Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report
Abstract Background Opportunistic infections associated with immunosuppressive treatments for inflammatory bowel disease pose an important safety concern. Here we report the case of a patient with active ulcerative colitis and cryptococcal pneumonia who was treated with vedolizumab combined with flu...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-023-03940-y |
| _version_ | 1797811477683372032 |
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| author | Yusuke Oki Sho Nagano Yoichi Ishikawa Takayoshi Yamada Toshiki Ichimori Kazushige Uchida |
| author_facet | Yusuke Oki Sho Nagano Yoichi Ishikawa Takayoshi Yamada Toshiki Ichimori Kazushige Uchida |
| author_sort | Yusuke Oki |
| collection | DOAJ |
| description | Abstract Background Opportunistic infections associated with immunosuppressive treatments for inflammatory bowel disease pose an important safety concern. Here we report the case of a patient with active ulcerative colitis and cryptococcal pneumonia who was treated with vedolizumab combined with fluconazole. Case presentation A 56-year-old Japanese man with ulcerative colitis and a history of Sweet’s syndrome who was taking prednisolone and azathioprine presented with a moderate exacerbation of ulcerative colitis, abdominal pain, diarrhea, and bloody stools along with cytomegalovirus infection. Increasing the prednisolone dose without using antiviral drugs improved cytomegalovirus infection; however, ulcerative colitis did not improve, and cryptococcal pneumonia occurred. Thus, treatment with fluconazole followed by vedolizumab was initiated for ulcerative colitis. The patient gradually recovered and achieved clinical remission without the exacerbation of pneumonia. Conclusions We reported the first case of a patient with ulcerative colitis who was treated with vedolizumab and concomitant fluconazole for active cryptococcal pneumonia. Vedolizumab constitutes a high-potential treatment regimen owing to its safety in inflammatory bowel disease associated with opportunistic infections. |
| first_indexed | 2024-03-13T07:24:08Z |
| format | Article |
| id | doaj.art-3ebd704fb2b449ae9ef7cb0fbcf5d508 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-13T07:24:08Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-3ebd704fb2b449ae9ef7cb0fbcf5d5082023-06-04T11:29:49ZengBMCJournal of Medical Case Reports1752-19472023-05-011711710.1186/s13256-023-03940-yUlcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case reportYusuke Oki0Sho Nagano1Yoichi Ishikawa2Takayoshi Yamada3Toshiki Ichimori4Kazushige Uchida5Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi UniversityDepartment of Gastroenterology, Kochi Health Sciences CenterDepartment of Gastroenterology and Hepatology, Kochi Medical School, Kochi UniversityDepartment of Gastroenterology and Hepatology, Kochi Medical School, Kochi UniversityDepartment of Internal Medicine, Susakikuroshio HospitalDepartment of Gastroenterology and Hepatology, Kochi Medical School, Kochi UniversityAbstract Background Opportunistic infections associated with immunosuppressive treatments for inflammatory bowel disease pose an important safety concern. Here we report the case of a patient with active ulcerative colitis and cryptococcal pneumonia who was treated with vedolizumab combined with fluconazole. Case presentation A 56-year-old Japanese man with ulcerative colitis and a history of Sweet’s syndrome who was taking prednisolone and azathioprine presented with a moderate exacerbation of ulcerative colitis, abdominal pain, diarrhea, and bloody stools along with cytomegalovirus infection. Increasing the prednisolone dose without using antiviral drugs improved cytomegalovirus infection; however, ulcerative colitis did not improve, and cryptococcal pneumonia occurred. Thus, treatment with fluconazole followed by vedolizumab was initiated for ulcerative colitis. The patient gradually recovered and achieved clinical remission without the exacerbation of pneumonia. Conclusions We reported the first case of a patient with ulcerative colitis who was treated with vedolizumab and concomitant fluconazole for active cryptococcal pneumonia. Vedolizumab constitutes a high-potential treatment regimen owing to its safety in inflammatory bowel disease associated with opportunistic infections.https://doi.org/10.1186/s13256-023-03940-yUlcerative colitisVedolizumabOpportunistic infectionCryptococcal pneumoniaCytomegalovirus |
| spellingShingle | Yusuke Oki Sho Nagano Yoichi Ishikawa Takayoshi Yamada Toshiki Ichimori Kazushige Uchida Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report Journal of Medical Case Reports Ulcerative colitis Vedolizumab Opportunistic infection Cryptococcal pneumonia Cytomegalovirus |
| title | Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report |
| title_full | Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report |
| title_fullStr | Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report |
| title_full_unstemmed | Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report |
| title_short | Ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections: a case report |
| title_sort | ulcerative colitis successfully treated with vedolizumab in the presence of comorbid opportunistic infections a case report |
| topic | Ulcerative colitis Vedolizumab Opportunistic infection Cryptococcal pneumonia Cytomegalovirus |
| url | https://doi.org/10.1186/s13256-023-03940-y |
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