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Terapia de inducción acelerada con infliximab en paciente con colitis ulcerosa grave refractaria a corticoides. Caso clínico
- Source :
- Revista médica de Chile v.145 n.8 2017, SciELO Chile, CONICYT Chile, instacron:CONICYT
- Publication Year :
- 2017
- Publisher :
- Sociedad Médica de Santiago, 2017.
-
Abstract
- Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition that requires early recognition, hospitalization and adequate treatment. Currently, the use of infliximab in ulcerative colitis (UC) is recommended in the case of severe disease refractory to corticosteroids, once that superimposed bacterial or viral infections (such as cytomegalovirus or Clostridium difficile) have been excluded. However, conventional weight-based regimens of infliximab might be insufficient for patients with ASUC. Accelerated infliximab induction regimen may increase its serum concentration levels and efficacy by reducing early colectomy rates in these patients. We report a 34 year old female presenting with an ASUC. She was initially treated with hydrocortisone 300 mg/day and mesalazine enemas 4 g/day with an unfavorable clinical response. At the fifth day of therapy, an accelerated induction therapy with infliximab was started in doses of 10 mg/kg at weeks 0, 1 and 4. After the second dose, there was a favorable response with reduction of abdominal pain, stool frequency and hematochezia. She was discharged with prednisone and azathioprine. After a year of starting infliximab, the patient remains in clinical remission.
- Subjects :
- medicine.medical_specialty
Azathioprine
Ulcerative
Gastroenterology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Mesalazine
Prednisone
Internal medicine
medicine
030212 general & internal medicine
Colitis
time-To-treatment
Gastrointestinal agent
business.industry
General Medicine
medicine.disease
Ulcerative colitis
Hematochezia
Infliximab
Surgery
chemistry
medicine.symptom
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- Language :
- Spanish; Castilian
- Database :
- OpenAIRE
- Journal :
- Revista médica de Chile v.145 n.8 2017, SciELO Chile, CONICYT Chile, instacron:CONICYT
- Accession number :
- edsair.doi.dedup.....f16508516f396dcdea2e990b345db3d8