{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T21:41:02Z","timestamp":1763415662748,"version":"3.37.3"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T00:00:00Z","timestamp":1686355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>An 18\u2009year-old man with autoimmune hepatitis-primary sclerosing cholangitis-overlap syndrome and ulcerative colitis was admitted due to relapsed enteritis and polyarthritis after cessation of infliximab. Colonoscopy and articular ultrasonography revealed large ulcers in the colon with crypt abscess in the specimens and active enthesitis and synovitis, respectively. His intestinitis was improved with golimumab but arthritis was persistent. Golimumab was switched to secukinumab, which was effective for arthritis. However, colitis was flared resulting in total colorectal resection. One month after colectomy, polyarthritis was relapsed. Tocilizumab ameliorated arthritis but enteritis emerged again, and switching tocilizumab to adalimumab improved enteritis but arthritis exacerbated. Finally, we restarted tocilizumab for arthritis with continued adalimumab for enteritis. The dual cytokine blocking strategy, tumour necrosis factor-\u03b1 and interleukin-6 inhibition, subsided both of his refractory enteritis and arthritis and maintained remission for more than 3\u2009years without any serious adverse event. Our case suggests that enteritis and arthritis in inflammatory bowel disease may be different in pathophysiology and raises the possible usefulness of simultaneous inhibition of two inflammatory cytokines in such cases.<\/jats:p>","DOI":"10.1093\/mrcr\/rxad031","type":"journal-article","created":{"date-parts":[[2023,6,10]],"date-time":"2023-06-10T14:38:43Z","timestamp":1686407923000},"page":"33-36","source":"Crossref","is-referenced-by-count":3,"title":["Successful treatment of\u00a0refractory enteritis and\u00a0arthritis with combination of\u00a0tumour necrosis factor and\u00a0interleukin-6 inhibition in\u00a0patients with ulcerative colitis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3100-9011","authenticated-orcid":false,"given":"Sho","family":"Ishigaki","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Ota","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Sung","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironari","family":"Hanaoka","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Keio University School of 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