Department of Pharmacology, University of Zagreb School of Medicine, Zagreb, Croatia.
Gastroenterology and Hepatology Unit, University Hospital Centre "Sestre Milosrdnice", Vinogradska 29, 10000, Zagreb, Croatia.
BMC Gastroenterol. 2021 Jul 31;21(1):303. doi: 10.1186/s12876-021-01876-5.
Epidemiological studies suggest an inverse association between H. pylori infection/exposure and inflammatory bowel disease prevalence/incidence, however, there are no reports of individual patients who developed a "non-transient" ulcerative colitis (UC) following H. pylori eradication.
We report a case of a 72-year-old female with an elderly-onset UC developed upon H. pylori eradication and a 3-year follow-up of the progression to steroid-dependent colitis complicated with enteropathic arthritis and final containment of the disease with golimumab. In our patient, H. pylori eradication was associated with the development of pancolitis that evolved into clinically, endoscopically, and pathohistologically confirmed UC.
The case of our patient provides a unique clinical context for a growing body of literature suggesting molecular mechanisms involved in the interaction of genes, environment, and microbiota to be of critical importance in the etiopathogenesis of UC, and thus, provides a valuable set of complementary translational information for preclinical and epidemiological research on the topic.
流行病学研究表明,幽门螺杆菌感染/暴露与炎症性肠病的患病率/发病率呈负相关,然而,尚无关于个别患者在幽门螺杆菌根除后发生“非一过性”溃疡性结肠炎(UC)的报道。
我们报告了一例 72 岁女性病例,其在幽门螺杆菌根除后出现老年发病的 UC,并进行了 3 年的随访,观察病情进展为类固醇依赖型结肠炎,并发肠病性关节炎,最终使用戈利木单抗控制了疾病。在我们的患者中,幽门螺杆菌根除与全结肠炎的发生有关,这种结肠炎进展为临床、内镜和组织病理学确诊的 UC。
我们患者的病例为越来越多的文献提供了一个独特的临床背景,这些文献表明,基因、环境和微生物群相互作用涉及的分子机制在 UC 的发病机制中至关重要,因此为该主题的临床前和流行病学研究提供了一套有价值的补充转化信息。