Abstract | BACKGROUND: CASE PRESENTATION: A 26-year-old Japanese man with history of common variable immune deficiency presented with diarrhea, abdominal pain, and fever. Venous administration of antibiotics did not improve his symptoms. Colonoscopy revealed multiple longitudinal ulcers as well as cobblestone-like change in the ileum end and the ascending colon. Histopathological examination of biopsy specimen showed erosion and infiltration of T lymphocytes with lack of B cells. Intravenous hyperalimentation, mesalazine, and steroid did not improve the symptoms and the patient subsequently presented with massive melena. Colonoscopy revealed a protuberant vessel on one of the ulcers in the ascending colon. Endoscopic clipping was repeatedly performed for hemostasis, which was only temporarily successful. In an attempt to manage the bleeding and colitis, a trial of infliximab was given on week 0, week 2 and week 6. Gastrointestinal hemorrhage from the ulcer halted immediately after the first infliximab injection. Colonoscopy performed after the third infliximab showed remarkable improvement in the ileocolitis. No evidence of increased susceptibility to infections was observed and the patient has been in clinical remission for 3 years. CONCLUSIONS:
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Authors | Yuko Akazawa, Fuminao Takeshima, Hiroyuki Yajima, Daisuke Imanishi, Tsutomu Kanda, Kayoko Matsushima, Hitomi Minami, Naoyuki Yamaguchi, Ken Ohnita, Hajime Isomoto, Tomayoshi Hayashi, Masahiro Nakashima, Kazuhiko Nakao |
Journal | BMC research notes
(BMC Res Notes)
Vol. 7
Pg. 382
(Jun 22 2014)
ISSN: 1756-0500 [Electronic] England |
PMID | 24952714
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Gastrointestinal Agents
- Infliximab
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Topics |
- Adult
- Antibodies, Monoclonal
(therapeutic use)
- Common Variable Immunodeficiency
(complications)
- Crohn Disease
(drug therapy, etiology)
- Gastrointestinal Agents
(therapeutic use)
- Gastrointestinal Hemorrhage
(etiology, prevention & control)
- Humans
- Infliximab
- Treatment Outcome
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