Wang Hong-Gang, Liu Shi-Peng, Ma Tian-Heng, Yan Wei, Zhou Jing-Fang, Shi Yun-Tao, Shen Peng, Yang Xiao-Zhong, Wu Shang-Nong
Department of Gastroenterology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an Department of Gastroenterology, Hongze District People's Hospital, Hongze, Jiangsu Province, China.
Medicine (Baltimore). 2018 May;97(19):e0675. doi: 10.1097/MD.0000000000010675.
Fecal microbiota transplantation (FMT) is currently being explored as a potential therapy for ulcerative colitis (UC). Here, we report the first case of a UC patient with allergy to 5-aminosalicylic acid (5-ASA) who underwent FMT and achieved clinical remission.
This patient had a 9-year history of UC and was allergic to 5-ASA. He suffered from gradually aggravated abdominal pain and frequent bloody diarrhea. There was a continuous distribution of superficial erosion and ulceration by colonoscopy. After steroid therapy failed, he underwent FMT. The donated fecal microbes were purified in laboratory and then transplanted into the terminal ileum and right colon of the patient by colonoscopy. During the 9 months' follow-up, FMT has proved its efficacy in inducing and maintaining clinical and endoscopic remission of the patient.
The choice of treatment for refractory UC patients who are allergic to 5-ASA is relatively limited. In our case, we highlight the specific role of FMT for refractory UC with absence of 5-ASA through intestinal microbiota reconstruction.
粪便微生物群移植(FMT)目前正作为溃疡性结肠炎(UC)的一种潜在治疗方法进行探索。在此,我们报告首例对5-氨基水杨酸(5-ASA)过敏的UC患者接受FMT并实现临床缓解的病例。
该患者有9年UC病史,对5-ASA过敏。他遭受逐渐加重的腹痛和频繁的血性腹泻。结肠镜检查显示有连续分布的浅表糜烂和溃疡。类固醇治疗失败后,他接受了FMT。捐赠的粪便微生物在实验室中进行纯化,然后通过结肠镜检查移植到患者的回肠末端和右结肠。在9个月的随访期间,FMT已证明其在诱导和维持患者临床及内镜缓解方面的疗效。
对5-ASA过敏的难治性UC患者的治疗选择相对有限。在我们的病例中,我们强调了FMT通过肠道微生物群重建对无5-ASA的难治性UC的特定作用。