Use of Janus Kinase Inhibitor Upadacitinib in Microscopic Colitis

Microscopic colitis is an inflammatory disease diagnosed via histopathology, often presenting with chronic nonbloody diarrhea. A 64-year-old woman was initially diagnosed in 2016 and received multiple standard treatments, which were ineffective and poorly tolerated. Trial of the Janus kinase inhibitor upadacitinib led to resolution of symptoms and improvement of treatment-resistant eczema. Although not FDA-approved for microscopic colitis, this case highlights potential benefit of Janus kinase inhibition in refractory cases and supports further investigation into its safety and efficacy.