Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2021; 9(13): 3219-3226
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3219
Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3219
Treatment of acute severe ulcerative colitis using accelerated infliximab regimen based on infliximab trough level: A case report
Ana Lorena Sousa de Vasconcelos Garate, Thiara Barcelos Rocha, Luciana Rocha Almeida, Jaqueline Ribeiro Barros, Julio Pinheiro Baima, Rogerio Saad-Hossne, Ligia Yukie Sassaki, Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Botucatu 18618687, São Paulo, Brazil
Rodrigo Quera, Inflammatory Bowel Disease Program, Gastroenterology, Medicine Department, Clínica Universidad de los Andes, Santiago 7550000, Chile
Author contributions: All authors contributed to this manuscript; Garate ALSV, Rocha TB, Almeida LR, Barros JR, Baima JP, Saad-Hossne R and Sassaki LY contributed to the conception and design of the study, acquisition, analysis and interpretation of data, drafting the article, revising it critically for important intellectual content, and final approval of the version to be submitted; Quera R contributed to the analysis and interpretation of data, revising it critically for important intellectual content, and final approval of the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors state that they have no conflicts of interest regarding this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Ligia Yukie Sassaki, MD, PhD, Academic Research, Assistant Professor, Department of Internal Medicine, São Paulo State University (Unesp), Medical School, Av. Professor Mário Rubens Guimarães Montenegro, s/n, Botucatu 18618687, São Paulo, Brazil. ligia.sassaki@unesp.br
Received: January 9, 2021
Peer-review started: January 9, 2021
First decision: January 24, 2021
Revised: February 4, 2021
Accepted: March 9, 2021
Article in press: March 9, 2021
Published online: May 6, 2021
Processing time: 102 Days and 22.7 Hours
Peer-review started: January 9, 2021
First decision: January 24, 2021
Revised: February 4, 2021
Accepted: March 9, 2021
Article in press: March 9, 2021
Published online: May 6, 2021
Processing time: 102 Days and 22.7 Hours
Core Tip
Core Tip: Acute severe ulcerative colitis (ASUC) is associated with high circulating levels of tumor necrosis factor-alpha, due to intense inflammation and faster stool clearance of the anti-tumor necrosis factor drug. Consequently, these patients may need higher doses or more frequent administrations of infliximab. A young patient with a recent diagnosis of ulcerative colitis presenting with ASUC associated with megacolon, was successfully treated with intravenous corticosteroids and an accelerated infliximab regimen, based on the serum levels of the medication. Despite the favorable outcome in the case reported, longitudinal studies are necessary to define the best therapeutic drug monitoring and treatment regimen for these patients.