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Title: Salvage therapy for acute severe ulcerative colitis during pregnancy.
Austin Authors: Raval, Manjri ;Choy, Matthew C ;De Cruz, Peter
Affiliation: General Medicine
Gastroenterology and Hepatology
The University of Melbourne, Melbourne, Victoria, Australia
Issue Date: 8-Jun-2018
Date: 2018-06-08
Publication information: BMJ Case Reports 2018; 2018: bcr-2017-223540
Abstract: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with an age of onset that affects young people during the peak of their reproductive years. Management of flares of disease during pregnancy can be complex and there are few case reports of pregnant women with acute severe ulcerative colitis (ASUC). We present the case of a 31-year-old pregnant woman who at 16 weeks gestation developed ASUC in the context of primary non-response to infliximab therapy. She subsequently underwent an emergency laparoscopic colectomy after failing to respond to hydrocortisone and cyclosporine salvage therapy. Her pregnancy was further complicated by HELLP (Haemolysis, Elevated liver enzymes and Low Platelets) syndrome resulting in premature delivery at 27 weeks gestation. This case highlights the management issues involved in ASUC during pregnancy and the assessment of disease activity, use of salvage therapies, and provides a framework to approach this complex medical emergency.
DOI: 10.1136/bcr-2017-223540
Journal: BMJ Case Reports
PubMed URL: 29884712
Type: Journal Article
Subjects: pregnancy
ulcerative colitis
Appears in Collections:Journal articles

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