SciELO - Scientific Electronic Library Online

 
vol.33 número2Fístula gastrobronquial post gastrectomía en mangaLa Organización Mundial de Gastroenterología y sus realizaciones en América Latina índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Indicadores

  • No hay articulos citadosCitado por SciELO

Links relacionados

  • No hay articulos similaresSimilares en SciELO

Compartir


Revista de Gastroenterología del Perú

versión impresa ISSN 1022-5129

Resumen

MUNOZ URRIBARRI, Ana; SYLVESTER, Francisco; DELGADO GODOS, Alex  y  CASTILLO DURAN, Raúl. Management of colonic Crohn disease with no response to corticoids and sulfazalazine: first case of pediatric use of infliximab in Peru. Rev. gastroenterol. Perú [online]. 2013, vol.33, n.2, pp.162-166. ISSN 1022-5129.

We present the first Peruvian pediatric case of induction of remission and maintenance of Crohn’s disease with infliximab. Case: 9-year old female who presented with perianal fistulas, intermittent diarrhea and poor weight gain since 8 months of age. Due to lack of improvement with medical therapy she had a colostomy at 4 years of age. A surgical biopsy showed chronic colitis with inflammation extending to the muscularis mucosae, with areas of glandular atrophy. A diagnosis of Crohn’s disease was made. She received prednisone, sulfasalazine and antibiotics without significant improvement. She became undernourished, stunted, and anemic. Consequently, at 8 years of age we started infliximab, 100 mg per doses (5.5 mg/kg/doses). After 4 infusions her perianal fistulas closed. However, after 8 months of treatment she had a disease exacerbation with abdominal pain and diarrhea. Therefore, we added azathioprine (2 mg/kg/d PO) and shortened maintenance infliximab infusions from every 8 to every 4 weeks. Gastrointestinal symptoms resolved. So far the patient has had no adverse events secondary to therapy. Conclusion: This patient has a rare early onset and aggressive form of Crohn’s disease that responded to infliximab, who needed the addition of azathioprine to maintain remission.

Palabras clave : Crohn disease; Pediatrics; infliximab; Adrenal cortex hormones.

        · resumen en Español     · texto en Español     · Español ( pdf )