sheeezooo
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25 y/o lady..with crohn disease present o ur office with reccurent abdominal pain and diarrhea..she has been takin mesalamine 4 grms per day for last year.last fall after developing diarrhea and pain, she was placed on prednisone 60 mg daily.she had a complete remission and after 3 months tapering of prednisone,suffered a relapse.prednisone was restarted 2 months ago at 60 mg daily,and now as the dose has decreased to 20 mg per day,diarrhea has recurred.she is having 6 to 8 watery stools per day, crampy pain,some weight gain..what would be the best next step??
1.restart prednisone and plan to maintain dose at 40 to 60mg indefinitely
2.restart prednisone with 6 mercaptopurine and plan on prednisone taper in 2 months
3.stop prednisone and add cyclosporine,
4.admit to hospital and give high dose i/v steriods to induce remission
5.stop mesalamine and add methotrexate
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| Jinx
Forum Elite
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b???
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| juanma0
Forum Senior
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I go for B, because this patient responds to prednisone and adding second agent might help maintain remission at lower dose of steroids.
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| sheeezooo
Forum Guru
Topics: 30
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 thats right...prednisone is effective treating active crohns disease for short durations(3to6 months) long term maintainnce not indicated.
6mercaptopurine and azathioprine are steroid sparing medications used to limit the need for prednisone.
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if u hold up your head with a smile on your face and are truely thankful,u are blessed because the majority can, but most do not..
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| study_ing
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intersting
good qs sheeezooo
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