Steroid-refractory ulcerative colitis and associated primary sclerosing cholangitis treated with infliximab  

作　　者：Ileana Duca Patricia Ramírez de la Piscina Silvia Estrada Rosario Calderón Katerina Spicakova Leire Urtasun Carlos Marra-López Salvador Zabaleta Raquel Bengoa María Asunción Marcaide Francisco García-Campos 

机构地区：[1]Service of Gastroenterology,Hospital Universitario de álava-Sede Txagorritxu,Universidad del País Vasco,E-01009 Vitoria-Gasteiz,Spain

出　　处：《World Journal of Gastroenterology》2013年第4期590-593,共4页世界胃肠病学杂志（英文版）

摘　　要：Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis.Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffective.We describe a patient with long-standing ulcerative colitis,which was refractory to corticosteroid therapy who developed primary sclerosing cholangitis(biochemical stage Ⅱ/Ⅳ) in the course of his pancolitis.Treatment with infliximab(5 mg/kg as an induction dose followed by maintenance doses every two months) was indicated because of steroid-dependent disease associated to primary sclerosing cholangitis as well as sacroiliitis and uveitis and previous episode of severe azathioprinerelated hepatic toxicity.At present,after two years of follow-up,the patient is asymptomatic with normal liver tests and complete resumption of daily life activities.This case draws attention to the usefulness of antitumor necrosis factor-alpha therapy for the management of primary sclerosing cholangitis as extraintestinal manifestation of inflammatory bowel disease.Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis. Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffective. We describe a patient with long-standing ulcerative colitis, which was refractory to corticosteroid therapy who developed primary sclerosing cholangitis (biochemical stage II/IV) in the course of his pancolitis. Treatment with infliximab (5 mg/kg as an induction dose followed by maintenance doses every two months) was indicated because of steroid-dependent disease associated to primary sclerosing cholangitis as well as sacroiliitis and uveitis and previous episode of severe azathioprine-related hepatic toxicity. At present, after two years of follow-up, the patient is asymptomatic with normal liver tests and complete resumption of daily life activities. This case draws attention to the usefulness of anti-tumor necrosis factor-alpha therapy for the management of primary sclerosing cholangitis as extraintestinal manifestation of inflammatory bowel disease.

关 键 词：ULCERATIVE colitis INFLIXIMAB Monoclonal antibodies SCLEROSING CHOLANGITIS Bile duct diseases Tumor necrosis FACTOR-ALPHA 

分 类 号：R574.62[医药卫生—消化系统] R575.7[医药卫生—内科学]