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

Registro completo de metadados
MetadadosDescriçãoIdioma
Autor(es): dc.contributorUniversidade Estadual Paulista (Unesp)-
Autor(es): dc.contributorClin Univ Los Andes-
Autor(es): dc.creatorSousa de Vasconcelos Garate, Ana Lorena [UNESP]-
Autor(es): dc.creatorRocha, Thiara Barcelos [UNESP]-
Autor(es): dc.creatorAlmeida, Luciana Rocha [UNESP]-
Autor(es): dc.creatorQuera, Rodrigo-
Autor(es): dc.creatorBarros, Jaqueline Ribeiro [UNESP]-
Autor(es): dc.creatorBaima, Julio Pinheiro [UNESP]-
Autor(es): dc.creatorSaad-Hossne, Rogerio [UNESP]-
Autor(es): dc.creatorSassaki, Ligia Yukie [UNESP]-
Data de aceite: dc.date.accessioned2022-02-22T00:59:24Z-
Data de disponibilização: dc.date.available2022-02-22T00:59:24Z-
Data de envio: dc.date.issued2021-06-25-
Data de envio: dc.date.issued2021-06-25-
Data de envio: dc.date.issued2021-05-06-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.12998/wjcc.v9.i13.3219-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/210285-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/210285-
Descrição: dc.descriptionBACKGROUND 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.descriptionSao Paulo State Univ Unesp, Med Sch, Dept Internal Med, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazil-
Descrição: dc.descriptionClin Univ Los Andes, Med Dept, Gastroenterol, Inflammatory Bowel Dis Program, Santiago 7550000, Chile-
Descrição: dc.descriptionSao Paulo State Univ Unesp, Med Sch, Dept Internal Med, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazil-
Formato: dc.format3219-3226-
Idioma: dc.languageen-
Publicador: dc.publisherBaishideng Publishing Group Inc-
Relação: dc.relationWorld Journal Of Clinical Cases-
???dc.source???: dc.sourceWeb of Science-
Palavras-chave: dc.subjectInfliximab-
Palavras-chave: dc.subjectAcute severe ulcerative colitis-
Palavras-chave: dc.subjectToxic megacolon-
Palavras-chave: dc.subjectUlcerative colitis-
Palavras-chave: dc.subjectInflammatory bowel disease-
Palavras-chave: dc.subjectCase report-
Título: dc.titleTreatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

Não existem arquivos associados a este item.