A clinical case of drug therapy complications in a patient with severe ulcerative colitis

A clinical case of thrombotic complications with a cerebral vascular damage and the development of aplastic anemia against the background of drug therapy for severe ulcerative colitis (UC) in a 34-year-old patient is presented. Treatment of inflammatory bowel diseases (IBD) is currently a complex problem. The main goal of therapy is to achieve stable remission without the use of systemic glucocorticosteroids (GCS). The administration of combined drug therapy, including 5 – aminosalicylic acid preparations, topical and systemic GCS, thiopurines, as well as genetically engineered biological drugs is often required to control an exacerbation. Adverse drug events occur in 40 % of patients and are most frequently associated with the use of GCS, thiopurines and genetically engineered biological drugs. Arterial and venous thrombosis are extra-intestinal manifestations of IBD, the development of which is associated with the activity of the inflammatory process, and may also be caused by taking high doses of systemic GCS. The occurrence of aplastic anemia in IBD is associated with the peculiarities of thiopurine metabolism in some individuals. Thus, the choice of drug therapy option should be carried out considering the course of the disease, the presence of a concomitant pathology, any complications, the effectiveness and safety of drug therapy, as well as the presence of adverse reactions predictors.