STEROID-REFRACTORY SEVERE ULCERATIVE-COLITIS RESPONDING TO CYCLOSPORINE AND LONG-TERM FOLLOW-UP

We report a case of steroid-refractory ulcerative colitis, treated wit h cyclosporine, in a 38-year-old woman with a 13-year history of ulcer ative colitis. No remission was achieved with treatments that included intravenous hyperalimentation, sulfasalazine, and intensive parentera l prednisolone therapy for 4 weeks. Intravenous infusion of cyclospori ne was performed because the patient refused to undergo surgery. Her c ondition improved dramatically and colectomy was avoided. She has been maintained on oral cyclosporine and azathioprine since steroids were discontinued, and she has remained in clinical and endoscopic remissio n for 2 years. The side effects were not significant, but mild paresth esia in both hands and mild hypertension, which was controlled by anti -hypertensives. Cyclosporine seems to be an effective treatment for pa tients with steroid-refractory severe active ulcerative colitis in who m colectomy seems inevitable. We believe further clinical trials of th e treatment are warranted.