Filipiuk Aleksandra, Gonciarz Maciej
Department of Gastroenterology and Internal Medicine, Military Institute of Medicine-National Research Institute in Warsaw, Warsaw 04-141, Poland.
World J Clin Cases. 2024 Aug 16;12(23):5441-5447. doi: 10.12998/wjcc.v12.i23.5441.
Ulcerative colitis (UC) is an idiopathic, chronic inflammatory bowel disease (IBD) most often located in the rectum, but may involve the entire colon. Extra intestinal manifestations (EIMs) occur with varying frequency depending on the affected organ. The most common ones are musculoskeletal EIMs, affecting up to 33%-40% of IBD patients. These include, among others, inflammatory back pain, tendinitis, plantar fasciitis and arthritis. Only a few case reports in literature discuss Achilles tendinitis.
This report describes a patient with UC and Achilles tendinitis in whom after many unsuccessful attempts of treatment with sulfasalazine, mesalazine, glucocorticosteroids, infliximab and tofacitinib, a complete UC remission and resolution of Achilles tendinitis were achieved with the use of dual biologic therapy (DBT)-ustekinumab and adalimumab (ADA).
This case mentions rare EIMs of UC and suggests that DBT may be an alternative for patient with ulcerative colitis and EIMs.
溃疡性结肠炎（UC）是一种特发性慢性炎症性肠病（IBD），最常累及直肠，但也可能累及整个结肠。肠外表现（EIMs）的发生频率因受累器官而异。最常见的是肌肉骨骼EIMs，高达33%-40%的IBD患者会出现。其中包括炎性背痛、肌腱炎、足底筋膜炎和关节炎。文献中仅有少数病例报告讨论了跟腱炎。
本报告描述了一名患有UC和跟腱炎的患者，在使用柳氮磺胺吡啶、美沙拉嗪、糖皮质激素、英夫利昔单抗和托法替布进行多次治疗均未成功后，使用双重生物疗法（DBT）——优特克单抗和阿达木单抗（ADA）实现了UC的完全缓解和跟腱炎的消退。
本病例提及了UC罕见的EIMs，并表明DBT可能是溃疡性结肠炎和EIMs患者的一种替代治疗方法。
