Severe Active Ulcerative Colitis and Resistance to Intravenous Hydrocortisone Therapy: Successful Treatment with Methylprednisolone Pulse Therapy

Abstract

Ulcerative colitis is a mucosal-inflammatory disease that usually involves the rectum and extends proximally to involve all or part of the colon. Medications for treatment include anti-inflammatory agents such as 5-ASA compounds, systemic and topical corticosteroids and immunomodulators. A 33 year-old female and 52 year-old male both diagnosed with severe active ulcerative colitis who were resistant to intravenous hydrocortisone therapy (400 mg/day) were admitted to our clinic. Respectively, the patients were treated with pulsed steroid therapy at doses of 500 and 1000 mg/day methylprednisolone intravenously, for three consecutive days. After the treatment, the patients potentially achieved complete clinical remission. In conclusion, pulsed steroid therapy may induce complete clinical remission in patients with severe, active ulcerative colitis who have resistance to intravenous conventional steroid therapy.