Matsuhashi N, Nakajima A, Watanabe K, Komeno Y, Suzuki A, Ohnishi S, Omata M, Kondo K, Usui Y, Iwadare J I, Watanabe T, Nagawa H, Muto T
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, Japan.
J Gastroenterol. 2000;35(8):635-40. doi: 10.1007/s005350070065.
We report a case of refractory ulcerative colitis treated with tacrolimus. The patient was a 73-year-old woman with a 45-year history of ulcerative colitis. An attack unresponsive to intravenous corticosteroid therapy occurred when she was age 73. Leukocytapheresis therapy was attempted, but was discontinued because of the patient's poor general condition. Cyclosporine A therapy brought about fair control of the disease. A liver injury that was suspected to be associated with this agent, however, occurred within 5 weeks of its initiation. At that time, the cyclosporine A was discontinued and azathioprine treatment was started. Within 6 weeks, signs of exacerbation of the ulcerative colitis became apparent. Tacrolimus administered at that time brought about remission of the disease, and the corticosteroid dose was then reduced. Tacrolimus, like cyclosporine A, appears to be effective for the treatment of attacks of ulcerative colitis.
我们报告了一例用他克莫司治疗的难治性溃疡性结肠炎病例。该患者为一名73岁女性，有45年溃疡性结肠炎病史。73岁时发生了对静脉注射皮质类固醇治疗无反应的发作。尝试了白细胞去除术治疗，但由于患者一般状况较差而停止。环孢素A治疗使疾病得到了一定程度的控制。然而，在开始使用该药物后5周内发生了疑似与之相关的肝损伤。当时停用了环孢素A并开始硫唑嘌呤治疗。6周内，溃疡性结肠炎加重的迹象变得明显。当时给予他克莫司使疾病缓解，随后皮质类固醇剂量降低。他克莫司与环孢素A一样，似乎对溃疡性结肠炎发作的治疗有效。
