Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis.Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffect...Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis.Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffective.We describe a patient with long-standing ulcerative colitis,which was refractory to corticosteroid therapy who developed primary sclerosing cholangitis(biochemical stage Ⅱ/Ⅳ) in the course of his pancolitis.Treatment with infliximab(5 mg/kg as an induction dose followed by maintenance doses every two months) was indicated because of steroid-dependent disease associated to primary sclerosing cholangitis as well as sacroiliitis and uveitis and previous episode of severe azathioprinerelated hepatic toxicity.At present,after two years of follow-up,the patient is asymptomatic with normal liver tests and complete resumption of daily life activities.This case draws attention to the usefulness of antitumor necrosis factor-alpha therapy for the management of primary sclerosing cholangitis as extraintestinal manifestation of inflammatory bowel disease.展开更多
文摘Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis.Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffective.We describe a patient with long-standing ulcerative colitis,which was refractory to corticosteroid therapy who developed primary sclerosing cholangitis(biochemical stage Ⅱ/Ⅳ) in the course of his pancolitis.Treatment with infliximab(5 mg/kg as an induction dose followed by maintenance doses every two months) was indicated because of steroid-dependent disease associated to primary sclerosing cholangitis as well as sacroiliitis and uveitis and previous episode of severe azathioprinerelated hepatic toxicity.At present,after two years of follow-up,the patient is asymptomatic with normal liver tests and complete resumption of daily life activities.This case draws attention to the usefulness of antitumor necrosis factor-alpha therapy for the management of primary sclerosing cholangitis as extraintestinal manifestation of inflammatory bowel disease.
