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World J Gastroenterol. May 7, 2014; 20(17): 5135-5140
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5135
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5135
Ulcerative colitis worsened after Clostridium difficile infection: Efficacy of infliximab
Andrada Seicean, Anca Moldovan-Pop, Radu Seicean, Regional Institute of Gastroenterology and Hepatology, First Surgical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca 400162, Romania
Author contributions: Seicean A, Moldovan-Pop A and Seicean R contributed equally to the patient treatment, literature review, and writing of this manuscript.
Correspondence to: Andrada Seicean, MD, PhD, Regional Institute of Gastroenterology and Hepatology, Iuliu Hatieganu University of Medicine and Pharmacy, Strada Croitorilor 19-21, Cluj-Napoca 400162, Romania. andradaseicean@gmail.com
Telephone: +40-74-4332107 Fax: +40-26-4431758
Received: November 21, 2013
Revised: January 25, 2014
Accepted: February 17, 2014
Published online: May 7, 2014
Revised: January 25, 2014
Accepted: February 17, 2014
Published online: May 7, 2014
Core Tip
Core tip:Clostridium difficile infection (CDI) in patients with ulcerative colitis (UC) can worsen the disease and increase the risk of colectomy and death, thus requiring an escalation of treatment. This report reveals a case of UC worsened by recurrent CDI, which likely activated the patient’s immune response and stimulated the relapse of UC. Lack of response to infliximab therapy was indicated by low trough levels, and a high-dose infliximab regimen yielded better clinical results. Infliximab trough levels were found to correspond with patient outcome, and thus may serve to guide treatment in similar cases of UC with CDI.