A case of refractory chronic pouchitis successfully treated with tofacitinib
| Autor: | Naoki Yoshimura, Soh Okano, Minako Sako, Masakazu Takazoe |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Pouchitis Vedolizumab 03 medical and health sciences Young Adult 0302 clinical medicine Refractory Piperidines Internal medicine Medicine Humans Pyrroles Tofacitinib business.industry Proctocolectomy Restorative Gastroenterology General Medicine Hepatology medicine.disease Ulcerative colitis Colorectal surgery Surgery Pyrimidines 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Colitis Ulcerative Female business Abdominal surgery medicine.drug |
| Zdroj: | Clinical journal of gastroenterology. 13(4) |
| ISSN: | 1865-7265 |
| Popis: | We describe a case of refractory pouchitis successfully treated with tofacitinib. The patient was a 20-year-old woman diagnosed with ulcerative colitis at the age of 14 years. She underwent surgery at the age of 18 years for chronic active inflammation, despite an optimal medication regimen. Ten months after surgery, she was diagnosed with pouchitis. She did not respond to conventional conservative treatment; thus, the case was considered as that of refractory chronic pouchitis. Anti-tumor necrosis factor-α (TNF-α) therapy was administered, which led to some improvement; however, pouchitis recurred. Systemic steroid and vedolizumab were also administered, but the response was unsatisfactory. Therefore, surgery was considered; however, the patient refused to undergo surgery. As identical therapies are recommended for ulcerative colitis and pouchitis, they are considered to have a common etiology. Therefore, we considered tofacitinib therapy in this case. After obtaining the patient’s informed consent, tofacitinib treatment was initiated. The therapy led to improvement in her symptoms as well as in the appearance of the pouch when observed on endoscopy, and surgery was avoided. Thus, tofacitinib may be considered a therapy option for refractory chronic pouchitis. |
| Databáze: | OpenAIRE |
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