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Ciclosporin (CsA) is an established treatment in severe, intravenous corticosteroid resistant ulcerative colitis (UC). Although one third of UC patients relapse during pregnancy, experience with CsA use during this period is limited to a few case reports.1 Most of the available data on CsA administration and pregnancy outcome have been obtained from the transplantation literature.2 We read the letter of Jayaprakash and colleagues (Gut 2004;53:1386–7) who described the case of a patient with fulminant corticosteroid resistant distal UC successfully treated with CyA and delivering a healthy baby. Herein we report the dramatic case of a 21 year old primigravida with a diagnosis of UC (in April 2000) who experienced a fulminant flare at the end of her first trimester despite immunosuppressive treatment and whose pregnancy could only …
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