Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2009; 15(14): 1771-1773
Published online Apr 14, 2009. doi: 10.3748/wjg.15.1771
Infliximab to treat severe ulcerative colitis
Dídia Bisamra Cury, Marcelo de Souza Cury, Geraldo Vinicius Hemerly Elias, Sender Jankiel Mizsputen
Dídia Bisamra Cury, Marcelo de Souza Cury, Geraldo Vinicius Hemerly Elias, Sender Jankiel Mizsputen, Department of Gastroenterology, Federal University of São Paulo, rua Botucatu, 740 São Paulo, SP 04023-900, Brazil
Author contributions: Cury DB wrote the article; Cury MS performed the second colonoscopy and collated the bibliographic references; Elias GVH performed the first colonoscopy; Mizsputen SJ helped to conduct this case, and reviewed the article.
Correspondence to: Dídia Bismara Cury, Department of Gastroenterology, Federal University of São Paulo, rua Botucatu, 740 São Paulo, SP 04023-900, Brazil. didia_cury@uol.com.br
Telephone: +55-67-33256040
Fax: +55-67-33256040
Received: October 29, 2008
Revised: March 10, 2009
Accepted: March 17, 2009
Published online: April 14, 2009
Abstract

A 48-year-old female with severe ulcerative colitis refractory to conventional therapy was referred to our facility for management. The patient showed extensive ulcerative colitis since the age of 20 years and had failed therapy with 5-aminosalicylic acid agents and azathioprine. The disease remained active despite treatment with steroids and cyclosporine. The clinical and endoscopic parameters were consistent with severe disease. Infectious precipitants were ruled out. Given the severity of the disease and in order to avoid a colectomy, we started the patient on infliximab therapy. A dramatic clinical and endoscopic response was observed and she remained in remission at the end of a 1-year follow-up period. We discuss findings in the literature regarding the use of infliximab therapy in patients with ulcerative colitis who have failed steroids and cyclosporine.

Keywords: Cyclosporine, Infliximab, Treatment failure, Ulcerative colitis, Inflammatory bowel diseases