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Multiple ulcerative colitis-associated aseptic abscesses successfully treated with infliximab: a case report
Takahito Toba1, Ryo Ikegami2, Akira Nogami2
1Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan. takahito.toba@med.toho-u.ac.jp.
Clinical Journal of Gastroenterology
|April 25, 2023
Summary
This study details a rare case of aseptic abscesses in a patient with ulcerative colitis. Infliximab effectively treated the condition when steroids and apheresis failed, showing promise for similar complex cases.
Area of Science:
- Gastroenterology
- Immunology
Background:
- Aseptic abscesses are uncommon extraintestinal manifestations of inflammatory bowel disease (IBD).
- Differentiating aseptic from infectious abscesses in IBD patients can be challenging.
- The periosteum is an unusual primary site for aseptic abscesses.
Observation:
- A 69-year-old female with ulcerative colitis presented with multiple aseptic abscesses, primarily affecting the periosteum.
- Initial treatment with prednisolone and granulocyte and monocyte adsorption apheresis showed inadequate response.
- Antibiotic therapy was ineffective, and cultures were negative, supporting an aseptic etiology.
Findings:
- Infliximab treatment demonstrated a strong positive effect in this steroid-resistant patient.
- The patient achieved remission with continued infliximab therapy, with no recurrence observed over a 2-year follow-up period.
- This case underscores the efficacy of infliximab in managing refractory aseptic abscesses associated with ulcerative colitis.
Implications:
- Infliximab offers a promising therapeutic option for patients with ulcerative colitis-associated aseptic abscesses who are resistant to standard treatments.
- Early consideration of infliximab may prevent disease progression and improve patient outcomes.
- Long-term monitoring is essential due to the potential for late recurrence, even after successful treatment.
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