Bui Hoang Huu, Dang Luan Minh, Thi-Ngoc Vo Diem, Nguyen Chuong Dinh
Department of Gastroenterology, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Department of Internal Medicine, University Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Case Rep Gastroenterol. 2023 Feb 7;17(1):82-88. doi: 10.1159/000529152. eCollection 2023 Jan-Dec.
Lately, emerging data suggest an association between the development of inflammatory bowel disease and anti-interleukin-17 therapy. Megacolon is a life-threatening complication of acute severe ulcerative colitis (ASUC), but its treatment has not yet been established in current practice guidelines. We report a rare case of known psoriasis treated by secukinumab in a patient who presented with ASUC and colonic dilatation. Neither steroids nor standard infliximab regimen was effective. Finally, rescue therapy with accelerated infliximab strategy resulted in excellent recovery. In certain cases of steroid-refractory ASUC complicated by megacolon, accelerated infliximab regimen can be an alternative to surgery.
最近,新出现的数据表明炎症性肠病的发展与抗白细胞介素-17治疗之间存在关联。巨结肠是急性重症溃疡性结肠炎(ASUC)的一种危及生命的并发症,但目前的实践指南中尚未确立其治疗方法。我们报告了一例罕见病例,一名已知患有银屑病的患者因ASUC和结肠扩张接受司库奇尤单抗治疗。类固醇和标准英夫利昔单抗方案均无效。最后,采用加速英夫利昔单抗策略进行抢救治疗,患者恢复良好。在某些合并巨结肠的类固醇难治性ASUC病例中,加速英夫利昔单抗方案可作为手术的替代方案。