dc.contributor.author
Awwad, Ibrahim
dc.contributor.author
Greuel, Selina
dc.contributor.author
Tacke, Frank
dc.contributor.author
Fischer, Christian
dc.date.accessioned
2022-01-27T11:37:40Z
dc.date.available
2022-01-27T11:37:40Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/33730
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-33450
dc.description.abstract
We present a case of a male patient in his mid-30s with COVID-19-induced lung failure requiring extracorporeal membrane oxygenation, who needed an emergency oesophagogastroduodenoscopy due to major upper gastrointestinal bleeding. Endoscopy exposed severe ulcerative duodenitis with diffuse mucosal bleeding. While CT angiography did not show any signs of ischaemia, histopathology revealed duodenitis with substantial inflammatory cell infiltrates consisting of neutrophils and CD3(+) T lymphocytes with equal CD4(+)/CD8(+) distribution. Since the composition of cell infiltrates coincides with changes in inflammatory patterns of the respiratory mucosa from patients with COVID-19 and in COVID-19-associated enterocolitis, and systemic dexamethasone treatment became standard of care in ventilated intensive care unit patients with COVID-19 infection, we initiated an individualised therapeutic attempt to treat the duodenitis with topical enteral budesonide. Follow-up oesophagogastroduodenoscopies within 4 weeks of enteral budesonide administration revealed a full clinical and histological healing of the duodenal mucosa with marked reduction of neutrophilic and lymphocytic infiltrates. To our knowledge, the current report is the first description of enteral budesonide treatment of duodenitis in a patient with COVID-19 infection and warrants further investigation, whether budesonide might constitute a novel therapeutic strategy for the management of COVID-19-related intestinal mucosal damage.
en
dc.rights.uri
https://creativecommons.org/licenses/by-nc/4.0/
dc.subject
duodenal mucosa
en
dc.subject
duodenal ulcer
en
dc.subject
intestinal tract
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Haemorrhagic ulcerative duodenitis in a patient with COVID-19 infection: clinical improvement following treatment with budesonide
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
e000757
dcterms.bibliographicCitation.doi
10.1136/bmjgast-2021-000757
dcterms.bibliographicCitation.journaltitle
BMJ Open Gastroenterology
dcterms.bibliographicCitation.number
1
dcterms.bibliographicCitation.originalpublishername
BMJ
dcterms.bibliographicCitation.volume
8
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34663581
dcterms.isPartOf.eissn
2054-4774