Rescue therapy with tacrolimus in a patient with toxic megacolon.
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.
Pascu
Maria
M
Division of Hepatology and Gastroenterology, Department of Internal Medicine, Campus Virchow, Charité Medical School, Augustenburger Platz 1, 13353 Berlin, Germany.
Müller
Andrea R
AR
Wiedenmann
Bertram
B
Dignass
Axel U
AU
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*
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D016559:Tacrolimus