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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 PDFRecent 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.
View Article and Find Full Text PDFCorticosteroids combined with infliximab vs. corticosteroids sequential infliximab for acute severe ulcerative colitis with mucosal deficiency: a retrospective study.
Front Med (Lausanne)
November 2024
State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Military Medical University, Xi'an, China.
Article Synopsis
- Mucosal deficiency in patients with acute severe ulcerative colitis (ASUC) poses significant treatment challenges, traditionally managed with intravenous corticosteroids and rescue therapy using infliximab.
- A retrospective study involving 43 patients found that combining corticosteroids with infliximab resulted in higher endoscopic improvement and durable clinical remission rates compared to a sequential treatment approach.
- The combination therapy was identified as a strong predictor of better outcomes, suggesting it may be a more effective first-line treatment for those with ASUC and mucosal deficiency, warranting further large-scale studies.
An Update on Kawasaki Disease.
Curr Rheumatol Rep
December 2024
Division of Rheumatology, Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Purpose: To summarize advances in research on the epidemiology, pathogenesis, diagnosis, and treatment of Kawasaki Disease (KD), a systemic inflammatory illness of unknown etiology that affects children globally.
Recent Findings: The epidemiology of KD was affected by the COVID-19 pandemic and advances in molecular immunology and machine learning have enabled research into its pathogenesis. There is ongoing research into agents that can be used to intensify initial treatment and accumulating evidence supporting the use of certain rescue regimens for refractory disease over others.
Clinical profile and short-term outcomes of acute severe ulcerative colitis in Vietnam: insights from a resource-limited setting.
Eur Rev Med Pharmacol Sci
October 2024
Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Article Synopsis
- Acute severe ulcerative colitis (ASUC) affects about 25% of ulcerative colitis patients and carries risks of colectomy and higher mortality rates; steroid treatment works for only 67% of patients, indicating a need for alternative therapies, particularly in the Vietnamese context where data is limited.
- In a study conducted with 17 patients at a Ho Chi Minh City hospital from January 2021 to June 2023, most participants were middle-aged males, and over half had a prior ulcerative colitis diagnosis; steroid treatment had a 64.7% success rate, with some needing alternative medications like infliximab or tofacitinib.
- The findings suggest corticosteroids are effective for initial ASUC treatment,
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