Not Signed In - Pictures
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enemas and oral 5 ASA for about 12 years Recently he relapsed and a colonoscopy showed rake ulcers in the terminal ileum and severe colitis in the left colon Slide 3 History cont Slide 4 History cont He was treated with prednisone which was tapered over about 6 months and discontinued about 4 weeks prior to the time that he was seen at our institution He was also
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The patient was suggested to have surgical intervention and was referred to a surgeon at our institution The surgeon referred the patient to me for evaluation for further therapy medically Slide 4 History cont The patient had just completed a prednisone taper from 40 mg was on 15 mg mesalamine enemas were given oral mesalamine at 4 8 g and azathioprine at 2 5 mg kg
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Slide 28 Initial Course of Treatment Slide 29 Initial Course of Treatment cont She received oral prednisone having not received intravenous steroids and this was tapered by 5 mg every 2
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parenteral cyclosporin perhaps methotrexate despite the data not showing that it is efficacious there s uncontrolled data that have shown such experimental agents and surgery Slide 8 Initial Course of Treatment cont The treatment that was chosen was that of infliximab 5 mg kg a single dose Prednisone was tapered the mesalamine enemas were continued oral
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treated with mesalamine enemas and oral 5 ASA for about 12 years Recently he relapsed and a colonoscopy showed rake ulcers in the terminal ileum and severe colitis in the left colon Slide 3 History cont Slide 4 History cont He was treated with prednisone which was tapered over about 6 months and discontinued about 4 weeks prior to the time that he was seen at our
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Slide 28 Initial Course of Treatment Slide 29 Initial Course of Treatment cont She received oral prednisone having not received intravenous steroids and this was tapered by 5 mg every 2 weeks and she was started on a 5 ASA
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as an outpatient and came in for a daily bolus infusion for a week The 5 ASA was continued and she completely responded with a week of IV bolus steroids with resolution of her symptoms Slide 31 Third Course of Treatment The IV steroids were then converted to oral prednisone the 5 ASA was continued and within a week she had recurrent symptoms What about infliximab at this
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