背景:肠道狭窄和梗阻是溃疡性结肠炎(UC)的罕见并发症。目前,关于治疗UC合并肠狭窄的研究很少,然而,尚无关于ustekinumab(UST)治疗UC合并良性肠狭窄的报道.
方法:我院收治一名22岁女性,因3年反复出现便血黏液,过去一个月出现间歇性腹痛和腹胀。她是类固醇依赖性的,并且对英夫利昔单抗产生了继发性反应丧失。
方法:诊断为UC合并狭窄所致不完全性肠梗阻。狭窄具有炎症和纤维化成分的混合模式,前者覆盖了肠道的较大部分。
方法:患者接受UST治疗56周。
结果:患者经UST治疗后症状消退。溃疡愈合了,狭窄减少。
结论:UST对合并良性肠狭窄的UC有效。认为UST抑制转化生长因子-β和白细胞介素-17的产生,导致肌成纤维细胞增殖的抑制,最终缓解肠狭窄。
BACKGROUND: Intestinal stricture and obstruction are rare complications of ulcerative colitis (UC). Currently, there are only a few studies on the treatment of UC with intestinal stenosis, however there are no
reports on the treatment of UC with benign intestinal stenosis with ustekinumab (UST).
METHODS: A 22-year-old woman was admitted to our hospital due to a 3-year history of recurrent bloody mucous in stool with intermittent abdominal pain and distension developed in the past month. She was steroid-dependent and had developed a secondary loss of response to infliximab.
METHODS: She was diagnosed with UC combined with incomplete intestinal obstruction due to stenosis. The stricture had a mixed pattern with both inflammatory and fibrotic components, with the former covering a larger section of the intestine.
METHODS: The patient was given UST for 56 weeks.
RESULTS: The patient\'s symptoms subsided after treatment with UST. The ulcers healed, and the stenosis was reduced.
CONCLUSIONS: UST is effective against UC with benign intestinal stenosis. It is thought that UST inhibits the production of transforming growth factor-β and interleukin-17, leading to the suppression of myofibroblast proliferation, ultimately alleviating intestinal stenosis.