Upadacitinib for refractory ulcerative colitis with primary nonresponse to infliximab and vedolizumab: A case report

Figure 1 Colonoscopy on November 26, 2019. A: Continuous mucosal erosions can be seen in the junction of the descending colon and sigmoid colon with more pus attached to the surface; B: Persistent mucosal erosion is observed in the sigmoid colon, covered with more pus.

Figure 2 Colonoscopy on February 17, 2021. A: The wrinkled wall of the sigmoid colon is smooth; B: The folded shape of the lower sigmoid colon is regular and the mucosa was smooth; the submucosal vascular texture is clear. No erosion or ulceration is observed in both images.

Figure 3 Colonoscopy on December 17, 2022. A: The mucosa in the sigmoid colon is extensively hyperaemic and oedematous, scattered with multiple irregular shallow ulcers and patchy erosions; B: The hyperaemia and oedema also can be observed in the junction of descending colon and sigmoid colon; and the submucosal vascular texture has disappeared. All the lesions are distributed throughout the mucosa and are covered with a large number of yellow and white secretions.

Figure 4 Colonoscopy on July 10, 2023. A: The mucousa of the descending colon is rough, and the vascular texture is unclear; B: There are extensive cicatricial changes in the sigmoid colon; scattered mucous hyperaemia is observed between the scars. No obvious erosion and ulcers are observed in both figures.