Steroid-refractory extensive enteritis complicated by ulcerative colitis successfully treated with adalimumab

Shinji Okabayashi, Taku Kobayashi, Tomohisa Sujino, Ryo Ozaki, Satoko Umeda, Takahiko Toyonaga, Eiko Saito, Masaru Nakano, Maria Carla Tablante, Shojiroh Morinaga, Toshifumi Hibi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down. Computed tomography revealed marked thickening of the ileal wall, and capsule endoscopy and balloon-assisted enteroscopy found diffuse mucosal inflammation with ulcers in the ileum. On the contrary, the inflammation in the colon and rectum was improving. Since the response to the second steroid course was inadequate, treatment with adalimumab and 6-mercaptopurine was initiated and finally achieved clinical and endoscopic remission. The investigation of small intestinal lesions is necessary in patients with UC whose clinical deterioration cannot be explained by colonic lesions.

Original languageEnglish
Pages (from-to)535-539
Number of pages5
JournalIntestinal Research
Issue number4
Publication statusPublished - 2017
Externally publishedYes


  • Balloon-assisted enteroscopy
  • Capsule endoscopy
  • Enteritis
  • Inflammatory bowel disease
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology


Dive into the research topics of 'Steroid-refractory extensive enteritis complicated by ulcerative colitis successfully treated with adalimumab'. Together they form a unique fingerprint.

Cite this