Hu Jianfang gave Wei Ping several reports.
The blood test was normal, and the stool test was also done. The stool OB was weakly positive, RBC and WBC were negative; fecal calprotectin was 850.9ug/g
An infection screening was also done, and all results were normal.
Imaging examinations were also performed, which showed no significant anal canal MRI enhancement; small bowel CT showed multiple segmental intestinal wall thickening in the abdomen and pelvis, with the most severe lesions in the hepatic flexure of the colon.
The final diagnosis was Crohn's disease, ileocolonic type, non-stenotic and non-penetrating type, moderately active.
And above, the biological agent infliximab is also given.
Wei Ping looked at the report and found that the diagnosis was in line with the procedure.
"Then what?"
"Then, one month after treatment, the patient developed a fever again. In addition to nausea, vomiting, abdominal pain, and increased bowel movements, he also developed painful erythema nodosum on both lower extremities and new small oral ulcers. Therefore, he was admitted to the hospital! His C-reactive protein level was significantly elevated, and infection was considered, but the evidence was insufficient. Hormone therapy was recommended, but the family, believing it had many drawbacks, refused it. They then began the biologic infliximab!"
Wei Ping looked at the report, which showed that his body temperature was normal after the second day.
Shows a decrease in C-reactive protein.
But three days later, the patient developed fever again.
"Three days later, the fever recurred, so we suggested hormone treatment to the family, and they agreed. We also achieved certain results," Luo Yuan added.
"Yes. After that treatment, the patient's temperature continued to improve, the erythema of the lower limbs improved, and the CRP level gradually dropped and did not rebound. Following this success, a second dose of infliximab was administered, and the patient's temperature also remained normal without rebounding. The patient was eventually discharged with oral steroids."
Hu Jianfang said.
It turned out to be a difficult patient. Wei Ping couldn't make a conclusion before seeing the patient.
"The last time I was hospitalized was a month ago," Luo Yuan added.
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