A 24-Year-Old Pregnant Woman With Inflammatory Bowel Disease
published online 01 May 2009.
A 24-year-old woman, 14 weeks pregnant with her first child, is referred by her obstetrician for management of her CD. She has a 5-year history of ileocolonic CD, diagnosed by colonoscopy. She was initially treated with mesalamine, antibiotics, and prednisone. She was intolerant of azathioprine (AZA) as a result of a rash and was initiated on infliximab induction therapy followed by 5 mg/kg every 8 weeks 2 years ago. She has been in remission since then with 1–2 bowel movements per day, no pain, and no blood in her stool. She is otherwise healthy and has not required surgery for her CD. After discovering she was pregnant, she skipped her scheduled infliximab infusion 6 weeks ago out of concern for her baby and is now reporting 5 loose stools a day with abdominal pain and hematochezia.
⁎Division of Gastroenterology, Baylor College of Medicine, Houston, Texas
‡Division of Gastroenterology, University of California, San Francisco, California
Reprint requests Address requests for reprints to: Uma Mahadevan, MD, Associate Professor of Medicine, Center for Colitis and Crohn's Disease, University of California, San Francisco, 2330 Post Street, #610, San Francisco, California 94115. fax: (415) 502-2249
Conflicts of interest Dr Mahadevan discloses the following: Consultant Abbott, Centocor, UCB, Elan, P&G, Shire, Genentech. Dr Hou discloses no conflicts.