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Case Reports
. 2018 Oct;21(4):355-360.
doi: 10.5223/pghn.2018.21.4.355. Epub 2018 Oct 10.

Fecal Microbiota Transplantation to Patients with Refractory Very Early Onset Ulcerative Colitis

Toshifumi Yodoshi  1   2 , Thomas L Hurt  3
Affiliations
Case Reports

Fecal Microbiota Transplantation to Patients with Refractory Very Early Onset Ulcerative Colitis

Toshifumi Yodoshi et al. Pediatr Gastroenterol Hepatol Nutr. 2018 Oct.

Abstract

Recently, fecal microbiota transplantation (FMT) has been attracting attention as a possible medical treatment of ulcerative colitis (UC). A randomized controlled trial of FMT for children with UC is currently underway. Therapeutic effects of FMT for adults with UC remain controversial. We report two cases of early-onset UC in children. A patient was diagnosed with UC at age 1-year 9-month and underwent FMT at age 2-year 3-month. He attained clinical remission for three weeks after FMT, but then relapsed at four weeks, ultimately undergoing a total colectomy. Another child was diagnosed with UC at 2-year 10-month and she underwent FMT at age 5 years. She has remained in clinical remission following FMT for 24 months and her UC has been maintained without complications with tacrolimus and azathioprine. We report that FMT for early-onset UC appears to be safe and potentially effective.

Keywords: Colectomy; Fecal microbiota transplantation; Gastrointestinal microbiome; Inflammatory bowel colitis; Ulcerative colitis.

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Figures

Fig. 1
Fig. 1. The endoscopic findings of case 1. Transverse colon (A) before fecal microbiota transplantation (FMT), and (B) at one week after starting FMT. (A) demonstrated severe diffuse and continuous mucosal inflammation with erythema and bleeding, whereas (B) demonstrated improved erythema and vascular pattern.
Fig. 2
Fig. 2. Fecal microbiota composition of the recipient and donor measured by T-RFLP (terminal restriction fragments length polymorphism). Before fecal microbiota transplantation (FMT), Bacteroides fragilis comprised more than two-thirds of the patient's microbiota. The graphs demonstrate that the patient's microbiota composition was quite different from the donor. However, fecal analysis three months after FMT revealed intestinal bacterial flora that was similar to that present in the stool of the donor, that led to clinical remission of ulcerative colitis activity for the subsequent two years.
See this image and copyright information in PMC

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