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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.
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 …