S90 Pediatric Atrophic Metaplastic Gastritis: A Rare Presentation of IPEX Syndrome

.Thiscaseseriespresented4patientswithCDwhoreceivedsirolimustherapyforaprimaryindicationofrefractoryCD.Allpatientshadfailedtreatmentwithatleast6otherIBD-therapies. Our results reveal 1 of 4 patients reporting symptomatic improvement and whilst treatment escalation was not required, imaging measures of in fl ammation remained equivocal. Furthermore, all 4 patients required sirolimus discontinuation due to adverse e ff ects. With minimal data currently available for use of sirolimus therapy in adults with refractory IBD, our fi ndings suggest that its role may be limited by treatment-derived adverse e ff ects. Further large-scale studies are needed to investigate the e ffi ciency of sirolimus therapy in refractory IBD, with particular attention to treatment-limiting adverse e ff ects.