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08:38
Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
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Severe diffuse duodenitis successfully treated with intravenous tacrolimus after colectomy for ulcerative colitis
Keiko Saito1, Tatsuro Katsuno, Tomoo Nakagawa
1Department of Gastroenterology and Nephrology (K1), Graduate School of Medicine, Chiba University, Japan.
Internal Medicine (Tokyo, Japan)
|November 5, 2014
Summary
This case report details a rare instance of severe duodenitis linked to ulcerative colitis (UC) in a post-surgery patient. Intravenous tacrolimus effectively treated the condition when steroids failed.
Area of Science:
- Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Case Studies
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease primarily affecting the colon.
- Gastrointestinal complications beyond the colon are recognized but less common.
- Post-surgical management of UC can present unique challenges.
Observation:
- A 23-year-old male with UC, status post total proctocolectomy, presented with persistent severe abdominal pain, fever, and bloody diarrhea for six months.
- Upper double-balloon enteroscopy revealed severe, diffuse duodenitis.
- Endoscopic and histological findings of the duodenal lesions were consistent with UC.
Findings:
- Standard prednisolone treatment was ineffective for the duodenitis.
- Intravenous tacrolimus administration resulted in significant clinical improvement.
- This represents the first reported successful use of intravenous tacrolimus for UC-associated diffuse duodenitis.
Implications:
- Highlights the potential for ulcerative colitis to affect the duodenum severely, even after colectomy.
- Suggests intravenous tacrolimus as a viable therapeutic option for refractory UC-associated duodenitis.
- Underscores the importance of considering upper gastrointestinal involvement in complex UC cases.
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