Colitis ulcerosa

溃疡性结肠炎
  • 文章类型: Journal Article
    背景:托法替尼适用于中度至重度溃疡性结肠炎(UC)患者;然而,鉴于其快速起效,对于住院的严重急性UC患者,它可能是另一种选择.文献中关于这种指示的数据很少。本研究的目的是描述托法替尼在治疗住院UC患者中的疗效和安全性。以及其临床特点和其他治疗模式。
    方法:2019年6月至2022年12月在哥伦比亚对接受托法替尼治疗的CUAG成人和儿童进行描述性观察研究。收集社会人口统计学和临床变量,评估不同时间段的治疗反应,并对定量和定性变量进行描述性分析.
    结果:6名患者(5名成人和1名儿童),平均年龄33.2(标准差8.5)岁,CUAG。在托法替尼开始后第7天,100%的患者获得了症状缓解。在三名患者中,获得了超过6个月的信息,100%临床,生物化学,和内窥镜缓解,不需要结肠切除术。在儿科患者的情况下,开始托法替尼后一周症状缓解,留在临床上,生化和内镜缓解超过6个月。在任何情况下均未报告严重不良事件。
    结论:Tofacitinib代表了CUAG的抢救治疗替代方案,具有快速的临床反应,足够的耐受性和较少的结肠切除术的需要,持续超过6个月。
    BACKGROUND: Tofacitinib is indicated in patients with moderate to severe ulcerative colitis (UC); however, given its rapid onset of action, it may constitute an alternative in patients with hospitalized severe acute UC. There are few data on this indication in the literature. The aim of this study was to describe the efficacy and safety of tofacitinib in the management of patients with hospitalized UC, as well as its clinical characteristics and other treatment patterns.
    METHODS: Descriptive observational study of adults and children with CUAG treated with tofacitinib between June 2019 and December 2022 in Colombia. Sociodemographic and clinical variables were collected, therapeutic response was evaluated in different periods of time and descriptive analysis of quantitative and qualitative variables was performed.
    RESULTS: Six patients (five adults and one pediatric), mean age 33.2 (SD: 8.5) years, with CUAG. Symptom remission was obtained in 100% of patients at day 7 after tofacitinib initiation. In three patients information was obtained beyond 6 months, with 100% clinical, biochemical, and endoscopic remission and without requiring colectomy. In the case of the pediatric patient, symptom remission was achieved one week after starting tofacitinib, remaining in clinical, biochemical and endoscopic remission beyond 6 months. No serious adverse events were reported in any of the cases.
    CONCLUSIONS: Tofacitinib represents a rescue therapeutic alternative in CUAG, with rapid clinical response, adequate tolerance and less need for colectomy, being sustained for periods beyond 6 months.
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  • 文章类型: Journal Article
    利什曼原虫感染。在诊断为炎症性肠病(IBD)的患者中很少见。被认为是地中海盆地的地方病,其表现几乎不包括细胞免疫受损的患者。大多数证据是通过病例报告发现的;没有IBD患者的治疗指南。在这项研究中,我们介绍了三例IBD患者的利什曼原虫感染病例,这使我们对当前文献进行了回顾。免疫抑制治疗有助于这种感染,非典型地呈现,具有挑战性的诊断。最初的全身治疗与停用免疫抑制剂药物似乎是最好的治疗策略。需要在流行地区进行研究,以确定其在IBD患者中的发病率,以及它可能与免疫抑制治疗有关。可能建议在引入免疫抑制药物之前需要进行血清学筛查。
    Infection by Leishmania spp. in patients diagnosed with inflammatory bowel disease (IBD) is rare. Considered endemic in the Mediterranean basin, its manifestations are almost exclusive of patients with impaired cellular immunity. Most of the evidence is found through case reports; without guidelines for its management in patients with IBD. In this study we present three cases of Leishmania infection in patients with IBD that lead us to carry out a review of the current literature. Immunosuppressive treatment contributes to this infection, which presents atypically, with a challenging diagnosis. Initial systemic treatment with withdrawal of the immunosuppressant drug seems to be the best therapeutic strategy. Studies are needed in endemic areas to determine its incidence in IBD patients, as well as its possible association with immunosuppressive therapy. The need for serological screening prior introduction of immunosuppressive drugs could be suggested.
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  • 文章类型: Journal Article
    The aim of the presented research was to analyze the nutritional status of male subjects with ulcerative colitis in remission by using body composition that was assessed by bioelectrical impedance measurement against a gender-matched control group. Forty-four male patients in remission with ulcerative colitis were recruited for the case-control study and simultaneously, a matched control group of 44 male individuals without inflammatory bowel diseases was pair-matched (general community individuals). The body composition measurement was conducted by the bioelectrical impedance method using BodyComp MF Plus and Bodygram Pro 3.0 software. Parameters assessed include body cell mass (BCM), total body water (TBW), extracellular body water (EBW), intracellular body water (IBW), fat mass (FM), fat-free mass (FFM), muscle mass (MM), and the body cell mass (BCM) index. A significant between-group difference was observed only for EBW, where subjects with ulcerative colitis were characterized by a higher mass of extracellular water (p = 0.0405). Individuals with ulcerative colitis were characterized by a lower BCM share than the control group (p = 0.0192). A comparative analysis of the body composition of male patients with ulcerative colitis with those who did not have ulcerative colitis revealed only minor differences. The risk of malnutrition, assessed using both BMI and bioelectrical impedance, in men with ulcerative colitis in remission is the same as in healthy males in the matched general population.
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