dc.description | Clin Univ Los Andes, Med Dept, Gastroenterol, Inflammatory Bowel Dis Program, Santiago 7550000, Chile | - |
Descrição: dc.description | Sao Paulo State Univ Unesp, Med Sch, Dept Internal Med, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazil | - |
Formato: dc.format | 3219-3226 | - |
Idioma: dc.language | en | - |
Publicador: dc.publisher | Baishideng Publishing Group Inc | - |
Relação: dc.relation | World Journal Of Clinical Cases | - |
???dc.source???: dc.source | Web of Science | - |
Palavras-chave: dc.subject | Infliximab | - |
Palavras-chave: dc.subject | Acute severe ulcerative colitis | - |
Palavras-chave: dc.subject | Toxic megacolon | - |
Palavras-chave: dc.subject | Ulcerative colitis | - |
Palavras-chave: dc.subject | Inflammatory bowel disease | - |
Palavras-chave: dc.subject | Case report | - |
Título: dc.title | Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report | - |
Tipo de arquivo: dc.type | livro digital | - |
Aparece nas coleções: | Repositório Institucional - Unesp |
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