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Infliximab treatment in a paediatric patient with ulcerative colitis, who developed acute pancreatitis due to azathioprine during follow-up

Ahmet Basturk, Aygen Yilmaz, Meryem Keceli, Reha Artan

Data publikacji online: 2017/09/30
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Pancreatitis is histologically defined as inflammation of the pancreatic parenchyma. Acute pancreatitis is a disorder manifested by interstitial oedema, acute decrease in inflammatory cells, apoptosis, necrosis, and reversible improvement in haemorrhage [1]. Azathioprine (AZA) is among the drugs associated with acute pancreatitis, although encountered rarely. Our objective is to present a paediatric case with ulcerative colitis (UC), who developed acute pancreatitis during AZA treatment, and was treated (after the discontinuation of azathioprine) with infliximab due to the relapse of UC.
A 17-year-old paediatric patient applied to us with complaints of bloody stool, diarrhoea, abdominal pain, and weight loss, which emerged in the previous 2 months. Medical and familial history was normal. In the physical examination, height was measured as 168 cm (10–25 p), body weight 49 kg (< 3 p), no mouth ulcers were observed, and bilateral sensitivity in the abdomen and increased bowel sounds were recorded. No anal abscess, fistula, or fissure were observed during the anal examination. Laboratory analysis revealed: haemoglobin (Hb) 11 g/dl, leukocyte count (WBC) 13,500/mm3, platelet count (PLT) 478,000/mm3, alanine aminotransferase (ALT) 28 U/l (N: 0-40), aspartate aminotransferase (AST) 32 U/l (N: 0-41), γ-glutamyl transferase (GGT) 24 U/l (N: 0–61), total bilirubin (T.bil.) 0.9 mg/dl (N: 0–0.9), direct bilirubin (D.bil.) 0.2 mg/dl (N: 0–0.2), prothrombin time (PT) 14.6 s (N: 11–14), international normalised ratio (INR) 1.1 (N: 0.9–1.2), activated partial thromboplastin time (aPTT) 26.1 s (N: 25–33), albumin 4.2 g/dl, and faecal occult blood (HHb) 234. Stool culture was negative. Rotavirus, adenovirus and Entamoeba histolytica antigens were also negative. The upper endoscopy, which was carried out due to suspected inflammatory bowel disease, displayed antral gastritis and mild duodenitis, which was confirmed with histopathological analysis. In the colonoscopy, aphthous ulcerative areas were observed in the rectum, sigmoid colon, and caecum. The results of the multiple biopsies were interpreted in favour of ulcerative colitis. Methylprednisolone treatment, which was initiated with a loading dose of 2 mg/kg b.w./day, was planned for 6 weeks. Mesalazine 30 mg/kg b.w./day was concomitantly initiated. Azathioprine was started with a dose of 0.5 mg/kg b.w./day, and then the dose was increased to 2 mg/kg b.w./day. For the exacerbation periods, which...

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Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993; 128: 586-90.
Herrlinger KR, Stange EF. The pancreas and inflammatory bowel diseases. Int J Pancreatol 2000; 27: 171-9.
Foitzik T, Forgacs B, Ryschich E, et al. Effect of different immunosuppressive agents on acute pancreatitis: a comparative study in an improved animal model. Transplantation 1998; 65: 1030-6.
Haber CJ, Meltzer SJ, Present DH, et al. Nature and course of pancreatitis caused by 6-mercaptopurine in the treatment of inflammatory bowel disease. Gastroenterology 1986; 91: 982-6.
Bermejo F, Lopez-Sanroman A, Taxonera C, et al. Acute pancreatitis in inflammatory bowel disease, with special reference to azathioprine-induced pancreatitis. Aliment Pharmacol Ther 2008; 28: 623-8.
Saiki T, Mitsuyama K, Toyonaga A, et al. Detection of pro- and anti-inflammatory cytokines in stools of patients with inflammatory bowel disease. Scand J Gastroenterol 1998; 33: 616-22.
Ford AC, Sandborn WJ, Khan KJ, et al. Efficacy of biological therapies in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 2011; 106: 644-59.
Probert CS, Hearing SD, Schreiber S, et al. Infliximab in moderately severe glucocorticoid resistant ulcerative colitis: a randomised controlled trial. Gut 2003; 52: 998-1002.
Miele E, Markowitz JE, Mamula P, et al. Human antichimeric antibody in children and young adults with inflammatory bowel disease receiving infliximab. J Pediatr Gastroenterol Nutr 2004; 38: 502-8.
Rutgeerts P, Sandborn WJ, Feagan BG, et al. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med 2005; 353: 2462-76.
Domm S, Cinatl J, Mrowietz U. The impact of treatment with tumour necrosis factor-alpha antagonists on the course of chronic viral infections: a review of the literature. Br J Dermatol 2008; 159: 1217-28.
Hansen RA, Gartlehner G, Powell GE, et al. Serious adverse events with infliximab: analysis of spontaneously reported adverse events. Clin Gastroenterol Hepatol 2007; 5: 729-35.
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