Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
Department of Medicine, The University of Adelaide Faculty of Health Sciences, Adelaide, South Australia, Australia.
BMJ Case Rep. 2020 Aug 24;13(8):e233135. doi: 10.1136/bcr-2019-233135.
A 19-year-old man presented with acute severe ulcerative colitis. He was taking azathioprine (therapeutic metabolites) and sulphasalazine as well as infliximab with a therapeutic drug level. On day 3 of hydrocortisone therapy, he met day Oxford criteria with >8 bloody stools per day and was given faecal microbiota transplantation and subsequently commenced on dietary therapy combining several strategies-(1) increased intake of fermentable fibres, (2) reduced intake of overall and sulfur-containing protein and (3) restriction of sulfate and sulfite food additives. At week 8 assessment, he was in clinical and endoscopic remission and remained in clinical and endoscopic remission at 12 months.
一名 19 岁男性患有急性重度溃疡性结肠炎。他正在服用硫唑嘌呤(治疗代谢物)和柳氮磺胺吡啶,同时还使用英夫利昔单抗,药物水平处于治疗范围。在接受氢化可的松治疗的第 3 天,他符合牛津标准,每天有>8 次血便,并接受了粪便微生物群移植,随后开始采用多种策略的饮食治疗-(1)增加可发酵纤维的摄入,(2)减少总蛋白和含硫蛋白的摄入,(3)限制硫酸盐和亚硫酸盐食品添加剂。在第 8 周评估时,他处于临床和内镜缓解状态,在 12 个月时仍处于临床和内镜缓解状态。