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Inflammatory Bowel Disease West Case Conference
Past Events
April
4/11/22
Main Case:
Stanford Emeryville, Dr. Kian Keyashian
Causal Agent of Disease:
25 year-old male with stricturing/penetrating Crohn's disease who transferred care from pediatric gastroenterology on anti-MAP therapy.
Clinical Vignette:
University of Washington, Dr. Jeffery Jacobs
Toxic Megacolon:
Toxic megacolon due to secukinumab with subsequent persistent anastomotic leak
March
3/14/22
Main Case:
University of Arizona, Dr. Jonathan Wong
Very Early Onset IBD:
3 y/o M found to have pancolitis. Failed medical management and underwent colectomy with diverting ileostomy for persistent symptoms. Clinically improved post-surgery and underwent staged j-pouch construction and re-anastomosis. Approximately 2 years after initial presentation patient reported to have stool incontinence and abdominal pain. Found to have marked acute inflammation consistent with pouchitis.
Clinical Vignette:
University of California Los Angeles, Dr. Jenny Sauk
Penetrating Crohn's Disease:
21 yo male with h/o Crohn's ileitis dx'd in 10/2021 presenting with 11 cm terminal ileitis and associated fistulous complex to appendix, cecum, and bladder.
February
2/13/22
Main Case:
Palo Alto Medical Foundation, Dr. Ryan McConnell
Ulcerative Colitis Surgery:
50 year-old status-post emergent subtotal colectomy for medically refractory ulcerative colitis now desires ileorectal anastomosis
Clinical Vignette:
Oregon Health and Science University, Drs. Ross Vyhmeister and Anil Sharma
Extraintestinal Manifestations of IBD:
58 year old man who presented with painless vision loss in the right eye. Found to have bilateral optic disc edema, right eye optic atrophy, and vitreous inflammation, along with MRI brain with two enhancing lesions and leptomeningeal enhancement. Subsequent work-up included positive FIT that led to a colonoscopy with findings suggestive of Chron's
January
1/9/22
Main Case:
University of Washington, Dr. Oviea Akpotaire
Refractory Disease:
33 yo F with refractory ileocolonic and perianal Chron's
Clinical Vignette:
Virginia Mason, Dr. Timothy Zisman
Patient with ulcerative colitis with a disease exacerbation while on an immune checkpoint inhibitor
December
12/12/21
Main Case:
University of Colorado, Drs. Katie Boland and Ahmed Waseem
Tofacitinib in Acute Severe Ulcerative Colitis:
22yo with steroid- dependent Ulcerative pan-colitis with history failure of multiple biologics who presents with ASUC. We consider utilizing Tofacitinib for acute rescue therapy
Clinical Vignette:
University of Arizona, Dr. Sasha Taleban
64 y/o Japanese M with IBD-U on 6-MP and adalimumab with a potential therapeutic complication
November
11/7/21
Main Case:
Standford Emeryville, Dr. Kian Keyashian
COVID-19:
22 year old male with history of ulcerative colitis in deep remission for 6 months with significant flare of colitis after 2nd COVID-19 vaccination.
Clinical Vignette:
Palo Alto Medical Foundation, Dr. Ryan McConnell
Therapeutic Drug Monitoring:
Patient with Crohn's disease who has breakthrough symptoms, undetectable infliximab level, and elevated antibodies to infliximab. Dose escalate or switch?
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