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CLINICAL CHARACTERISTICS AND RESPONSE TO INTRAVENOUS STEROID THERAPY IN PATIENTS WITH ACUTE SEVERE ULCERATIVE COLITIS
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Abstract
Objective: Acute severe ulcerative colitis (ASUC) is a serious complication in patients with ulcerative colitis. This study aims to provide preliminary data of the clinical characteristics and response rate to intravenous (IV) steroid therapy of Vietnamese patients with ASUC. Subject and method: A retrospective analysis was conducted on the data of 14 patients with ASUC admitted to the University Medical Center in Ho Chi Minh City between January 2021 and December 2022. Response to IV steroid therapy was evaluated using the Travis-Oxford criteria. Results: The median age was 41.9 years, and 71.4% of the patients were men. The median time from symptom onset to diagnosis was 25.6 days. 50% of the patients had a history of ulcerative colitis. The median value of serum CRP was 63 mg/L. 100% had Mayo endoscopic subscore of 2 or 3, and 14.2% had deep ulcers on endoscopy. 9/14 (64.3%) cases were in-hospital steroid responders, while 5/14 (35.7%) needed rescue therapy with infliximab and tofacitinib. All of the patients with steroid refractory responded to rescue therapy. Conclusion: IV steroids remain the cornerstone of initial therapy for Vietnamese patients with ASUC. However, 1/3 of patients may not respond to IV steroid therapy and need rescue therapy.
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Keywords
Acute severe ulcerative colitis; Intravenous steroid; Vietnam
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