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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

57
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
57
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

300
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
300
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

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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...
100
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

93
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...
93
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

124
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
124
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

97
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...
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Related Experiment Video

Updated: May 9, 2025

Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
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Varicella Development after Infliximab Therapy for Refractory Pouchitis in Post-surgical Ulcerative Colitis.

Kae Ishii1, Shuko Iwatani1, Takuro Kawaguchi1

  • 1Department of Gastroenterology, Osaka International Medical and Science Center, Osaka Keisatsu Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|April 30, 2025
PubMed
Summary
This summary is machine-generated.

A teenage patient treated with infliximab (IFX) for ulcerative colitis developed a rare varicella zoster virus (VZV) infection. This case highlights the importance of considering VZV reactivation in immunosuppressed individuals.

Keywords:
immunosuppressive therapyinfliximabpouchitisreactivationulcerative colitisvaricella

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Area of Science:

  • Gastroenterology
  • Immunology
  • Infectious Diseases

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a surgical option for refractory UC.
  • Pouchitis, inflammation of the ileal pouch, can occur post-surgery.
  • Immunosuppressive therapies, such as infliximab (IFX), are used to manage IBD and its complications.

Purpose of the Study:

  • To report a rare case of varicella zoster virus (VZV) reactivation in an adolescent patient undergoing treatment for ulcerative colitis complications.
  • To emphasize the need to consider VZV infection in immunosuppressed patients presenting with vesicular rashes.

Main Methods:

  • Case report of a teenage patient with ulcerative colitis.
  • Review of patient's medical history, including proctocolectomy and treatment with infliximab (IFX).
  • Clinical presentation assessment, including fever and generalized rash.
  • Diagnostic confirmation of Varicella zoster virus (VZV) antigen positivity in blisters.
  • Evaluation of VZV vaccination history, environmental exposure, and VZV antibody titers.

Main Results:

  • The patient developed fever and a generalized rash two days after IFX injection.
  • VZV antigen was positive in blister fluid, confirming varicella infection.
  • Despite a history of VZV vaccination, VZV reactivation was suspected based on clinical context and antibody titers.
  • The patient was immunosuppressed due to treatment for ulcerative colitis and pouchitis.

Conclusions:

  • Varicella zoster virus (VZV) reactivation, presenting as varicella, can occur in immunosuppressed patients, even those with prior vaccination.
  • This case underscores the importance of maintaining a high index of suspicion for VZV infections in patients receiving immunosuppressive therapy for inflammatory bowel disease.
  • Early diagnosis and appropriate management are crucial for outcomes in such rare presentations.