万古霉素对肝和骨髓移植后顽固性溃疡性结肠炎和原发性硬化性胆管炎患者缓解的诱导和维持作用

IF 0.6 Q4 GASTROENTEROLOGY & HEPATOLOGY
Case Reports in Gastroenterology Pub Date : 2025-03-12 eCollection Date: 2025-01-01 DOI:10.1159/000544076
Mohammad Shehab, Anwar Almajdi, Mohammed Alotaibi, Maen Almattooq
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引用次数: 0

摘要

简介:炎症性肠病-原发性硬化性胆管炎(IBD-PSC)是一种独特的疾病实体,其发病机制和独特的临床表现尚不清楚。这种疾病的患者最终可能需要肝移植,因为目前还没有治愈PSC的治疗方法来阻止肝衰竭的疾病进展。30%的IBD患者在接受免疫抑制治疗后仍可能出现复发。很少有研究表明万古霉素已被用于难治性溃疡性结肠炎(UC)恶化患者的救助性治疗。在本报告中,我们讨论了一例25岁的女性,既往有镰状细胞病(SCD)、UC、继发于PSC的肝移植后的病史,她发展为UC恶化,对常规治疗和大多数生物药物都难治,并通过口服万古霉素(OV)诱导和维持缓解。病例介绍:这是一例25岁女性,有SCD, UC和原发性硬化性胆管炎(PSC)病史,并发肝硬化并接受肝移植。在肝移植之前,她有UC的复发性恶化,难治性常规治疗和大多数生物药物。肝移植后,尽管接受了ustekinumab治疗,她仍出现了另一次UC耀斑。肝移植后,口服OV 125 mg,每日4次,用于控制UC。结论:本报告支持在常规和生物制剂难治性UC加重的SCD患者中使用OV。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vancomycin for the Induction and Maintenance of Remission in Biologics Refractory Patient with Ulcerative Colitis and Primary Sclerosing Cholangitis Post-Liver and Bone Marrow Transplantation.

Introduction: Inflammatory bowel disease-primary sclerosing cholangitis (IBD-PSC) is a unique disease entity that has very poorly understood pathogenesis and unique clinical presentation. Patients with this disease may eventually require liver transplantation as there is no current curative treatment for PSC to halt disease progression for liver failure. Thirty percent of patients with IBD may experience recurrence despite being on immunosuppression. Few studies have shown that vancomycin has been used as a salvage treatment for patients with refractory ulcerative colitis (UC) exacerbation refractory to conventional and biological agents. In this report, we discuss the case of 25-year-old female with a prior history of sickle cell disease (SCD), UC, post-liver transplant secondary to PSC, who developed UC exacerbation refractory to conventional therapies and most biological agents and was induced and maintained in remission with oral vancomycin (OV).

Case presentation: This is the case of 25-year-old female with a history of SCD, UC, and primary sclerosing cholangitis (PSC) who developed liver cirrhosis and underwent liver transplantation. Prior to liver transplantation, she had recurrent exacerbations of UC, refractory conventional therapies, and most biological agents. Post-liver transplantation, she developed another UC flare despite being treated with ustekinumab. OV 125 mg four times daily was used as salvage therapy post-liver transplantation to control her UC.

Conclusion: This report supports the use of OV in patient with SCD who had UC exacerbation refractory to conventional and biological agents.

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来源期刊
Case Reports in Gastroenterology
Case Reports in Gastroenterology Medicine-Gastroenterology
CiteScore
1.10
自引率
0.00%
发文量
99
审稿时长
7 weeks
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