Combined eosinophilic gastroenteritis and ulcerative colitis successfully treated by vedolizumab: a case report.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY Intestinal Research Pub Date : 2024-08-29 DOI:10.5217/ir.2024.00013

Hironobu Takedomi, Kayoko Fukuda, Suma Inoue, Nanae Tsuruoka, Yasuhisa Sakata, Shigehisa Aoki, Motohiro Esaki

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Abstract

A 47-year-old man with over 10 years' duration of ulcerative colitis treated by 5-aminosalicylic acid and intermittent topical steroids complained of acute epigastric pain. Esophagogastroduodenoscopy revealed diffuse mucosal edema with patchy redness, multiple erosions and nodularity of the stomach. Bioptic examination revealed marked eosinophilic infiltration, confirming the diagnosis of eosinophilic gastroenteritis. Systemic steroid therapy was initiated, whereas his ulcerative colitis and eosinophilia recurred when tapering the steroid. Addition of azathioprine was ineffective, and we subsequently started vedolizumab for eosinophilic gastroenteritis and ulcerative colitis. The medication effectively improved his abdominal symptoms and esophagogastroduodenoscopy and ileocolonoscopy 1 year later revealed endoscopic improvement of both diseases with histologically decreased level of eosinophilic infiltration. Considering that eosinophils also express α4β7 integrins, vedolizumab can be a possible therapeutic candidate for eosinophilic gastroenteritis as well as ulcerative colitis.

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韦多珠单抗成功治疗嗜酸性粒细胞性胃肠炎和溃疡性结肠炎：一份病例报告。

一名 47 岁的男子患有溃疡性结肠炎 10 多年，曾接受 5- 氨基水杨酸和间歇性局部类固醇治疗，主诉急性上腹痛。食管胃十二指肠镜检查发现，胃部有弥漫性粘膜水肿、斑片状发红、多发性糜烂和结节。生物镜检查发现明显的嗜酸性粒细胞浸润，确诊为嗜酸性粒细胞性胃肠炎。他开始接受全身类固醇治疗，但在减少类固醇用量时，溃疡性结肠炎和嗜酸性粒细胞增多症又复发了。后来，我们开始使用维多珠单抗治疗嗜酸性粒细胞性胃肠炎和溃疡性结肠炎。一年后，食管胃十二指肠镜检查和回结肠镜检查显示，这两种疾病在内镜下均有所改善，组织学上的嗜酸性粒细胞浸润水平也有所下降。考虑到嗜酸性粒细胞也表达α4β7整合素，维多珠单抗可能成为嗜酸性粒细胞性胃肠炎和溃疡性结肠炎的候选治疗药物。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.