Vancomycin Therapy for Induction and Maintenance of Remission in a Patient with Refractory Ulcerative Colitis and Primary Sclerosing Cholangitis: A Case Report and Literature Review.

Introduction: Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon. About 5% of ulcerative colitis patients also present with primary sclerosing cholangitis, a chronic inflammatory disease marked by cholestasis and progressive fibrosis of the bile ducts, and results in the necessity of liver transplantation. Ulcerative colitis treatment in primary sclerosing cholangitis patients is challenging due to potential resistance to conventional therapies.

Case presentations: We describe a patient with ulcerative colitis and primary sclerosing cholangitis, whose ulcerative colitis relapsed following a liver transplant. After failure of conventional treatment and further deterioration in her colitis, with negative clostridium difficile, she was treated with vancomycin with beneficial long-term clinical and endoscopic responses.

Conclusion: This case report, along with others we reviewed, suggests that vancomycin treatment should be considered as a treatment for ulcerative colitis and primary sclerosing cholangitis patients after conventional therapies for the colitis prove ineffective.