Filipiuk A, Gonciarz M. Rare extraintestinal manifestations of ulcerative colitis treated with dual biologic therapy: A case report. World J Clin Cases 2024; 12(23): 5441-5447 [PMID: 39156084 DOI: 10.12998/wjcc.v12.i23.5441]
Corresponding Author of This Article
Aleksandra Filipiuk, MD, Doctor, Department of Gastroenterology and Internal Medicine, Military Institute of Medicine–National Research Institute in Warsaw, Szaserów 128, Warsaw 04-141, Poland. afilipiuk@wim.mil.pl
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2024; 12(23): 5441-5447 Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5441
Rare extraintestinal manifestations of ulcerative colitis treated with dual biologic therapy: A case report
Aleksandra Filipiuk, Maciej Gonciarz
Aleksandra Filipiuk, Maciej Gonciarz, Department of Gastroenterology and Internal Medicine, Military Institute of Medicine–National Research Institute in Warsaw, Warsaw 04-141, Poland
Author contributions: Filipiuk A, Gonciarz M contributed equally to the entire work on the article: Patient treatment planning, substantial contributions to conception and design of the case report, data gathering, or analysis and interpretation of the data, drafting the article or making critical revisions related to important intellectual content of the article, final approval of the version of the article to be published.
Informed consent statement: Informed consent was given by the patient.
Conflict-of-interest statement: We have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aleksandra Filipiuk, MD, Doctor, Department of Gastroenterology and Internal Medicine, Military Institute of Medicine–National Research Institute in Warsaw, Szaserów 128, Warsaw 04-141, Poland. afilipiuk@wim.mil.pl
Received: April 27, 2024 Revised: May 29, 2024 Accepted: June 20, 2024 Published online: August 16, 2024 Processing time: 68 Days and 15.9 Hours
Abstract
BACKGROUND
Ulcerative colitis (UC) is an idiopathic, chronic inflammatory bowel disease (IBD) most often located in the rectum, but may involve the entire colon. Extra intestinal manifestations (EIMs) occur with varying frequency depending on the affected organ. The most common ones are musculoskeletal EIMs, affecting up to 33%-40% of IBD patients. These include, among others, inflammatory back pain, tendinitis, plantar fasciitis and arthritis. Only a few case reports in literature discuss Achilles tendinitis.
CASE SUMMARY
This report describes a patient with UC and Achilles tendinitis in whom after many unsuccessful attempts of treatment with sulfasalazine, mesalazine, glucocorticosteroids, infliximab and tofacitinib, a complete UC remission and resolution of Achilles tendinitis were achieved with the use of dual biologic therapy (DBT)-ustekinumab and adalimumab (ADA).
CONCLUSION
This case mentions rare EIMs of UC and suggests that DBT may be an alternative for patient with ulcerative colitis and EIMs.
Core Tip: Achilles tendinitis is one of the rarest extra intestinal manifestations of ulcerative colitis (UC). To our best knowledge only a few case reports in literature discuss this problem. This article is a case report of a patient immobilized by Achilles tendinitis and excluded from social life by a very long-lasting exacerbation of UC. His way to recovery was full of ups and downs. We tried many lines of biological treatment with no permanent success. Only dual biologic therapy with ustekinumab and adalimumab thanks to combining two mechanisms of action brought the desired effect–a steroid free remission of UC and Achilles tendinitis.
