Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
BMJ Case Rep. 2021 Mar 22;14(3):e239404. doi: 10.1136/bcr-2020-239404.
Active inflammatory bowel disease (IBD), combined immunosuppression and corticosteroid therapy have all been identified as risk factors for a poor outcome in COVID-19 infection. The management of patients with both COVID-19 infection and active IBD is therefore complex. We present the case of a 31-year-old patient with Crohn's disease, on dual immunosuppression with infliximab and mercaptopurine presenting with inflammatory small bowel obstruction and COVID-19 infection. The case highlights the use of nutritional therapy, which remains underused in the management of adults with IBD, to manage his flare acutely. Following negative SARS-CoV-2 PCR testing and SARS-CoV-2 IgG testing confirming an antibody response, ustekinumab (anti-interleukin 12/23) was prescribed for long-term maintenance.
活动性炎症性肠病（IBD）、联合免疫抑制和皮质类固醇治疗均被确定为 COVID-19 感染不良结局的危险因素。因此，COVID-19 感染合并活动性 IBD 的患者的管理非常复杂。我们报告了一例 31 岁克罗恩病患者的病例，该患者正在接受英夫利昔单抗和巯嘌呤双重免疫抑制治疗，出现炎症性小肠梗阻和 COVID-19 感染。该病例强调了营养治疗的使用，这在成人 IBD 管理中仍未得到充分应用，可用于急性管理其疾病发作。在 SARS-CoV-2 PCR 检测和 SARS-CoV-2 IgG 检测均为阴性并确认抗体反应后，给予乌司奴单抗（抗白细胞介素 12/23）用于长期维持治疗。
