Open AccessUstekinumab Treatment for Toxic Megacolon in Severe Colonic Crohn�s Disease: First Case Report
Author(s) -
Martín Irabien,
P Arreba,
Jone Ortiz de Zárate,
Nerea Hernández-Aretxabaleta,
Saioa de la Maza-Ortiz,
Nahia Ispízua-Madariaga,
C Muñoz-Villafranca
Publication year - 2020
Publication title -
revista española de enfermedades digestivas/revista española de enfermedades digestivas
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 38
eISSN - 2340-4167
pISSN - 1130-0108
DOI - 10.17235/reed.2020.7228/2020
Subject(s) - medicine , ustekinumab , crohn's disease , megacolon , gastroenterology , toxic megacolon , crohn disease , disease , dermatology , ulcerative colitis , infliximab
Toxic megacolon is most commonly considered as a complication of inflammatory bowel disease, especially ulcerative colitis and colonic Crohn's disease to a lesser extent. It appears in the context of moderate-to-severe disease and often requires colectomy. Currently, after an inadequate response to conventional therapy with systemic corticosteroids, the use of cyclosporine or infliximab is considered as an alternative option, prior to surgical intervention. We present a case report of toxic megacolon in a patient with a severe refractory colonic Crohn's disease, where anti-tumor necrosis factor (anti-TNF) therapies were contraindicated. Consequently, we decided to use ustekinumab as a rescue therapy, despite insufficient evidence to provide recommendations for this indication.