Infliximab stopped severe gastrointestinal bleeding in Crohn's disease

Table 1 Clinical characteristics and outcomes of infliximab treatment in 2 Crohn’s disease patients with severe gastrointestinal bleeding as a flare-up disease

No.	Age(yr)	Sex	Duration of CD	Location	Current treatment	Presenting symptom	Dropped rate of Hb (g/dL)	PRBC (unit)	Characteristic of lesion	Infliximab therapy	Bleeding controlled in	Follow-up (mo)
1	11	F	2 mo	Colon	Prednisolone 35 mg/d azathioprine	GIB (1 d)	from 11 to 8 in 3 d	4	Multiple deep colonic ulcers without oozing	Infliximab 5 mg/kg (single dose)	1 d	12
2	19	F	7 mo	Ileocolon	Budesonide 9 mg/d 5-ASA	GIB (1 d)	from 12 to 10 in 3 d	1	Multiple ileal and colonic ulcers with oozing	Infliximab 5 mg/kg (d0, d10)	10 d	10

CD: Crohn’s disease; GIB: Gastrointestinal bleeding; Hb: Hemoglobin; 5-ASA: 5-aminosalicylates; PRBC: Packed red blood cell; F: Female.

Table 2 Clinical characteristics and outcomes of infliximab treatment in 5 Crohn’s disease patients with severe gastrointestinal bleeding as a first presentation

No.	Age (yr)	Sex	Presenting symptom	Dropped rate of Hb (g/dL)	PRBC (unit)	Location	Characteristic of lesion	Infliximab therapy	Bleeding controlled in	Follow-up (mo)
1	59	M	Diarrhea and abdominal pain (10 d) GIB (1 d)	from 10 to 8 in 3 d	6	Ileum	Multiple ileal ulcers with oozing and one visible vessel	Infliximab 5 mg/kg (d0, week 2)	1 d	24
2	86	M	GIB (1 d)	from 12 to 8.5 in 4 d	7	Ileum	Multiple ileal ulcers with oozing	Infliximab 5 mg/kg (d0, week 2)	1 d	36
3	71	F	Diarrhea and abdominal pain (10 d) GIB	from 13 to 10 in 3 d	3	ileum	Multiple ileal ulcers with oozing	Infliximab 5 mg/kg (d0, week 2)	1 d	12
4	50 yr	F	Diarrhea and abdominal pain (14 d) GIB (1 d)	from 14 to 10 in 3 d	2	Ileum and jejunum	Multiple ileal and jejunum ulcers with oozing	Infliximab 5 mg/kg (d0, week 2)	1 d	36
5	71 yr	M	1st episode GIB from ileal ulcer (1 mo)Recurrent GIB (1 d)	from 11 to 6.5 in 5 d	6	Ileum	Multiple ileal ulcers with oozing and one visible vessel	Infliximab 5 mg/kg (single dose )	1 d	24

CD: Crohn’s disease; GIB: Gastrointestinal bleeding; Hb: Hemoglobin; 5-ASA: 5-aminosalicylates; PRBC: Packed red blood cell; M: Male; F: Female.

Table 3 Successful control severe lower gastrointestinal bleeding in Crohn's disease with infliximab

Study	Sex	Age (yr)	Location	Duration of disease	Current treatment	Presenting symptom	PRBC (unit)	Characteristic of lesion	Infliximab therapy	Bleeding controlled in	Follow-up (mo)
Belaihe et al[26], 2002	F	28	Ileocolon CD	3 yr	Budesonide azathioprine	Lower GIB	5	Multiple deep ulcers at colon without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6)	14 d	5
	F	59	colon CD	9 yr	Prednisolone, metronidazole, ciprofloxacin	Lower GIB	4	Multiple deep ulcers at colon without bleeding stigmata	Infliximab 5 mg/kg (single dose)	4 d	4
Papi et al[7], 2003	M	50	Ileocolon CD S/P resection and ileocolonic anastomosis due to bleeding	9 mo	Prednisolone azathioprine	Lower GIB with hypovolumic shock	NA	Deep ulcers at ileocolon anastomosis without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6)	NA	12
	M	68	Ileum CD S/P ileal resection due to stricture	24 yr	Mesalamine	Melena	4	Large ulcer at ileocolon anastomosis without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6)	NA	3
Tsujikawa et al[25], 2004	M	31	Ileocolon CD S/P ileocolectomy due to ulcer bleeding	12 yr	Salazosulfap yrimidine	Lower GIB	NA	Multiple ulcers at ileocolon anastomsosis and ileum without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6)	NA	4
Ando et al[22], 2009	F	16	Colonic CD	1 yr	Mesalamine prednisolone	Lower GIB with hypovolumic shock	6	Multiple deep ulcers at colon with diffuse mucosal inflammation without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6)	3 d	12
Meyer et al[24], 2009	F	19	Ileocolonic CD	6 yr	Mesalamine prednisolone	Lower GIB with hypovolumic shock	4	Multiple ulcers at terminal ileum without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6)	NA	6
Julián Gómez et al[23], 2010	M	44	Ileocolon CD S/P total colectomy with ileostomy due to toxic megacolon	NA	NA	Postop small bowel resection due to obstruction bleeding	10	Multiple deep ulcers at small bowel without bleeding stigmata	Infliximab 5 mg/kg (d0, week 2, week 6) and maintenance dose	5 d	3
Alcalde Vargas et al[21], 2011	M	27	Ileocolon CD	2 yr	Mesalamine	Massive lower GIB	8	Multiple ulcers entire colon and abundant dark red blood at terminal ileum	Infliximab 5 mg/kg (single dose)	4 d	NA
	F	36	Colon and perianal CD	NA	Amoxicillin-clavulanate metronidazole	Massive lower GIB	12	Multiple deep ulcers entire colon and blood clots	Infliximab 5 mg/kg (single dose)	6 d	NA
	M	24	Colon CD	1 mo	Prednisolone	Massive lower GIB	5	Multiple deep ulcers entire colon and spontaneous bleeding mucosa	Infliximab 5 mg/kg (single dose)	4 d	NA

CD: Crohn’s disease; GIB: Gastrointestinal bleeding; PRBC: Packed red blood cell; M: Male; F: Female; NA: Not available.