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Vol. 7, No. 1, 2013
Issue release date: January – April

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Case Rep Gastroenterol 2013;7:122-126
(DOI:10.1159/000350320)

Effective Treatment of Intestinal Behçet's Disease with Long-Term, Low-Dose Clarithromycin

Hakozaki Y. · Mitani K. · Okada C. · Terada H. · Kobari S.
Department of Internal Medicine, Japan Self Defense Forces Central Hospital, Tokyo, Japan

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Abstract

A 51-year-old man was referred for body weight loss and lower right abdominal pain. Total colonoscopy revealed discrete and round ulceration at the ileocecal valve, and he was diagnosed with intestinal Behçet's disease (BD). By treatment with glucocorticoid, colchicine and salazosulfapyridine, the symptoms and ulceration were improved, but cessation of glucocorticoid resulted in relapse of ulceration at the terminal ileum. Long-term, low-dose treatment with clarithromycin (CAM) was implemented for chronic respiratory infections. Furthermore, we expected that this CAM treatment would also be effective in BD. During this long-term, low-dose treatment with CAM, discrete ulceration at the terminal ileum was never revealed by follow-up total colonoscopy once or twice per year for 7 years. No reports have described the effectiveness of this treatment in patients with intestinal BD; however, we confirm that long-term treatment with low-dose CAM might have clinical benefits for patients with intestinal BD.



 goto top of outline Author Contacts

Dr. Yukiya Hakozaki
1-2-24 Ikejiri, Setagaya-ku
Tokyo 154-8532 (Japan)
E-Mail yukiya-ha.ko@nifty.com


 goto top of outline Article Information

Published online: March 13, 2013
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 0, Number of References : 9


 goto top of outline Publication Details

Case Reports in Gastroenterology

Vol. 7, No. 1, Year 2013 (Cover Date: January - April)

Journal Editor: Urrutia R. (Rochester, Minn.), Lomberk G. (Rochester, Minn.)
ISSN: 1662-0631 (Print), eISSN: 1662-0631 (Online)

For additional information: http://www.karger.com/CRG


Open Access License / Drug Dosage

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

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  3. Hatemi G, Silman A, Bang D, et al: EULAR recommendation for the management of Behçet's disease. Ann Rheum Dis 2008;67:1656-1662.
  4. Crosbie PA, Woodhead MA: Long-term macrolide therapy in chronic inflammatory airway diseases. Eur Respir J 2009;33:171-181.
  5. Shinkai M, Henke MO, Rubin BK: Macrolide antibiotics as immunomodulatory medications: proposed mechanisms of action. Pharmacol Ther 2008;117:393-405.
  6. Ding FM, Zhu SL, Shen C, Jiang YQ: Low-dose clarithromycin therapy modulates CD4(+) T-cell responses in a mouse model of chronic Pseudomonas aeruginosa lung infection. Respirology 2012;17:727-734.
  7. Leiper K, Morris AI, Rhodes JM: Open label trial of oral clarithromycin in active Crohn's disease. Aliment Pharmacol Ther 2000;14:801-806.
  8. Naganuma M, Sakuraba A, Hisamatsu T, et al: Efficacy of infliximab for induction and maintenance of remission in intestinal Behçet's disease. Inflamm Bowel Dis 2008;14:1259-1264.
  9. Hirohata S: Is the long-term use of systemic corticosteroids beneficial in the management of Behçet's syndrome? Nat Clin Pract Rheumatol 2006;2:358-359.


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