Rescue therapy with tacrolimus for a patient with severe ulcerative colitis refractory to combination leukocytapheresis and high-dose corticosteroid therapy.
A19-year-old man complaining of severe diarrhea and hematochezia was admitted to our hospital. Endoscopic findings and laboratory data revealed that he had ulcerative colitis (UC). Despite combination therapy with high-dose corticosteroids and intensive granulocytapheresis, his condition did not improve. Therefore, we initiated tacrolimus therapy. Intravenous administration of tacrolimus with a trough level of 10 to 15 ng/ml relieved his abdominal symptoms within 1 week. The patient experienced no UC relapse 1 year after treatment with oral tacrolimus. Tacrolimus is a promising therapy for patients with UC refractory to the combination of high-dose corticosteroids and leukocytapheresis.
Nakase
Hiroshi
H
Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University. hiropy@kuhp.kyoto-u.ac.j
Mikami
Sakae
S
Matsuura
Minoru
M
Ueno
Satoru
S
Uza
Norimitsu
N
Inoue
Satoko
S
Kitamura
Hiroshi
H
Kasahara
Katsuhiro
K
Yoshino
Takuya
T
Takeda
Yasuhiro
Y
Chiba
Tsutomu
T
D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007937:Leukapheresis / Q000379:methods; D008297:Male; D016879:Salvage Therapy / Q000379:methods; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D016559:Tacrolimus