title: Infliximab induces remission in cryptogenic multifocal ulcerous stenosing enteritis: first case.
abstract: We present the case of a 29-year-old patient with a history of abdominal pain and vomiting. Based on wireless video capsule findings he was previously diagnosed with ileal Crohn's disease at a different institution, although the clinical and radiological picture was not typical and the response to corticosteroids was poor. We performed a single-balloon enteroscopy showing a short, ulcerous stenosis 50 cm proximal from Bauhin's valve. The endoscopic and clinical histopathological findings were compatible with cryptogenic multifocal ulcerous stenosing enteritis (CMUSE). High dose corticosteroids were again started, without effect. The monoclonal tumor necrosis factor-α (TNF-α) antibody infliximab was added to the medical therapy. After induction therapy, both clinical and endoscopic amelioration was obtained. Larger case studies are needed to confirm the efficacy of TNF-α inhibition in steroid refractory CMUSE.
authors.affiliation: Department of Gastroenterology and Hepatology, Antwerp University Hospital, B-2650 Edegem-Antwerp, Belgium. heiko.de.schepper@uza.be
authors.forename: Heiko
authors.initials: H
authors.lastname: De Schepper
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Macken
authors.forename: Veerle
authors.initials: V
authors.lastname: Van Marck
authors.forename: Maarten
authors.initials: M
authors.lastname: Spinhoven
authors.forename: Paul
authors.initials: P
authors.lastname: Pelckmans
authors.forename: Tom
authors.initials: T
authors.lastname: Moreels
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D053704:Capsule Endoscopy; D003251:Constriction, Pathologic; D003424:Crohn Disease / Q000175:diagnosis; D003951:Diagnostic Errors; D057915:Drug Substitution; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007079:Ileitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D000069285:Infliximab; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D011237:Predictive Value of Tests; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014456:Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab
keywords: Cryptogenic multifocal ulcerous stenosing enteritis; Inflammatory bowel disease; Infliximab; Intestinal ulceration; Stenosis
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