Year 2023 / Volume 115 / Number 6
Letter
Use of teduglutide for short bowel syndrome and Crohn’s disease in a patient treated with ustekinumab and vedolizumab dual biologic therapy

331-332

DOI: 10.17235/reed.2022.9194/2022

Lidia Martí Romero, Laura Peño Muñoz, Vanesa Martínez Escapa, Joaquín Hinojosa del Val,

Abstract
Surgery in Crohn’s disease may be the cause of short bowel syndrome that may lead to kidney dysfunction. Dual biologic therapy is rarely needed to control activity. We present a case of a 61-year-old steroid dependent (A2L1B3p) female who had undergone surgery on three occasions: ileocecal resection (resection of 15 cm of terminal ileum); resection of right and left colon up to sigmoid; proctectomy with intersphincteric resection along with ileostomy due to a rectovaginal fistula. She had been previously treated with prednisone, azathioprine, methotrexate, infliximab and adalimumab but the treatment was discontinued owing to adverse effects. Vedolizumab was started, showing good control of the luminal activity but the rectovaginal fistula recurred. Treatment changed to ustekinumab, the fistula activity was controlled but the mucosa activity recurred. 11 months after commencing with ustekinumab, vedolizumab was added to the treatment and complete remission was achieved for three years. Simultaneously, the patient developed renal dysfunction derived from the short bowel syndrome that led to chronic kidney failure. In the face of potential renal replacement therapy, a new therapy with 2.5 mg/sc/d teduglutide was started achieving stable figures of creatinine and normalization of the glomerular filtration rate.
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References
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Martí Romero L, Peño Muñoz L, Martínez Escapa V, Hinojosa del Val J. Use of teduglutide for short bowel syndrome and Crohn’s disease in a patient treated with ustekinumab and vedolizumab dual biologic therapy. 9194/2022


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Publication history

Received: 08/09/2022

Accepted: 21/09/2022

Online First: 30/09/2022

Published: 06/06/2023

Article Online First time: 22 days

Article editing time: 271 days


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