Maintenance treatment with infliximab for ulcerative ileitis after intestinal transplantation: A case report

Takumi Fujimura, Yohei Yamada, Tomoshige Umeyama, Yumi Kudo, Hiroki Kanamori, Teizaburo Mori, Takahiro Shimizu, Mototoshi Kato, Naoki Shimojima, Ken Hoshino, Tatsuo Kuroda, Miho Kawaida, Naoki Hosoe, Yasushi Hasegawa, Kentaro Matsubara, Masahiro Shinoda, Hideaki Obara, Yuko Kitagawa, Masahiro Shinoda, Makoto Naganuma

研究成果: Article査読

抄録

BACKGROUND Evidence has been published on the successful applications of the anti-tumor necrosis factor alpha antibody infliximab, such as induction therapy, salvage treatment for acute cellular rejection, and treatment for chronic ulcerative inflammation, in intestinal transplant recipients. However, the optimal protocol for the effective use of infliximab remains largely undetermined due to scarcity of available clinical data. We report a continuative application of infliximab as maintenance therapy for recurrent chronic ulcerative ileitis in a recipient of isolated intestinal transplantation (ITx). CASE SUMMARY The patient was a 11-year-old boy with intestinal motility disorder classified as a hypogenic type of intestinal dysganglionosis. The patient underwent living-donor related intestinal transplant. His immunosuppression regimen consisted of daclizumab, tacrolimus, and steroids. Although he did not show rejection while on tacrolimus monotherapy, routine screening endoscopy showed several ulcerative lesions in the distal end of the graft 2 years after the intestinal transplant. Endoscopic work up to evaluate the progression of anemia revealed stenosis with ulcerative inflammatory changes and multiple longitudinal ulcers in the graft. Since the endoscopic findings suggested ulcerative lesions in Crohn's disease, infliximab treatment was considered. Treatment with infliximab and a small dose of oral prednisolone afforded successful withdrawal of total parenteral nutrition and maintenance of a well-functioning graft without infectious complications for 5 years since the administration of the first dose of infliximab. CONCLUSION Infliximab is effective as maintenance therapy for recurrent chronic ulcerative ileitis in an isolated ITx patient.

本文言語English
ページ(範囲)5270-5279
ページ数10
ジャーナルWorld Journal of Clinical Cases
9
19
DOI
出版ステータスPublished - 2021
外部発表はい

ASJC Scopus subject areas

  • 医学(全般)

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