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Severe multiple therapy refractory colitis in a 46-year-old man
  1. Nora Carpay1,2,
  2. Nanne K H de Boer3,
  3. Andra Neefjes-Borst4,
  4. Steven Bots1
  1. 1Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  2. 2Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  3. 3Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism (AGEM) Research Institute, Amsterdam University Medical Centre, VU University Amsterdam, Amsterdam, The Netherlands
  4. 4Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Nora Carpay, Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; n.c.carpaij{at}

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Clinical presentation

A 46-year-old male patient was referred to our tertiary care hospital with multiple therapy refractory severely active ulcerative colitis (diagnosis since approximately 1 year). He was previously treated with infliximab, prednisolone, vedolizumab, filgotinib and mercaptopurine.

There was no significant medical history. Six weeks prior to admission at our ward, our patient was diagnosed with Kaposi sarcoma based on lesions on the feet and lower legs. His family history was positive for Crohn’s disease.

On admission, a sigmoidoscopy was performed, of which the images are shown below (figure 1). In anticipation of the pathology results, prednisolone was restarted without significant clinical effect.

Figure 1

Endoscopic view of the distal 25 cm of the colon and rectum.

Additionally, an ultrasound was performed to determine the extent of the inflammation, as this …

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  • Contributors NC analysed and interpreted the patient data, designed and drafted the manuscript and designed the figures. AN-B performed the histological examination of the biopsies and colectomy specimen, described the histological findings and prepared the histological figures. NKHdB and SB analysed and interpreted the patient data and critically revised and supervised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests NKHdB served as a speaker for AbbVie and MSD and as consultant and principal investigator for Teva Pharma BV and Takeda and received an unrestricted research grant from Dr Falk Pharma, Teva Pharma BV, MLDS and Takeda, all outside the submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.