Year 2021 / Volume 113 / Number 3
Original
Ustekinumab treatment for toxic megacolon in severe colonic Crohn’s disease

189-192

DOI: 10.17235/reed.2020.7228/2020

Martín Irabien, Paz Arreba, Jone Ortiz de Zárate, Nerea Hernández-Aretxabaleta, Saioa de la Maza-Ortiz, Nahia Ispizua-Madariaga, Carmen Muñoz-Villafranca,

Abstract
Toxic megacolon is most commonly considered as a complication of inflammatory bowel disease, especially ulcerative colitis and colonic Crohn’s disease to a lesser extent. It appears in the context of moderate-to-severe disease and often requires colectomy. Currently, after an inadequate response to conventional therapy with systemic corticosteroids, the use of cyclosporine or infliximab is considered as an alternative option, prior to surgical intervention. We present a case report of toxic megacolon in a patient with a severe refractory colonic Crohn’s disease, where anti-tumor necrosis factor (anti-TNF) therapies were contraindicated. Consequently, we decided to use ustekinumab as a rescue therapy, despite insufficient evidence to provide recommendations for this indication.
Share Button
New comment
Comments
No comments for this article
References
1. Sheth SG, LaMont JT. Toxic megacolon. Lancet 1998;351(9101):509-13.
2. Jalan KN, Circus W, Cord WI. An experience of ulcerative colitis: Toxic dilation in 55 cases. Gastroenterology 1969; 57:68-82.
3. Present DH, Wolfson D, Gelernt IM, et al: Medical decompression of toxic megacolon by "rolling". A new technique of decompression with favorable long-term follow-up. J Clin Gastroenterol 1988;10:485-90.
4. Römkens THE, Bulte GJ, Nissen LHC, Drenth JPH. Cytomegalovirus in inflammatory bowel disease: A systematic review. World J Gastroenterol 2016;22(3):1321-30.
5. Gan SI, Beck PL. A new look at toxic megacolon: An update, and review of incidence, etiology, pathogenesis and management. Am J Gastroenterol 2003;98:2363-71.
6. Panos MZ, Wood MJ, Asquith P. Toxic megacolon: the knee-elbow position relieves bowel distension. Gut 1993;34:1726.
7. Katzka I, Katz S, Morris E. Management of toxic megacolon: the significance of early recognition in medical management. J Clin Gastroenterol 1979;1(4):307–11.
8. Flatmark A, Fretheim B, Gjone E. Early colectomy in severe ulcerative colitis. Scand J Gastroenterol 1975;10(4):427-31.
9. D’Amico C, Vitale A, Angriman I, et al. Early surgery for the treatment of toxic megacolon. Digestion 2005;72(2-3):146–9.
10. Bemelman WA, et al. ECCO-ESCP Consensus on Surgery for Crohn’s Disease. Journal of Crohn's and Colitis 2018;1–16.
11. Laharie D, Bourreille A, Branche J, Allez M, Bouhnik Y, Filippi J, et al. Groupe d’Etudes Thérapeutiques des Affections Inflammatoires Digestives. Cyclosporin versus infliximab in patients with severe ulcerative colitis refractory to intravenous steroids: a parallel, open-label randomised controlled trial. Lancet 2012;380:1909-15.
12. Núñez-Ortiz A, Trigo-Salado C, Cruz-Ramírez MD, Márquez-Galán JL, Herrera-Justiniano JM, Leo-Carnerero E. Megacolon en la enfermedad inflamatoria intestinal: respuesta a infliximab. Rev Esp Enferm Dig 2020;112(2):90-3.
13. Van Geenen EJ, Sachar DB. Infliximab in Crohn’s disease-associated toxic megacolon. J Clin Gastroenterol 2012;46(4):321-3.
Related articles

Letter

Duodenal stenosis surgical treatment in Crohn’s disease

DOI: 10.17235/reed.2023.9521/2023

Digestive Diseases Image

Peristomal cutaneous Crohn's disease by contiguity

DOI: 10.17235/reed.2022.8909/2022

Letter

Experience with ustekinumab in reservoir Crohn's disease

DOI: 10.17235/reed.2021.8457/2021

Letter

Anal neoplasia and perianal Crohn’s disease: myth or reality?

DOI: 10.17235/reed.2021.8317/2021

Letter

Crohn’s disease in patients treated with etanercept

DOI: 10.17235/reed.2019.6554/2019

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Letter to the Editor

Adnexal localization of Crohn’s disease and recurrent massive ovary cysts

DOI: 10.17235/reed.2016.4301/2016

Case Report

Metastatic Crohn’s disease in pediatrics

DOI: 10.17235/reed.2016.3948/2015

Letter to the Editor

Crohn’s disease and Sweet’s syndrome: A debut together

DOI: 10.17235/reed.2015.3842/2015

Case Report

Ovarian involvement in Crohn´s disease: A rare complication

DOI: 10.17235/reed.2015.3764/2015

Citation tools
Irabien M, Arreba P, Ortiz de Zárate J, Hernández-Aretxabaleta N, de la Maza-Ortiz S, Ispizua-Madariaga N, et all. Ustekinumab treatment for toxic megacolon in severe colonic Crohn’s disease. 7228/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 473 visits.
This article has been downloaded 264 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 05/05/2020

Accepted: 06/08/2020

Online First: 27/11/2020

Published: 08/03/2021

Article revision time: 89 days

Article Online First time: 206 days

Article editing time: 307 days


Share
This article has been rated by 3 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology