Pyoderma gangrenosum in an ulcerative colitis patient during treatment with vedolizumab responded favorably to adsorptive granulocyte and monocyte apheresis
| العنوان: | Pyoderma gangrenosum in an ulcerative colitis patient during treatment with vedolizumab responded favorably to adsorptive granulocyte and monocyte apheresis |
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| المؤلفون: | Hirofumi Fukushima, Koki Okahara, Tomoyoshi Shibuya, Michio Saeki, Osamu Nomura, Akihito Nagahara, Hitoshi Tsuchihashi, Mayuko Haraikawa, Keiichi Haga, Dai Ishikawa, Shigaku Ikeda, Takashi Murakami |
| المصدر: | Journal of Clinical Apheresis. 35:488-492 |
| بيانات النشر: | Wiley, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Erythema nodosum, medicine.medical_specialty, business.industry, Hematology, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, Gastroenterology, Inflammatory bowel disease, Ulcerative colitis, Golimumab, Vedolizumab, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Prednisolone, Colitis, business, Pyoderma gangrenosum, 030215 immunology, medicine.drug |
| الوصف: | Pyoderma gangrenosum (PG) is an extra-intestinal skin lesion in inflammatory bowel disease (IBD) as is erythema nodosum. Vedolizumab (VED) is a monoclonal antibody that targets α4β7 integrin and has an intestinal selective mechanism. Despite good therapeutic effects on colitis, the effect on extra-intestinal manifestations (EIMs) remains unclear. Here we report a case of ulcerative colitis complicated by PG during treatment with VED, which was successfully treated with prednisolone in combination with adsorptive granulocyte and monocyte apheresis (GMA). The patient was a 50-year-old woman with a past medical history of extensive ulcerative colitis managed by golimumab (GLM). She developed flare symptoms due to loss of response to GLM, and treatment was switched to VED. Her gastrointestinal symptoms were improved with VED treatment with less frequent bowel movements. However, infiltrative erythema with pain appeared on the right lower leg and right knee, and expanded and gradually ulcerated. Her skin lesions were treated with corticosteroid, but showed poor improvement. Therefore, granulocyte and monocyte apheresis (GMA) treatment was administered in combination with prednisolone. After 3 months, the ulcer gradually improved, and at the time of this writing, the eruptions were nearly replaced by epithelial tissue. This case study showed that patients with UC and EIMS may respond well to combination therapy of VED and GMA. GMA has a very favorable safety profile. On the other hand, the causal connection between VED and PG is still unclear. We believe that a combination therapy involving VED and GMA in IBD patients with EIMs warrants consideration. |
| تدمد: | 1098-1101 0733-2459 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::baf60ad6a9d8efd7395de3c83cf1966e https://doi.org/10.1002/jca.21821 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........baf60ad6a9d8efd7395de3c83cf1966e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10981101 07332459 |
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