Maintenance treatment with infliximab for ulcerative ileitis after intestinal transplantation: A case report

Figure 1 Ulcerative lesion in graft before and after administration infliximab. A: The location of the diseases in the graft; B and C: Stenosis with inflammation in the proximal anastomosis between the graft and the original intestine (B, indicated by a white diamond in A), and a longitudinal ulcerative lesion in the distal end of the graft (C, indicated by a black diamond in A); D and E: Mucosal healing was observed in the distal ulcerative lesion after the administration of two doses of infliximab. IFN: Infliximab.

Figure 2 Clinical course during infliximab administration. A: Height and body weight indicating a steady growth, in line with the initiation of infliximab (5 mg/kg). Hemoglobin (g/dL) level rapidly recovered. Following attenuation in the clinical response, the dose was increased to 7.5 mg/kg and immunomodulatory agents were added (mycophenolate mofetil was later switched with oral prednisolone); B: Dots (●) indicate the trough serum tissue necrosis factor alpha level, which declined immediately after each infliximab infusion (indicated by squares). In contrast, almost normal white blood cell counts and C-reactive protein level were observed throughout the course of treatment. Partial resection and stoma reversal were performed (indicated by dotted lines). IFN: Infliximab; MMF: Mycophenolate mofetil; PSL: Prednisolone; TAC: Tacrolimus; Hb: Hemoglobin.

Figure 3 Pathological findings of the ulcerative lesion. A: The resected specimen of the graft showing ulcerative inflammation with fibrotic tissue; B: No signs of chronic rejection are observed.