Case Report
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World J Gastroenterol. Mar 14, 2013; 19(10): 1661-1664
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1661
Infliximab induces remission in cryptogenic multifocal ulcerous stenosing enteritis: First case
Heiko De Schepper, Elisabeth Macken, Veerle Van Marck, Maarten Spinhoven, Paul Pelckmans, Tom Moreels
Heiko De Schepper, Elisabeth Macken, Paul Pelckmans, Tom Moreels, Department of Gastroenterology and Hepatology, Antwerp University Hospital, B-2650 Edegem-Antwerp, Belgium
Veerle Van Marck, Department of Pathology, Antwerp University Hospital, B-2650 Edegem-Antwerp, Belgium
Maarten Spinhoven, Department of Radiology, Antwerp University Hospital, B-2650 Edegem-Antwerp, Belgium
Author contributions: All authors contributed equally to this case report; all authors have read and approved the final manuscript.
Correspondence to: Heiko De Schepper, MD, Department of Gastroenterology and Hepatology, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem-Antwerp, Belgium. heiko.de.schepper@uza.be
Telephone: +32-3-8215585 Fax: + 32-3-8214478
Received: November 13, 2012
Revised: November 26, 2012
Accepted: December 22, 2012
Published online: March 14, 2013
Processing time: 121 Days and 13 Hours
Abstract

We present the case of a 29-year-old patient with a history of abdominal pain and vomiting. Based on wireless video capsule findings he was previously diagnosed with ileal Crohn’s disease at a different institution, although the clinical and radiological picture was not typical and the response to corticosteroids was poor. We performed a single-balloon enteroscopy showing a short, ulcerous stenosis 50 cm proximal from Bauhin’s valve. The endoscopic and clinical histopathological findings were compatible with cryptogenic multifocal ulcerous stenosing enteritis (CMUSE). High dose corticosteroids were again started, without effect. The monoclonal tumor necrosis factor-α (TNF-α) antibody infliximab was added to the medical therapy. After induction therapy, both clinical and endoscopic amelioration was obtained. Larger case studies are needed to confirm the efficacy of TNF-α inhibition in steroid refractory CMUSE.

Keywords: Cryptogenic multifocal ulcerous stenosing enteritis; Infliximab; Stenosis; Intestinal ulceration; Inflammatory bowel disease