Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2017; 23(48): 8660-8665
Published online Dec 28, 2017. doi: 10.3748/wjg.v23.i48.8660
Stricturing Crohn’s disease-like colitis in a patient treated with belatacept
Anne Bozon, Guillaume Jeantet, Benjamin Rivière, Natalie Funakoshi, Gaspard Dufour, Roman Combes, Jean-Christophe Valats, Sylvie Delmas, Jean Emmanuel Serre, Michael Bismuth, Jeanne Ramos, Moglie Le Quintrec, Pierre Blanc, Guillaume Pineton de Chambrun
Anne Bozon, Natalie Funakoshi, Gaspard Dufour, Roman Combes, Jean-Christophe Valats, Michael Bismuth, Pierre Blanc, Guillaume Pineton de Chambrun, Gastroenterology Department, Saint-Eloi Hospital, Montpellier University Hospital, Montpellier 34000, France
Guillaume Jeantet, Sylvie Delmas, Jean Emmanuel Serre, Moglie Le Quintrec, Nephrology Department, Lapeyronie Hospital, Montpellier University Hospital, Montpellier 34000, France
Benjamin Rivière, Jeanne Ramos, Pathology Department, Guy de Chauliac Hospital, Montpellier University Hospital, Montpellier 34000, France
Author contributions: Bozon A, Jeantet G, Rivière B, Dufour G, Combes R, Valats JC, Bismuth M, Le Quintrec M, Blanc P, and Pineton de Chambrun G searched literature and designed study; Bozon A, Jeantet G, Dufour G, Combes R, Delmas S, Serre JE, and Pineton de Chambrun G collection data; Bozon A, Jeantet G, Rivière B, Ramos J, Le Quintrec M, and Pineton de Chambrun G analysis data and interpretation; Bozon A, Jeantet G, Rivière B, Ramos J, and Pineton de Chambrun G Writing and figures; Rivière B, Funakoshi N, Dufour G, Combes R, Valats JC, Delmas S, Serre JE, Bismuth M, and Ramos J, Le Quintrec M, Blanc P critical review of the manuscript.
Informed consent statement: All study participants provided informed consent prior to study enrolment.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guillaume Pineton de Chambrun, MD, PhD, Assistant Professor, Department of Gastroenterology, Saint-Eloi Hospital, Montpellier University Hospital, 80 avenue Augustin Fliche, Montpellier 34000, France. gpinetondechambrun@yahoo.fr
Telephone: +33-467-337397 Fax: +33-467-337694
Received: July 28, 2017
Peer-review started: July 28, 2017
First decision: August 30, 2017
Revised: September 15, 2017
Accepted: October 17, 2017
Article in press: October 17, 2017
Published online: December 28, 2017
Processing time: 152 Days and 2.9 Hours
Abstract

Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) modifying agents have been involved in the development of intestinal inflammation, especially therapeutic monoclonal antibodies directed against CTLA-4. Here we report the appearance of a severe stricturing Crohn’s disease-like colitis in a patient with a kidney allograft who was treated with belatacept, a recombinant CTLA-4-Ig fusion protein.

Keywords: Crohn’s disease; Colitis; Belatacept; HHV-6; Inflammatory bowel disease

Core tip: Belatacept is a cytotoxic T-lymphocyte-associated antigen 4 Ig fusion protein used for kidney transplant rejection prophylaxis. We report the appearance of a severe stricturing Crohn’s disease-like colitis in a patient who was treated with belatacept. After belatacept withdrawal, complete mucosal healing was observed with the persistence of a non-ulcerated left-sided colonic stricture which did not allow passage of the colonoscope. So, in patients treated with belatacept who develop digestive symptoms such as diarrhea or intestinal bleeding, we recommend performing early colonoscopy and considering belatacept withdrawal in case of suggestive endoscopic and histologic findings in order to avoid colonic sequela.