title: Rescue therapy with tacrolimus in a patient with toxic megacolon.
abstract: BACKGROUND
  Toxic megacolon is a life-threatening complication most commonly observed in patients with ulcerative colitis or Crohn's disease that is characterized by total or segmental nonobstructive colonic dilatation of at least 6 cm on plain abdominal films associated with systemic toxicity.
  
  
  METHODS
  We report an unusual case of fulminant steroid-refractory ulcerative colitis complicated by toxic megacolon treated successfully with the immunosuppressant tacrolimus.
  
  
  CONCLUSIONS
  Tacrolimus administration induced clinical remission and bridged the time interval, until the standard immunosuppressant azathioprine could maintain clinical remission, thereby avoiding eminent emergency colectomy.
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Internal Medicine, Campus Virchow, Charité Medical School, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Pascu
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Müller
authors.forename: Bertram
authors.initials: B
authors.lastname: Wiedenmann
authors.forename: Axel U
authors.initials: AU
authors.lastname: Dignass
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008532:Megacolon, Toxic / Q000188:drug therapy* / Q000209:etiology; D013256:Steroids; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D016559:Tacrolimus