Refractory case of ulcerative colitis with idiopathic thrombocytopenic purpura successfully treated by Janus kinase inhibitor tofacitinib:A case report  

作　　者：Yoriaki Komeda Toshiharu Sakurai Arito Hashimoto Tomoyuki Nagai Satoru Hagiwara Masatoshi Kudo Kazuko Sakai Kazuto Nishio Yasuyoshi Morita Itaru Matsumura 

机构地区：[1]Department of Gastroenterology and Hepatology,Kindai University Faculty of Medicine,Osaka 589-8511,Japan [2]Department of Genome Biology,Kindai University Faculty of Medicine,Osaka 589-8511,Japan [3]Department of Hematology and Rheumatology,Kindai University Faculty of Medicine,Osaka 589-8511,Japan

出　　处：《World Journal of Clinical Cases》2020年第24期6389-6395,共7页世界临床病例杂志

基　　金：Supported by JSPS KAKENHI, No.17K09396, No. 17H06404, and No.20K08368.

摘　　要：BACKGROUND Concomitant ulcerative colitis (UC) and idiopathic thrombocytopenic purpura(ITP) is a rare phenomenon. The management of UC with ITP can be challenging,since a decreased platelet count augments UC.CASE SUMMARY A 24-year-old man with UC and steroid-resistant ITP experienced UC flare.Although continuous infusion of cyclosporine was initiated, UC did not improve.The administration of tofacitinib subsequently led to the induction of remission.The patient has maintained remission of UC and ITP for over one year ontofacitinib treatment. Whole transcriptomic sequencing was performed forinflamed rectal mucosae obtained before and after the initiation of Janus kinase(JAK) inhibitor, suggesting that distinct molecular signatures seemed to beregulated by JAK inhibitors and other conventional therapies including tumornecrosis factor lockers.CONCLUSION Tofacitinib should be considered in refractory cases of UC with ITP.

关 键 词：Ulcerative colitis Idiopathic thrombocytopenic purpura Tofacitinib Whole transcriptome analysis Case report Predictive biomarker 

分 类 号：R574.62[医药卫生—消化系统] R558.2[医药卫生—内科学]