ナカムラ　シンイチ   Nakamura Shin'ichi   中村　真一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	A Patient with Crohn's Disease Who Gave Birth Despite Sigmoid Volvulus, Venous Thrombosis, Nontraumatic Fracture of the Rib, and Sepsis during Pregnancy
掲載誌名	正式名：Case reports in gastroenterology 略　 称：Case Rep Gastroenterol ISSNコード：16620631/16620631
掲載区分	国外
巻・号・頁	17(1),pp.255-263
著者・共著者	ITO Ayumi, MURASUGI Shun, YONEZAWA Maria, OMORI Teppei, NAKAMURA Shinichi, TOKUSHIGE Katsutoshi
発行年月	2023/08
概要	The patient was a woman in her 40s who was diagnosed with Crohn's disease (CD) of the large and small intestines in 1996. In 2005, she was referred to our hospital for treatment. We treated her for 17 years with corticosteroids, biologics, immunosuppressive agents, 5-aminosalicylic acid, and nutrition care. However, her Crohn's Disease Activity Index remained between 200 and 250, indicating refractory CD. During her medical treatment, the patient also underwent 3 operations. One year ago, the patient became pregnant through in vitro fertilization. Even after pregnancy was confirmed, the patient continued her treatment for refractory CD with ustekinumab, granulocyte apheresis, and budesonide. Nonetheless, her CD was highly active during pregnancy, and she experienced various complications: sigmoid volvulus at gestational week 15, venous thrombosis at gestational week 17, nontraumatic rib fracture due to fetal movement at gestational week 32, and sepsis from central venous catheter infection at gestational week 37. At gestational week 38, the patient gave birth by emergency cesarian delivery. This paper reports details of the case in which delivery was achieved after various complications were overcome and discusses previous relevant reports.
DOI	10.1159/000531705
PMID	37928969