scholarly journals An unusual association of pyoderma gangrenosum with ulcerative colitis and thyrotoxicosis successfully treated with infliximab: a case report

2020 ◽  
Vol 8 (4) ◽  
pp. 1585
Author(s):  
Abdullah Abualiat ◽  
Hala Edris ◽  
Salaheldin Alfadni ◽  
Tariq Aziz ◽  
Mahmoud Hussein
Keyword(s):  
Ulcerative Colitis ◽  
Pyoderma Gangrenosum ◽  
Systemic Disease ◽  
Neutrophil Function ◽  
Innate Immune ◽  
Lower Limbs ◽  
Inflammatory Dermatosis ◽  
Immune Mediated ◽  
Inflammatory Bowel ◽  
Necrosis Factor

Pyoderma Gangrenosum (PG) is a rare chronic immune-mediated inflammatory dermatosis manifested as painful skin ulceration, commonly affecting the lower limbs. The pathogenesis of the disease is complex. Abnormalities in neutrophil function, dysregulation of the innate immune system, and Tumor Necrosis Factor (TNF) were postulated. An underlying associated systemic disease was reported in more than 50% of PG patients, including inflammatory bowel disease, rheumatoid arthritis, and malignancies, with few cases reported an associated thyroid disease. Authors report a case of extensive PG associated with both ulcerative colitis and thyrotoxicosis co-morbidities not mentioned before in one patient. The patient was successfully treated with the anti-TNF alpha infliximab.

scholarly journals Pyoderma gangrenosum: A clinico- therapeutic profile of patients attending a tertiary care hospital in Nepal

2012 ◽  
Vol 8 (1) ◽  
pp. 29-35
Author(s):  
C Kharel ◽  
S Agrawal ◽  
A Rijal ◽  
S Bhattarai
Keyword(s):  
Ulcerative Colitis ◽  
Pyoderma Gangrenosum ◽  
Tertiary Care ◽  
Lower Limbs ◽  
Neutrophilic Dermatosis ◽  
Care Hospital ◽  
Medical Sciences ◽  
Inflammatory Bowel ◽  
Therapeutic Profile

Pyoderma gangrenosum (PG) is a primarily sterile inflammatory neutrophilic dermatosis characterized by recurrent cutaneous ulcerations with mucopurulent or hemorrhagic exudate. In many cases, PG is associated with inflammatory bowel disease, rheumatic disorder or neoplasia. The peak of incidence occurs between the ages of 20 to 50 years with women being more often affected than men. To study the clinical and therapeutic profile of patients with pyoderma gangrenosum. All patients diagnosed as pyoderma gangrenosum in the department of dermatology from July 14th 2003- July 12th 2008 were included in the study. Demographic profile, clinical features as well as relevant investigations, treatment and follow-up were noted. A total of 8 patients with pyoderma gangrenosum were diagnosed over a 5 year period. There were 3 males and 5 female patients whose ages ranged from 32 to 80 years. Lower limbs were the commonest site to be involved in 6 patients (75%). Recurrent episodes were noted in 4 patients (50%) and among them 3 patients (75%) had multiple ulcers. Histopathological confirmation of the diagnosis was done in 7 patients (87.5%). Association with ulcerative colitis was seen in 2 patients (25%). All patients were treated with dapsone and systemic steroids which showed resolution of the lesions in all patients. Pyoderma gangrenosum was seen more frequently in females and association with ulcerative colitis was seen in 25% of the patients. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 29-35 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6823

scholarly journals A156 SERUM TUMOUR NECROSIS FACTOR-α ANTAGONIST DRUG CONCENTRATIONS IN PATIENTS WITH PYODERMA GANGRENOSUM ASSOSCIATED WITH INFLAMMATORY BOWEL DISEASE

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 162-163
Author(s):  
M Mikail ◽  
A Wilson
Keyword(s):  
Inflammatory Bowel Disease ◽  
Pyoderma Gangrenosum ◽  
Bowel Disease ◽  
Complete Resolution ◽  
Therapeutic Drug ◽  
Drug Concentrations ◽  
Median Serum ◽  
Inflammatory Bowel ◽  
Factor Α ◽  
Necrosis Factor

Abstract Background The utility of therapeutic drug monitoring for guiding the dosing of tumor necrosis factor-α antagonists (TNFAs) in luminal inflammatory bowel disease (IBD) is well-established and well-accepted. TNFAs, specifically infliximab and adalimumab, have become integral to the management of the rare, neutrophilic dermatosis, pyoderma gangrenosum (PG) in IBD. Little is known regarding the target serum TNFA concentrations to guide dosing to achieve resolution of PG in IBD. Aims To describe the serum TNFA concentrations (infliximab or adalimumab) associated with the resolution of PG lesions in patients with IBD. Methods Patients with IBD and associated PG treated with one of infliximab or adalimumab (collectively known as TNFAs) seen at two academic hospitals affiliated with Western University were identified. Serum TNFA concentrations were assessed at the time of PG treatment. Results Nine patients were identified. All patients had IBD-associated PG. Seven patients were treated with infliximab and 2 patients were treated with adalimumab. All patients received standard dosing. Eight patients had complete resolution of their PG, while one had near complete resolution at the time of last follow-up. A median serum infliximab concentration of 3.00 (IQR, 3.52) µg/ml at week 14 and a median serum adalimumab concentration of 2.02 (IQR, 0.98) µg/ml at week 12 were seen at the time of PG treatment. Conclusions Herein, we report low serum TNFA concentrations despite PG healing in a cohort of IBD patients. This is lower than what is in patients for successful TNFA treatment in luminal and fistulising IBD. Funding Agencies NoneNone.

scholarly journals Management of Acute Severe Ulcerative Colitis in a Pregnant Woman With COVID-19 Infection: A Case Report and Review of the Literature

2020 ◽  
Vol 26 (7) ◽  
pp. 971-973 ◽  
Author(s):  
Melissa H Rosen ◽  
Jordan Axelrad ◽  
David Hudesman ◽  
David T Rubin ◽  
Shannon Chang
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
First Trimester ◽  
Review Of The Literature ◽  
Severe Ulcerative Colitis ◽  
Immune Mediated ◽  
First Trimester Of Pregnancy ◽  
Inflammatory Bowel ◽  
High Level

Abstract First detected in Wuhan, China, the novel 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA beta-coronavirus responsible for an unprecedented, worldwide pandemic caused by COVID-19. Optimal management of immunosuppression in inflammatory bowel disease (IBD) patients with COVID-19 infection currently is based on expert opinion, given the novelty of the infection and the corresponding lack of high-level evidence in patients with immune-mediated conditions. There are limited data regarding IBD patients with COVID-19 and no data regarding early pregnancy in the era of COVID-19. This article describes a patient with acute severe ulcerative colitis (UC) during her first trimester of pregnancy who also has COVID-19. The case presentation is followed by a review of the literature to date on COVID-19 in regard to inflammatory bowel disease and pregnancy, respectively.

scholarly journals A Case of Bilateral Acute Inferior Limb Ischemia in a Patient With Ulcerative Colitis

2020 ◽  
Vol 13 ◽  
pp. 117954762091273
Author(s):  
Mimari Kanazawa ◽  
Takeshi Sugaya ◽  
Fumiaki Takahashi ◽  
Kazuhiro Takenaka ◽  
Kouhei Tsuchida ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Blood Flow ◽  
Balloon Catheter ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Bloody Stool ◽  
Mayo Score ◽  
High Incidence ◽  
Inflammatory Bowel ◽  
Inferior Limb

A patient was diagnosed with ulcerative colitis (UC) in 2010. In March 2015, she had abdominal pain, diarrhea, bloody stool, and UC has relapsed. In June 2015, pain and sensory disturbance of both lower limbs appeared. Blood flow at the distal femoral artery was not confirmed with magnetic resonance angiography, and it was diagnosed as bilateral acute inferior limb ischemia. Arterial thrombolectomy with Fogarty’s balloon catheter was performed and blood flow was improved. The severity of UC was moderate with Mayo score 8. Thrombosis is considered to be a complication with a high incidence in inflammatory bowel disease. Reports of arterial thrombosis are very rare. It is important to evaluate the risk of bleeding and thrombosis in active or severe cases in UC and need to do thrombotic prophylactic treatment simultaneously with UC treatment.

scholarly journals Sulfasalazine-Induced Pancytopenia in Ulcerative Colitis

2016 ◽  
Vol 6 (3) ◽  
pp. 164-165
Author(s):  
NS Neki ◽  
Ankur Jain
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Adverse Effects ◽  
Bowel Disease ◽  
Modifying Agent ◽  
Immune Mediated ◽  
Established Disease ◽  
Inflammatory Bowel ◽  
Disease Modifying

Sulfasalazine is a well-established disease-modifying agent. It is commonly used in the treatment of rheumatic disorders and inflammatory bowel disease. The most frequently reported adverse effects are gastrointestinal effects, headache, dizziness and rash; myelosuppression can also occur. Patients treated with sulfasalazine can develop thrombocytopenia which is immune mediated. We report a case of ulcerative colitis that was on sulfasalazine subsequently developing thrombocytopenia.J Enam Med Col 2016; 6(3): 164-165

scholarly journals Pyoderma gangrenosum and ulcerative colitis in the tropics

2008 ◽  
Vol 41 (6) ◽  
pp. 664-667 ◽  
Author(s):  
Olatunji B. Alese ◽  
David O. Irabor
Keyword(s):  
Rheumatoid Arthritis ◽  
Ulcerative Colitis ◽  
Pyoderma Gangrenosum ◽  
Myeloproliferative Disorders ◽  
Skin Lesions ◽  
Skin Condition ◽  
Wound Dressings ◽  
Systemic Disorder ◽  
Inflammatory Bowel ◽  
The Tropics

Pyoderma gangrenosum is a rare inflammatory skin condition, characterized by progressive and recurrent skin ulceration. There may be rapidly enlarging, painful ulcers with undermined edges and a necrotic, hemorrhagic base. Disorders classically associated with pyoderma gangrenosum include rheumatoid arthritis, inflammatory bowel disease, paraproteinemia and myeloproliferative disorders. There have been some reports of the occurrence of pyoderma gangrenosum in Africa, and in Nigeria, but only one specifically reported pyoderma gangrenosum in association with ulcerative colitis. We report on a 45-year-old man who presented with pyoderma gangrenosum associated with ulcerative colitis; the second report in Nigeria. The skin lesions were managed with daily honey wound dressings. Oral dapsone and prednisolone were started. The frequency of the bloody diarrhea decreased, and was completely resolved by the second week after admission. The ulcers also showed accelerated healing. The goal of therapy is directed towards the associated systemic disorder, if present.

scholarly journals Secukinumab therapy in reactive arthritis: Report of two cases

2021 ◽  
Author(s):  
Prasanta Padhan ◽  
Debashis Maikap
Keyword(s):  
Reactive Arthritis ◽  
Tumour Necrosis ◽  
Treatment Options ◽  
Lower Limbs ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Immune Mediated ◽  
Factor Inhibitor ◽  
Inflammatory Drugs ◽  
Necrosis Factor

ABSTRACT Reactive arthritis (ReA) is an immune-mediated aseptic synovitis resulting either from genitourinary or gastrointestinal tract, commonly presenting as oligoarthritis of the lower limbs and rarely urethritis and conjunctivitis. The treatment options include nonsteroidal anti-inflammatory drugs, conventional disease-modifying antirheumatic drugs, and biologics in severe cases. We report successful use of secukinumab in two cases of chronic severe ReA who initially failed to treatment with tumour necrosis factor inhibitor.

Postoperative pyoderma gangrenosum after spinal fusion with instrumentation: case report

2020 ◽  
Vol 32 (2) ◽  
pp. 285-291
Author(s):  
M. Harrison Snyder ◽  
Leonel Ampie ◽  
Vernon J. Forrester ◽  
JoAnne C. Wilson ◽  
James H. Nguyen ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Inflammatory Bowel Disease ◽  
Case Report ◽  
Pyoderma Gangrenosum ◽  
Spinal Instrumentation ◽  
Severe Adverse Effect ◽  
Inflammatory Dermatosis ◽  
Effective Care ◽  
Surgical Incisions ◽  
Inflammatory Bowel

Pyoderma gangrenosum (PG) is a rare inflammatory dermatosis that is most often associated with inflammatory bowel disease, but which can occur as a pathergic reaction around surgical incisions. The authors report the case of a patient who developed postoperative PG over the course of several months after undergoing extensive spinal instrumentation between the T4 and iliac levels. This is only the second such case occurring after spine surgery to be reported. The authors additionally review the literature to characterize treatment approaches and outcomes for this condition. The case highlights a potentially severe adverse effect of surgery that can be difficult to recognize and causes delays in effective treatment. It also demonstrates the importance of multidisciplinary collaboration in the effective care of patients.

Chemotherapy-induced pyoderma gangrenosum

WCET Journal ◽  
2019 ◽  
pp. 9-17
Author(s):  
Michelle Wai Kuen Lee ◽  
Steven Kar Kay Chan
Keyword(s):  
Pyoderma Gangrenosum ◽  
Systemic Disease ◽  
Skin Lesions ◽  
Skin Condition ◽  
The Other ◽  
Acute Trauma ◽  
Inflammatory Bowel ◽  
Haematological Disorders ◽  
Chronic Myelomonocytic Leukaemia ◽  
Rheumatoid Diseases

Pyoderma gangrenosum (PG) is a refractory, painful, non-infectious, ulcerative and inflammatory skin condition. Approximately 50% of patients with PG showed an existing systemic disease, such as inflammatory bowel conditions, haematological disorders, rheumatoid diseases or hepatopathies. Some patients developed PG following acute trauma or injury in a process known as pathergy. In the other cases, PG is characterised by isolated skin lesions with unknown causes and classified as idiopathic. However, in recent decades, PG has been reported in patients treated with certain medications. In this manuscript, we report two cases of PG, which were triggered by chemotherapy in patients with myelodysplastic syndrome (MDS) and chronic myelomonocytic leukaemia (CMML).

scholarly journals Recent advances and emerging therapies in the non-surgical management of ulcerative colitis

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1207 ◽  
Author(s):  
Jan Wehkamp ◽  
Eduard F. Stange
Keyword(s):  
Ulcerative Colitis ◽  
Small Molecules ◽  
Primary Response ◽  
Emerging Therapies ◽  
Novel Drugs ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Established Role ◽  
New Algorithms ◽  
Necrosis Factor

The so-called “biologicals” (monoclonal antibodies to various inflammatory targets like tumor necrosis factor or integrins) have revolutionized the treatment of inflammatory bowel diseases. In ulcerative colitis, they have an established role in inducing remission in steroid-refractory disease and, thereafter, maintaining remission with or without azathioprine. Nevertheless, their limitations are also obvious: lack of primary response or loss of response during maintenance as well as various, in part severe, side effects. The latter are less frequent in anti-integrin treatment, but efficacy, especially during induction, is delayed. New antibodies as well as small molecules have also demonstrated clinical efficacy and are soon to be licensed for ulcerative colitis. None of these novel drugs seems to be much more effective overall than the competition, but they provide new options in otherwise refractory patients. This increasing complexity requires new algorithms, but it is still premature to outline each drug’s role in future treatment paradigms.

Sign in / Sign up

Export Citation Format

Share Document