Buness Cynthia, Lindor Keith D, Miloh Tamir
National Patient Advocate Foundation, Paradise Valley, Phoenix, AZ, USA.
College of Health Solutions, Arizona State University, Phoenix, AZ, USA.; Department of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA.
Pediatr Gastroenterol Hepatol Nutr. 2016 Sep;19(3):210-213. doi: 10.5223/pghn.2016.19.3.210. Epub 2016 Sep 29.
Primary sclerosing cholangitis (PSC), a rare progressive liver disease characterized by cholestasis and bile duct fibrosis, has no accepted, effective therapy known to delay or arrest its progression. We report a 15 year old female patient diagnosed with PSC and moderate chronic active ulcerative colitis (UC) who achieved normalization of her liver enzymes and bile ducts, and resolution of her UC symptoms with colonic mucosal healing, after treatment with a single drug therapy of the antibiotic oral vancomycin. We postulate that the oral vancomycin may be acting both as an antibiotic by altering the intestinal microbiome and as an immunomodulator. Oral vancomycin may be a promising treatment for PSC that needs to be further studied in randomized trials.
原发性硬化性胆管炎（PSC）是一种罕见的进行性肝病，其特征为胆汁淤积和胆管纤维化，目前尚无已知的可延缓或阻止其进展的有效治疗方法。我们报告了一名15岁女性患者，她被诊断患有PSC和中度慢性活动性溃疡性结肠炎（UC），在接受抗生素口服万古霉素单一药物治疗后，其肝酶和胆管恢复正常，UC症状得到缓解，结肠黏膜愈合。我们推测口服万古霉素可能既作为一种通过改变肠道微生物群起作用的抗生素，又作为一种免疫调节剂。口服万古霉素可能是一种有前景的PSC治疗方法，需要在随机试验中进一步研究。
