Sustained clinical response to infliximab in refractory Cronkhite-Canada syndrome
| Autor: | Caroline Di Jiang, Helen Myint, Nigel H Stace, Andy Tie |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Abdominal pain Combination therapy Colon Drug Resistance Azathioprine Case Report Gastroenterology Sepsis 03 medical and health sciences 0302 clinical medicine Refractory Gastrointestinal Agents Internal medicine Gastroscopy medicine Pyloric Antrum Humans Intestinal Mucosa Glucocorticoids business.industry Intestinal Polyposis General Medicine Colonoscopy Induction Chemotherapy Middle Aged medicine.disease Infliximab Parenteral nutrition Treatment Outcome 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Cronkhite–Canada syndrome medicine.symptom business Immunosuppressive Agents medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 59-year-old man with refractory Cronkhite-Canada syndrome (CCS) had poor clinical response to high-dose intravenous steroids, azathioprine, total parenteral nutrition and best supportive care. He remained highly symptomatic with abdominal pain, diarrhoea, recurrent sepsis and profound weight loss. Infliximab induction was given as rescue therapy, with marked clinical improvement observed within 3 weeks. This allowed steroid taper. Within 12 months of infliximab therapy, he achieved complete clinical remission and returned to his baseline weight and a full oral diet. Sequential endoscopies observed significant regression of previous marked gastrointestinal polyposis, including histological remission on colonic biopsies at 3.5 and 5 years of treatment. He currently remains in remission following 6 years of combination therapy with 5 mg/kg 8 weekly infliximab and azathioprine, and there is ongoing discussion with regard to the benefits and risks of therapy de-escalation. This case demonstrates the effectiveness of infliximab in inducing and maintaining remission in refractory CCS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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