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Acute severe ulcerative colitis (ASUC) in pregnancy poses a clinical challenge with significant risk to both mother and fetus. Anti-TNF alpha therapy is known to be safe in pregnancy, however, data surrounding outcomes in ASUC is limited. In this report, we present the case of a pregnant patient of 10 weeks' gestation with ASUC successfully managed with intensified and accelerated infliximab therapy for a total dose of 35 mg/kg during a single admission.
View Article and Find Full Text PDFFuture of Acute Severe Ulcerative Colitis-A Narrative Review.
J Clin Med
December 2024
Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Melbourne 3052, Australia.
While corticosteroids have led to significant reduction in ASUC mortality over the last few decades, they are associated with significant side effects and up to 30% of patients have steroid refractory ASUC, which means we require safer and better therapies for patients with ASUC. Several salvage therapies have been proposed in guidelines; however, we lack high quality head-to-head randomised controlled trials to assess effectiveness and safety of these agents. Furthermore, the role of newer novel agents in ASUC management is unclear.
View Article and Find Full Text PDFPrior Anti-TNF Exposure Is Associated with an Increased Risk of Short- and Long-Term Colectomy in Acute Severe Ulcerative Colitis.
Dig Dis Sci
January 2025
The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Background: Acute severe ulcerative colitis (ASUC) affects up to 25% of patients with UC and is associated with an increased risk of colectomy. Despite improvements in medical management, individual patient prognostication and risk stratification in ASUC remains challenging. We explored clinical, biochemical, and endoscopic factors as potential predictors for colectomy in patients hospitalized with ASUC.
View Article and Find Full Text PDFAtypical Kawasaki disease with giant coronary artery aneurysms in a 2-month-old boy: a case report.
J Med Case Rep
December 2024
Department of Pediatrics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Article Synopsis
- - The case involves a 2-month-old Iranian boy who developed persistent fever after receiving a 5-in-1 vaccine, leading to a diagnosis of atypical Kawasaki disease, which is rare in infants.
- - Initial tests showed abnormal blood counts and echoed results revealed giant coronary artery aneurysms, highlighting serious complications related to the disease.
- - The case stresses the importance of timely diagnosis and treatment for Kawasaki disease in infants, emphasizing healthcare providers' need to recognize it in similar situations to prevent severe health outcomes.
Recent Advances in the Management of Acute Severe Ulcerative Colitis.
J Clin Med
December 2024
Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, St James University Hospital, Bexley Wing, Beckett Street, Leeds LS9 7TF, UK.
Acute severe ulcerative colitis is a medical emergency requiring inpatient treatment with intravenous steroids. Approximately one-third of patients do not respond to steroids sufficiently and require medical rescue therapy. Infliximab and cyclosporine are equally effective rescue agents, though infliximab is often preferred by clinicians for ease of use and greater familiarity.
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