Patient Case

A 33-year-old female patient has been diagnosed with Crohn’s disease and is experiencing an active flare of systemic lupus erythematosus (SLE). Her flare includes esophageal lesions related to Crohn’s disease, activity in the sigmoid colon, and on the stoma of her descending loop colostomy. Additionally, she has a large re-opened oral ulcer which was previously biopsied and diagnosed as TUGSE. The patient’s current medication regimen consists of ustekinumab 90mg every 8 weeks, 6MP 50mg daily, pantoprazole 40mg daily, hydroxychloroquine 200mg twice daily, and tapering prednisone, currently at 15mg daily for the past week. Previous medications, including adalimumab, infliximab, vedolizumab, mesalamine, sulfasalazine, imuran, and methotrexate, have failed to provide adequate relief. Given the complexity and severity of the patient’s conditions and the failure of multiple medications, further suggestions for treatment options are needed.

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