Rescue Therapy with Tacrolimus for a Patient with Severe Ulcerative Colitis Refractory to Combination Leukocytapheresis and High-Dose Corticosteroid Therapy

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  • Nakase Hiroshi
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Mikami Sakae
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Matsuura Minoru
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Ueno Satoru
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Uza Norimitsu
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Inoue Satoko
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Kitamura Hiroshi
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Kasahara Katsuhiro
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Yoshino Takuya
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Takeda Yasuhiro
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University
  • Chiba Tsutomu
    Department of Gastroenterology & Hepatology, Graduate School of Medicine, Kyoto University

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Description

A19-year-old man complaining of severe diarrhea and hematochezia was admitted to our hospital. Endoscopic findings and laboratory data revealed that he had ulcerative colitis (UC). Despite combination therapy with high-dose corticosteroids and intensive granulocytapheresis, his condition did not improve. Therefore, we initiated tacrolimus therapy. Intravenous administration of tacrolimus with a trough level of 10 to 15 ng/ml relieved his abdominal symptoms within 1 week. The patient experienced no UC relapse 1 year after treatment with oral tacrolimus. Tacrolimus is a promising therapy for patients with UC refractory to the combination of high-dose corticosteroids and leukocytapheresis.<br>

Journal

  • Internal Medicine

    Internal Medicine 46 (11), 717-720, 2007

    The Japanese Society of Internal Medicine

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