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Cyclosporin A treatment of steroid-refractory ulcerative colitis during pregnancy: report of two cases
  1. Wolfgang Reindl,
  2. Roland M Schmid,
  3. Wolfgang Huber
  1. Department of Internal Medicine II, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
  1. Correspondence to:
    Dr W Reindl II
    Medizinische Klinik, Klinikum rechts der Isar, Ismaninger Str 22, Munich D-81675, Germany; Wolfgang.Reindl{at}lrz.tum.de

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Treatment of fulminant, steroid-resistant ulcerative colitis during pregnancy is extremely challenging. Calcineurin antagonists like cyclosporin A (CyA) have been used in the past in fulminant colitis; yet, the experience using CyA during pregnancy is limited, as are the data on the long-term course after the initial treatment phase.

Case reports

The first patient is a 31-year-old woman with a 7-year history of ulcerative colitis. During her first pregnancy, she developed an acute flare of ulcerative colitis confirmed using endoscopy. Despite taking intravenous steroids, disease activity remained high, necessitating the transfusion of packed red blood cells. Within 7 days after initiating intravenous CyA the blood loss and abdominal pain subsided, and the frequency of bowel movements was reduced to 5 per day. The patient was discharged …

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