scholarly journals Anti-TNF-Related Leukocytoclastic Vasculitis in Ulcerative Colitis: A Case Report

Author(s):  
Valentina Giorgio ◽  
Elisa Blasi ◽  
Donato Rigante ◽  
Cristina Guerriero ◽  
Clara De Simone ◽  
...  

Background: The development of drugs directed against tumor necrosis factor (TNF)-α has dramatically modified the therapeutic approach to inflammatory bowel diseases: a larger use of such drugs has also led to a major knowledge about their adverse effects, especially on skin. The aim of this report was to describe a rare steroid-dependent form of leukocytoclastic vasculitis induced by an anti-TNF-α agent in a young woman with ulcerative colitis. Case presentation: A young girl with ulcerative colitis developed a form of leukocytoclastic vasculitis induced by an anti-TNF-α agent. Recurrent palpable purpuric lesions on her legs were the main cutaneous manifestation. Skin lesions were steroid-dependent, but improved after withdrawal of the anti-TNF-α agent and second-line immunosuppressant therapy. Conclusions: The need to develop specific recommendations to guide the use of medications for managing skin reactions induced by anti-TNF-α drugs is herein emphasized.

2016 ◽  
Vol 34 (1-2) ◽  
pp. 140-146 ◽  
Author(s):  
Hans H. Herfarth

Methotrexate (MTX) is an established therapy for patients with steroid-dependent Crohn's disease (CD). MTX is also frequently used in combination with anti-TNF agents to suppress anti-drug antibody formation. It has been suggested in the past that MTX lacks any clinical effectiveness in patients with ulcerative colitis (UC); however, newer data at least partially contradict this assumption. The following review will discuss recent data for the use of MTX in CD, UC and in combination with anti-TNF agents.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. Homolak ◽  
M. Nikolić ◽  
D. Potoč ◽  
M. Živković ◽  
D. Bakula ◽  
...  

Abstract Background Epidemiological studies suggest an inverse association between H. pylori infection/exposure and inflammatory bowel disease prevalence/incidence, however, there are no reports of individual patients who developed a "non-transient” ulcerative colitis (UC) following H. pylori eradication. Case presentation We report a case of a 72-year-old female with an elderly-onset UC developed upon H. pylori eradication and a 3-year follow-up of the progression to steroid-dependent colitis complicated with enteropathic arthritis and final containment of the disease with golimumab. In our patient, H. pylori eradication was associated with the development of pancolitis that evolved into clinically, endoscopically, and pathohistologically confirmed UC. Conclusions The case of our patient provides a unique clinical context for a growing body of literature suggesting molecular mechanisms involved in the interaction of genes, environment, and microbiota to be of critical importance in the etiopathogenesis of UC, and thus, provides a valuable set of complementary translational information for preclinical and epidemiological research on the topic.


2018 ◽  
Vol 132 (20) ◽  
pp. 2169-2174 ◽  
Author(s):  
Xavier Escoté

In a recent issue of Clinical Science, Prieto-Vicente et al. [Clin. Sci. (2018) 132, 985–1001] have smartly demonstrated a potential new use of cardiotrophin-1 (CT-1) to treat and palliate an inflammatory bowel disease such as ulcerative colitis. In that work, authors report that in ulcerative colitic mice, administration of exogenous recombinant CT-1 (rCT-1) promotes lower colon damage and lower disease activity index, reducing systemic levels of tumor necrosis factor α (TNF-α) and also diminishing TNF-α expression in colon together with the reduction in other common inflammation markers. Besides, in vivo rCT-1 administration induces activation of several molecular pathways, including nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) and signal transducer and activator of transcription (STAT)-3, and abolishes bacterial translocation from intestine to other organs, including mesenteric ganglia, lungs, and spleen. Additionally, these results were nicely corroborated in CT-1 depleted mice; in which colon damage and ulcerative colitis severity were greater compared with the wild-type counterparts. All together, these results suggested that CT-1 could be a promising new therapeutic approach for treating inflammatory bowel disease, particularly ulcerative colitis. However, further studies are required to determine its major mechanisms of action and the potential efficacy of CT-1 in human inflammatory bowel diseases.


2020 ◽  
Author(s):  
Muhammet Fatih Aydin ◽  
Hamit Tasdemir

Abstract Background: COVID-19 pneumonia is a widespread viral disease, which affects all the world and has been accepted as pandemic by the World Health Organization (WHO). Coronavirus can remain in the stool for certain time even after recovery from COVID-19 pneumonia in some infected patients. Studies increasingly report involvement of other organs including gastrointestinal system in addition to respiratory symptoms in COVID-19. Ulcerative colitis is an inflammatory bowel disease with unknown cause. Emerging data suggest that gastrointestinal system may also be influenced by COVID-19 based via the expression of ACE-2. However, data abour the association of COVID-19 and inflammatory bowel diseases including ulcerative colitis are lacking. Case Presentation: In this report, we present a case of ulcerative colitis diagnosed in a 50-year-old male patient who presented with the complaints of bloody diarrhea and abdominal pain following the completion of the treatment of COVID-19 pneumonia. Conclusion: Patients presenting with gastrointestnal complaints should also be evaluated for COVID-19.


2020 ◽  
pp. 6-11
Author(s):  
Svetlana Svetlana ◽  
Mikhail Klimentov ◽  
Olga Neganova ◽  
Alina Nazmieva ◽  
Anastasiya Kochurova

Nowadays there are certain difficulties in the early diagnosis of ulcerative colitis, proceeding with minimal intestinal symptoms. The etiology of the disease remains unclear to this day; there is no exact information about the prevalence of the disease due to the large number of latent forms and the low number of patients seeking medical help. This article presents the results of a retrospective analysis of the incidence of ulcerative colitis in the coloproctology department of the First Republic Clinical Hospital of Izhevsk. The study was conducted to assess the frequency of occurrence and determine the internal picture of ulcerative colitis. To achieve this goal, we selected 34 patients with ulcerative colitis. A statistical study was conducted on the following criteria: gender composition, age groups, forms of the disease, localization, complications, and main complaints. The length of hospital stay often was not more than 20 days. The literature on this pathology was also studied and presented in the form of a theoretical basis, which consisted of the determination and etiology of inflammatory bowel diseases. Due to the unknown etiology, insufficiently studied pathogenesis, difficult differential diagnosis with other intestinal diseases and insufficiently perfect treatment methods, there are a large number of unresolved problems in the field of ulcerative colitis. That is why, in this article we tried to reveal the problem of the features of the course and complex therapy of that disease in clinical practice.


Author(s):  
Dr. Sumedh Wasnik ◽  
Anita Ghodke ◽  
Vaibhav Sulakhe

Westernization and today’s changing life style is resulting in various health problems like Inflammatory Bowel diseases, which is a common entity encountered in surgical practise. Ulcerative colitis is the most common among them. Though it is believed to have auto immune and genetic origin, today’s life style, environment, diet and stress plays an important role in aetiology. The disease is prevalent in middle aged western and northern people characterised by abdominal pain with bloody diarrhoea, weight loss, anaemia and general debility. This condition has remissions and exacerbations. One should always keep in mind that inflammatory bowel diseases can have anorectal manifestations. Diagnosis is made on the basis of symptoms, stool exam. and endoscopy. Management is symptomatic i.e. antibiotics, anti-inflammatory, anti-spasmodic, multivitamins, immune suppression and if required admission, intravenous fluids. if no response colectomy. As such there is no satisfactory treatment till date, so it remains the difficult issue. Here we need to have an alternative, safe, convenient treatment. Ayurveda has an answer for such cases.


2021 ◽  
Vol 8 (1) ◽  
pp. e000587
Author(s):  
Giacomo Caio ◽  
Lisa Lungaro ◽  
Fabio Caputo ◽  
Maria Muccinelli ◽  
Maria Caterina Marcello ◽  
...  

Inflammatory bowel diseases such as ulcerative colitis (UC) may be complicated by several extraintestinal manifestations. These involve joints, skin, eyes and less commonly lungs and heart. Myocarditis may result from the toxic effect of drugs (ie, mesalazine) commonly used for the treatment of UC or due to infections (eg, Coxsackieviruses, enteroviruses, adenovirus). Here, we report a case of a 26-year old man affected by UC and complicated by two episodes of myocarditis. Both episodes occurred during two severe exacerbations of UC. However, in both cases the aetiology of myocarditis remains uncertain being ascribable to extraintestinal manifestation, drug toxicity or both.


2021 ◽  
Vol 8 (1) ◽  
pp. 37-39
Author(s):  
Alexia Maillard ◽  
Damien Pastor ◽  
Rastine Merat

Mucocutaneous adverse events are commonly observed under immune checkpoint inhibitors (ICIs) therapy. Here, we report the case of a 43-year-old male patient with a stage IIIC melanoma disease who developed hidradenitis suppurativa (HS) three months after the beginning of an anti-PD-1 (nivolumab) adjuvant therapy. The patient had no comorbidities other than obesity and severe acne during adolescence. After an unsuccessful course of lymecycline while he was still treated with nivolumab, he gradually improved under zinc gluconate therapy and, more importantly, after nivolumab cessation. HS is a recurrent follicular inflammatory disease in the apocrine gland-bearing areas of the body often associated with obesity, metabolic syndrome, tobacco smoking, inflammatory bowel diseases, psoriasis, and arthritis. In our patient, the latency period between drug initiation and onset of HS symptoms and the improvement after immunotherapy discontinuation, argued strongly in favor of an anti-PD-1-induced HS. Anti-PD-1 therapies often trigger T cells-mediated adverse events that mimic Th17-mediated inflammatory and neutrophilic diseases. We suggest that HS, as other pustular skin reactions and ICIs-induced neutrophilic colitis, can be part of the anti-PD-1 mucocutaneous adverse event spectrum.


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