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Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
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Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
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Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
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Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
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[Ulcerative colitis: exceptional consequence after rituximab therapy].

Y Sekkach1, S Hammi, M Elqatni

  • 1Département de Médecine Interne B, Hôpital Militaire D'instruction Med V, Rabat, Maroc. sekkach@hotmail.com

Annales Pharmaceutiques Francaises
|September 20, 2011
PubMed
Summary
This summary is machine-generated.

Rituximab (RTX) treatment for refractory lupus can cause rare gastrointestinal issues like appendicitis and ulcerative colitis. Close monitoring for digestive symptoms is crucial during RTX therapy.

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Area of Science:

  • Immunology
  • Gastroenterology
  • Rheumatology

Background:

  • Rituximab (RTX) is an immunomodulatory therapy used for refractory systemic lupus erythematosus (SLE).
  • Adverse complications associated with RTX are generally rare.
  • This case highlights an unusual presentation of RTX-induced gastrointestinal complications.

Observation:

  • A 34-year-old patient with refractory bullous lupus (cutaneous, articular, hematologic, immunologic) was treated with RTX.
  • During RTX therapy, the patient experienced acute catarrhal appendicitis and later, erythematous, ulcerative colitis.
  • Histological examination revealed significant CD8+ T lymphocyte infiltrates in the colitis tissue.

Findings:

  • RTX treatment, while effective for refractory SLE, can precipitate rare gastrointestinal complications.
  • Appendicitis and ulcerative colitis are potential adverse events requiring careful monitoring.
  • CD8+ T lymphocyte infiltrates may play a role in RTX-induced gastrointestinal pathology.

Implications:

  • Gastrointestinal complications of targeted immunotherapies necessitate vigilant monitoring.
  • Early and thorough morphological investigation of digestive symptoms is essential during RTX treatment.
  • Prompt diagnosis and management can prevent severe outcomes, including surgical emergencies and life-threatening conditions.