An older patient with active ulcerative colitis and coronavirus disease 2019 (COVID-19) pneumonia successfully treated with the combination of anti-TNFα therapy and azathioprine.
Tsukasa YamakawaKeisuke IshigamiSae OhwadaTomoe KazamaDaisuke HirayamaShinji YoshiiHiro-O YamanoHiroshi NakasePublished in: Clinical journal of gastroenterology (2022)
A 77-year-old patient with ulcerative colitis (UC) was transferred to our department because of worsening bloody diarrhea and abdominal pain, which was consistent with a UC flare. Two days after admission, she complained of cough and high fever. The polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive, and a computed tomography showed pneumonia in the left lobe, consistent with coronavirus disease 2019 (COVID-19) pneumonia. However, frequent bloody diarrhea and abdominal pain due to the UC flare persisted; therefore, an additional immunosuppressive agent needed to be considered. We initiated infliximab biosimilar (IFX-BS), and her abdominal symptoms improved. However, they deteriorated after the second IFX-BS infusion. After confirming that the patient was negative for SARS-CoV-2 by PCR, we administered a combination of azathioprine and IFX-BS. The combination treatment improved her intestinal symptoms without worsening COVID-19 pneumonia. She has remained in remission for over a year since her discharge.
Keyphrases
- respiratory syndrome coronavirus
- coronavirus disease
- sars cov
- ulcerative colitis
- abdominal pain
- case report
- computed tomography
- rheumatoid arthritis
- magnetic resonance imaging
- low dose
- respiratory failure
- stem cells
- irritable bowel syndrome
- positron emission tomography
- depressive symptoms
- clostridium difficile
- community dwelling
- bone marrow
- mesenchymal stem cells
- replacement therapy
- cell therapy