Ashizuka Shinya, Kuroishi Nobuko, Nakashima Koji, Inatsu Haruhiko, Kita Toshihiro, Kitamura Kazuo
Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan.
Intern Med. 2019 Jun 1;58(11):1573-1576. doi: 10.2169/internalmedicine.1791-18. Epub 2019 Feb 1.
A 35-year-old man with refractory Crohn's disease showed a loss of response to infliximab after requiring treatment with infliximab at 10 mg/kg together with steroid to maintain remission. His symptoms recurred, and colonoscopy showed extensive active ulcers in the colon. Adrenomedullin therapy was started in addition to the conventional infliximab therapy. A few days after, his symptoms went into remission. Endoscopy at 2 and 7 weeks revealed significant mucosal remission without steroid therapy. Adrenomedullin promoted mucosal healing and led to the re-induction of remission in Crohn's disease in a patient with a loss of response to infliximab.
一名35岁的难治性克罗恩病男性患者，在接受10mg/kg英夫利昔单抗联合类固醇治疗以维持缓解后，对英夫利昔单抗出现反应丧失。他的症状复发，结肠镜检查显示结肠有广泛的活动性溃疡。除了传统的英夫利昔单抗治疗外，开始了肾上腺髓质素治疗。几天后，他的症状缓解。在2周和7周时的内镜检查显示，在未使用类固醇治疗的情况下，黏膜有显著缓解。肾上腺髓质素促进了黏膜愈合，并使一名对英夫利昔单抗反应丧失的克罗恩病患者再次诱导缓解。
