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Rescue therapy with tacrolimus in a patient with toxic megacolon
Maria Pascu1, Andrea R Müller, Bertram Wiedenmann
1Division of Hepatology and Gastroenterology, Department of Internal Medicine, Campus Virchow, Charité Medical School, Augustenburger Platz 1, 13353 Berlin, Germany.
Background:
Toxic megacolon is a life-threatening complication most commonly observed in patients with ulcerative colitis or Crohn's disease that is characterized by total or segmental nonobstructive colonic dilatation of at least 6 cm on plain abdominal films associated with systemic toxicity.
Case Report:
We report an unusual case of fulminant steroid-refractory ulcerative colitis complicated by toxic megacolon treated successfully with the immunosuppressant tacrolimus.
Conclusion:
Tacrolimus administration induced clinical remission and bridged the time interval, until the standard immunosuppressant azathioprine could maintain clinical remission, thereby avoiding eminent emergency colectomy.