title: Severe diffuse duodenitis successfully treated with intravenous tacrolimus after colectomy for ulcerative colitis.
abstract: We encountered a rare case of severe diffuse duodenitis associated with ulcerative colitis (UC). A 23-year-old man underwent total proctocolectomy with ileal J-pouch anal anastomosis for UC. He suffered from severe abdominal pain, fever and bloody diarrhea for six months after the surgery. Upper double-balloon enteroscopy disclosed severe diffuse duodenitis, of which the findings were endoscopically and histologically similar to those of colonic lesions of UC. Although the administration of prednisolone was ineffective, treatment with intravenous tacrolimus markedly improved the clinical findings. This is the first report of the successful treatment of severe UC-associated diffuse duodenitis with intravenous tacrolimus.
authors.affiliation: Department of Gastroenterology and Nephrology (K1), Graduate School of Medicine, Chiba University, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Saito
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Katsuno
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Shoko
authors.initials: S
authors.lastname: Minemura
authors.forename: Arata
authors.initials: A
authors.lastname: Oyamada
authors.forename: Naoya
authors.initials: N
authors.lastname: Kanogawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Saito
authors.forename: Sayuri
authors.initials: S
authors.lastname: Yoshihama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Maruoka
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Matsumura
authors.forename: Makoto
authors.initials: M
authors.lastname: Arai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tohma
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyauchi
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology / Q000601:surgery; D039021:Colonic Pouches; D058582:Double-Balloon Enteroscopy; D004382:Duodenitis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D016737:Proctocolectomy, Restorative; D016559:Tacrolimus / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus