Author/Editor | Urlep, Darja; Dolinšek, Jernej; Mičetić-Turk, Dušanka | |
Title | Infliximab pri zdravljenju hudega na kortikosteroide neodzivnega zagona ulceroznega kolitisa - prikaz primera | |
Translated title | Infliximab in the treatment of severe steroid-refractory ulcerative colitis - a case report | |
Type | članek | |
Source | Zdrav Vestn | |
Vol. and No. | Letnik 73, št. 4 | |
Publication year | 2004 | |
Volume | str. 187-90 | |
Language | slo | |
Abstract | Background. The natural course of ulcerative colitis (UC) can be complicated with an acute severe attack of high degree of activity of inflammation which represents a life-threatening condition. High-dose intravenous steroids have been the treatment of choice for induction of clinical remission of acute severe attack. In corticosteroid refractory ulcerative colitis a surgical therapy is required. Patients and methods. A case of a ten year-old girl with severe steroid-refractory UC is presented. The treatment with infliximab was introduced with intention to avoid colectomy. After the first infusion of infliximab her condition improved and clinical remission was achieved which was maintained with azathioprine. Conclusions. Therapy with infliximab can be successful for a severe steroid-refractory UC. The patients treated with infliximab can avoid surgical therapy (colectomy) which can represent a life-long disablement. The achieved remission is best maintained with conventional immunosuppressive therapy (azathioprine or 6-mercaptopurin). | |
Summary | Izhodišča. Ulcerozni kolitis (UK) lahko poteka kot akutni zagon s hudo stopnjo vnetne dejavnosti, ki predstavlja življenje ogrožajoče stanje. Kortikosteroidi (KS) v intravenski obliki so zdravilo prve izbire za indukcijo klinične remisije pri akutnem hudem zagonu UK. Pri hudi obliki ulceroznega kolitisa, neodzivni na kortikosteroide, je potrebno kirurško zdravljenje. Bolniki in metode. Prikazan je primer desetletne deklice s hudo obliko na KS neodzivnega ulceroznega kolitisa. Da bi se izognili kirurškemu posegu, smo uvedli zdravljenje z infliximabom. Že po enkratni infuziji infliximaba je prišlo do hitrega izboljšanja kliničnega stanja in remisije bolezni, ki smo jo nato vzdrževali z azatioprinom. Zaključki. Zdravljenje z infliximabom je lahko uspešno pri hudo potekajočem, na KS neodzivnem UK. S tovrstnim zdravljenjem se lahko izognemo kirurškemu zdravljenju (kolektomiji), ki za bolnike predstavlja doživljenjsko invalidnost. Doseženo remisijo vzdržujemo z uveljavljenimi imunosupresivi (azatioprinom ali 6-merkaptopurinom). | |
Descriptors | COLITIS, ULCERATIVE ADRENAL CORTEX HORMONES TUMOR NECROSIS FACTOR ANTIBODIES, MONOCLONAL CHILD TREATMENT OUTCOME |