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Tumour necrosis factor α downregulation and therapeutic response to infliximab in a case of segmental colitis associated with diverticula
  1. C Hassan1,
  2. A Zullo1,
  3. E Ierardi2,
  4. O Burattini2,
  5. V De Francesco2,
  6. S Morini3
  1. 1Gastroenterology and Digestive Endoscopy Unit, “Nuovo Regina Margherita” Hospital, Rome, Italy
  2. 2Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, Italy
  3. 3Gastroenterology and Digestive Endoscopy Unit, “Nuovo Regina Margherita” Hospital, Rome, Italy
  1. Correspondence to:
    Professor S Morini
    Ospedale Nuovo Regina Margherita, Gastroenterologia ed Endoscopia Digestiva, Via Morosini 30, 00153, Roma, Italia; gastroroma{at}

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Inflammatory bowel disease (IBD) confined to the diverticular tract—defined as segmental colitis associated with diverticula (SCAD)—occurs in 3.8% of diverticular patients.1 Recently, infliximab was reported to have a dramatic impact on severe Crohn’s disease and ulcerative colitis therapy.2,3 However, tumour necrosis factor α (TNF-α) involvement and the efficacy of anti-TNF-α in SCAD are unknown.

A 60 year old male smoker and non-NSAID user was admitted for severe bloody diarrhoea. At colonoscopy, the sigmoid and descending mucosa showed granularity, friability, and erosions confined to the diverticular tract, without alterations of the remaining ileocolonic mucosa. Histology of the inflamed tract revealed an ulcerative colitis-like picture. Therefore, a diagnosis of SCAD was made. After mesalazine and antibiotic failure, intravenous steroid therapy was successfully administered. After two years of steroid dependence, repeat endoscopy showed, in addition …

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  • Conflict of interest: None declared.