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Localized Colitis Associated With Cholecystectomy in Multiple Sclerosis Patient Treated With Ocrelizumab
Rhea Chowdhury1, Vladimir Neychev1
1Surgery, University of Central Florida College of Medicine, Orlando, USA.
Abstract:
Our understanding of multiple sclerosis (MS) has led to the development of new therapeutic strategies, including ocrelizumab, a third-generation humanized anti-CD20 antibody. Ocrelizumab is largely well tolerated with favorable effectiveness, however, it has been associated with reports of colitis presenting weeks to months following infusion. We present a case of severe localized colitis in the setting of recent surgery and chronic ocrelizumab use. High-dose IV hydrocortisone was initiated, and the patient showed gradual improvement. Repeat imaging after discharge showed near-complete resolution of the patient's condition. This case aims to increase awareness of possible postoperative severe localized colitis in MS patients on Ocrevus.
Insights
Ocrelizumab, used for multiple sclerosis (MS), can cause colitis, especially after surgery. This case highlights severe colitis in an MS patient on Ocrevus, treated successfully with hydrocortisone.
Area of Science:
- Immunology
- Gastroenterology
- Neurology
Background:
- Multiple sclerosis (MS) management involves targeted therapies like ocrelizumab, a humanized anti-CD20 antibody.
- While generally safe and effective, ocrelizumab has been linked to colitis developing weeks to months post-infusion.
Observation:
- A case study involving a patient with MS on chronic ocrelizumab therapy.
- The patient developed severe localized colitis following recent surgery.
Findings:
- High-dose intravenous hydrocortisone treatment led to gradual improvement in the patient's condition.
- Post-discharge imaging revealed near-complete resolution of the colitis.
Implications:
- This case underscores the importance of recognizing potential postoperative colitis in MS patients undergoing ocrelizumab treatment.
- Increased clinical awareness may improve early diagnosis and management of this adverse event.
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