RESUMEN
BACKGROUND: We assessed whether differential efficacy of early combined immunosuppression (ECI) in comparison with conventional management (CM) is present in patients with Crohn disease (CD) according to disease location. METHODS: In this posthoc analysis of the Randomized Evaluation of an Algorithm for Crohn's Treatment trial, the effect of ECI vs CM modified by disease location (isolated-colonic vs ileal-dominant) in terms of time to first complication (hospitalization, surgery, or disease-related complications-presence of a new abscess, fistula, or stricture; serious worsening of disease activity; extraintestinal manifestations) was analyzed using a marginal Cox proportional hazard model to account for cluster randomization. Factors adjusted included practice size, country, and other covariates selected in a backward logistic regression analysis with the first composition as outcome and P < 0.10. RESULTS: Of the 1969 patients with CD, 435 had isolated colonic CD (ECI n = 257, CM n = 178) and 1534 had ileal CD (ECI n = 817, CM n = 717). Over 24 months there was a significant differential impact for ECI vs CM for reducing the risk of a CD-related complication between patients with colonic CD and ileal CD (colonic CD hazard ratio [HR] = 0.51; 95% CI, 0.30-0.85 vs ileal CD HR = 0.79; 95% CI, 0.57-1.10; P = 0.033). No difference was identified between ECI vs CM for reducing the risk of surgery (colonic HR = 0.52 vs ileal HR = 0.74; P = 0.468) or hospitalization (colonic HR = 0.77 vs ileal HR = 0.83; P = 0.806). CONCLUSIONS: In this posthoc analysis of the Randomized Evaluation of an Algorithm for Crohn's Treatment trial, symptom-based ECI was associated with greater efficacy for reducing the risk of CD-related complications in patients with colonic disease location relative to ileal disease location.
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Enfermedades del Colon , Enfermedad de Crohn , Enfermedades del Íleon , Terapia de Inmunosupresión , Enfermedades del Colon/tratamiento farmacológico , Enfermedad de Crohn/tratamiento farmacológico , Humanos , Enfermedades del Íleon/tratamiento farmacológicoAsunto(s)
Diverticulitis/diagnóstico , Enfermedades del Íleon/diagnóstico , Enfermedades del Yeyuno/diagnóstico , Anciano , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Diverticulitis/tratamiento farmacológico , Diverticulitis/cirugía , Humanos , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/cirugía , Enfermedades del Yeyuno/tratamiento farmacológico , Enfermedades del Yeyuno/cirugía , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Insuficiencia del TratamientoAsunto(s)
Enfermedades del Íleon/diagnóstico , Íleon/patología , Mucosa Intestinal/patología , Isospora/aislamiento & purificación , Isosporiasis/diagnóstico , Adulto , Biopsia , Colonoscopía , Femenino , Humanos , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/parasitología , Enfermedades del Íleon/patología , Íleon/diagnóstico por imagen , Mucosa Intestinal/parasitología , Isosporiasis/tratamiento farmacológico , Isosporiasis/parasitología , Isosporiasis/patología , Estadios del Ciclo de Vida , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoRESUMEN
A 52-year-old man with known hereditary angio-oedema (HAE) presented with a 2-day history of progressive severe abdominal pain, distension, nausea, vomiting and constipation. CT of his abdomen and pelvis showed small-bowel obstruction and ascites. HAE is a rare autosomal dominant disorder caused by a C1 esterase deficiency and involves episodic oedema of subcutaneous and mucosal tissues. It commonly affects the face and limbs, causing deformity; the respiratory tract, causing life-threatening laryngeal swelling; and the gastrointestinal tract, causing small-bowel obstruction. An infusion of a C1 esterase inhibitor was given to the patient. His symptoms resolved within 6 hours, and a repeat CT showed complete resolution 24 hours later. Small-bowel obstruction in HAE is often misdiagnosed, leading to ineffective treatment and unnecessary surgery. Therefore, this should be suspected in patients with HAE presenting with an acute abdomen, and clinicians should understand the unique treatment required.
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Angioedemas Hereditarios/complicaciones , Enfermedades del Íleon/etiología , Obstrucción Intestinal/etiología , Dolor Abdominal , Angioedemas Hereditarios/tratamiento farmacológico , Proteína Inhibidora del Complemento C1/uso terapéutico , Inactivadores del Complemento/uso terapéutico , Diagnóstico Diferencial , Humanos , Enfermedades del Íleon/tratamiento farmacológico , Obstrucción Intestinal/tratamiento farmacológico , Masculino , Persona de Mediana EdadAsunto(s)
Artritis Psoriásica/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Enfermedades del Íleon/tratamiento farmacológico , Úlcera/tratamiento farmacológico , Ustekinumab/uso terapéutico , Artritis Psoriásica/complicaciones , Artritis Psoriásica/patología , Humanos , Enfermedades del Íleon/complicaciones , Enfermedades del Íleon/patología , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Úlcera/complicaciones , Úlcera/patologíaRESUMEN
INTRODUCTION: Chronic nonspecific multiple ulcers of the small intestine (CNSU), an entity with female preponderance and manifestations including anemia and hypoproteinemia reflecting persistent gastrointestinal bleeding and intestinal protein loss, has been considered idiopathic. Umeno et al recently reported that CNSU is caused by loss-of-function mutations in the solute carrier organic anion transporter family member 2A1 gene (SLCO2A1) encoding a prostaglandin transporter, renaming the disorder "chronic enteropathy associated with SLCO2A1 gene mutation" (CEAS). Treatments for chronic enteropathies such as inflammatory bowel disease, including 5-aminosalicylic acid, corticosteroids, azathioprine, and anti-tumor necrosis factor-α antibody, often are ineffective in CEAS, which frequently requires surgery. CASE PRESENTATION: A 14-year-old girl had refractory anemia and hypoproteinemia for more than 2 years. Video capsule endoscopy showed nonspecific jejunal and ileal ulcers with varied sizes and shapes. She was diagnosed with CEAS resulting from compound heterozygous mutation of the SLCO2A1 gene. After corticosteroid treatment without improvement, azathioprine treatment improved her anemia and edema as hemoglobin and serum protein increased. Video capsule endoscopy 1 year after initiation of azathioprine showed improvement of small intestinal ulcers. CONCLUSION: Physicians should consider CEAS in patients with refractory anemia, hypoproteinemia, and multiple small intestinal ulcers. Why our patient responded to azathioprine but not to corticosteroids is unclear, but azathioprine might benefit some other patients with CEAS.
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Azatioprina/uso terapéutico , Inmunosupresores/uso terapéutico , Intestino Delgado , Transportadores de Anión Orgánico/genética , Úlcera Péptica/tratamiento farmacológico , Úlcera Péptica/genética , Adolescente , Endoscopía Capsular , Enfermedad Crónica , Femenino , Humanos , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/genética , Enfermedades del Yeyuno/tratamiento farmacológico , Enfermedades del Yeyuno/genéticaRESUMEN
The introduction of ustekinumab, an interleukin [IL]12/23 p40 inhibitor, to the therapeutic armamentarium of Crohn's disease has provided a much needed treatment option for patients who have failed conventional biologics with anti-tumour necrosis factor [TNF] and anti-integrin agents. Despite targeting two major cytokine pathways, the side effect profile of ustekinumab appears to be favourable in clinical trials. In particular, the risk of tuberculosis infection was observed to be lower than in patients who have received anti-TNF agents. The risk of non-tuberculosis mycobacterium infection, however, remains unknown. Here, we report the first case of a patient with Crohn's disease who developed Mycobacterium abscessus infection while on ustekinumab treatment.
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Amicacina/administración & dosificación , Cefoxitina/administración & dosificación , Enfermedad de Crohn , Enfermedades del Íleon , Subunidad p40 de la Interleucina-12/antagonistas & inhibidores , Infecciones por Mycobacterium no Tuberculosas , Ustekinumab , Antibacterianos/administración & dosificación , Anticuerpos Monoclonales Humanizados/administración & dosificación , Anticuerpos Monoclonales Humanizados/efectos adversos , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Esquema de Medicación , Femenino , Humanos , Enfermedades del Íleon/complicaciones , Enfermedades del Íleon/tratamiento farmacológico , Inyecciones Subcutáneas , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Infecciones por Mycobacterium no Tuberculosas/diagnóstico por imagen , Infecciones por Mycobacterium no Tuberculosas/etiología , Micobacterias no Tuberculosas/aislamiento & purificación , Muslo , Resultado del Tratamiento , Ustekinumab/administración & dosificación , Ustekinumab/efectos adversosAsunto(s)
Síndrome de Churg-Strauss/diagnóstico , Dolor Abdominal/etiología , Síndrome de Churg-Strauss/diagnóstico por imagen , Síndrome de Churg-Strauss/cirugía , Terapia Combinada , Disnea/etiología , Urgencias Médicas , Femenino , Humanos , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/etiología , Enfermedades del Íleon/cirugía , Inmunosupresores/uso terapéutico , Perforación Intestinal/tratamiento farmacológico , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Persona de Mediana Edad , Peritonitis/etiología , Peritonitis/cirugía , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Neostigmine is traditionally administered intravenously for treatment of acute colonic pseudo-obstruction (ACPO), though use is associated with administration constraints and adverse effects. OBJECTIVE: To evaluate whether an alternative route of administration for neostigmine via subcutaneous (SQ) delivery is safe and effective in a broad cohort of medical and surgical patients. METHODS: This multicenter, retrospective observational study included adult patients administered SQ neostigmine for ileus, ACPO, or refractory constipation. Efficacy indicators were time to first bowel movement (BM) following initiation of the medication, total SQ neostigmine dose administered to produce a BM, and administration of a rescue intervention to produce a BM. Safety events evaluated were cardiac arrest, bradycardia, bronchospasm requiring intervention, nausea requiring intervention, or severe salivation, lacrimation, or diarrhea. RESULTS: A total of 182 patients were eligible for inclusion. The most commonly utilized dosing strategy of neostigmine was 0.25 mg SQ 4 times daily. The median time to first BM following initiation of SQ neostigmine was 29.19 hours (interquartile range = 12.18-56.84) with a median dose administered before first BM of 1.25 mg. Three patients (1.65%) experienced an adverse drug event leading to drug discontinuation, with 2 developing bradycardia that resolved with drug discontinuation alone. CONCLUSIONS: SQ neostigmine may be reasonable for management of ileus, ACPO, or refractory constipation, though use should be avoided in patients with new-onset heart block, a history of second-degree heart block, or following bowel resection with primary anastomosis. Despite the low incidence of adverse drug events observed, monitoring for bradycardia with telemetry may be considered.
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Inhibidores de la Colinesterasa/administración & dosificación , Seudoobstrucción Colónica/tratamiento farmacológico , Estreñimiento/tratamiento farmacológico , Enfermedades del Íleon/tratamiento farmacológico , Neostigmina/administración & dosificación , Enfermedad Aguda , Adulto , Anciano , Bradicardia/inducido químicamente , Inhibidores de la Colinesterasa/efectos adversos , Femenino , Humanos , Inyecciones Subcutáneas , Persona de Mediana Edad , Neostigmina/efectos adversos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
A 66-year-old Japanese male with a history of Behçet disease exhibited oral and genital ulcers, and a round deep ileocecal ulcer. He was treated with a combination of mesalazine and 20 mg/day of prednisolone (PSL), but was only partially responsive to PSL and we were not able to reduce the steroid dosage. Adalimumab was also administered. However, the ulcer was not completely responsive, and weaning the patient off PSL remained impossible. In contrast, additional treatment with clarithromycin completely healed the refractory active ulcer and left only a scar. Furthermore, the ulcer has since maintained the scar stage despite successfully weaning the patient from PSL.
Asunto(s)
Adalimumab/uso terapéutico , Antiinflamatorios/uso terapéutico , Síndrome de Behçet/tratamiento farmacológico , Enfermedades del Ciego/tratamiento farmacológico , Claritromicina/uso terapéutico , Enfermedades del Íleon/tratamiento farmacológico , Úlcera/tratamiento farmacológico , Anciano , Quimioterapia Combinada , Humanos , Masculino , Mesalamina/uso terapéutico , Prednisolona/uso terapéuticoAsunto(s)
Hemorragia Gastrointestinal/diagnóstico , Tumores del Estroma Gastrointestinal/diagnóstico , Enfermedades del Íleon/diagnóstico , Inmunoglobulina M/sangre , Paraproteinemias/complicaciones , Macroglobulinemia de Waldenström/diagnóstico , Antineoplásicos/uso terapéutico , Biopsia , Quimioterapia Adyuvante , Diagnóstico Diferencial , Hemorragia Gastrointestinal/complicaciones , Hemorragia Gastrointestinal/patología , Tumores del Estroma Gastrointestinal/complicaciones , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/patología , Humanos , Enfermedades del Íleon/complicaciones , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/patología , Mesilato de Imatinib/uso terapéutico , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Paraproteinemias/sangre , Paraproteinemias/patología , Proteínas Proto-Oncogénicas c-kit/análisis , Recurrencia , Resultado del Tratamiento , Macroglobulinemia de Waldenström/complicaciones , Macroglobulinemia de Waldenström/tratamiento farmacológico , Macroglobulinemia de Waldenström/patologíaRESUMEN
We describe a young female patient who had refractory intestinal Behçet's disease that responded to tocilizumab, a humanised anti-interleukin-6 receptor antibody. The patient had suffered from long disease activity courses and was treated with multiple medications, and the disease became refractory when immunosuppressants (e.g., thalidomide, sulfasalazine and azathioprine) were limited for poor remission, methylprednisolone pulse therapy, cyclophosphamide, and biological agents (e.g., adalimumab or infliximab) were restricted due to side effects after administration. Therefore, tocilizumab was considered as a therapeutic option and the symptoms resolved during 9 months of administration. Tocilizumab may be a good choice for intestinal Behçet's disease refractory to conventional treatment.
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Anticuerpos Monoclonales Humanizados/uso terapéutico , Síndrome de Behçet/tratamiento farmacológico , Enfermedades del Íleon/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Receptores de Interleucina-6/antagonistas & inhibidores , Úlcera/tratamiento farmacológico , Adulto , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/inmunología , Resistencia a Medicamentos , Sustitución de Medicamentos , Femenino , Humanos , Enfermedades del Íleon/diagnóstico , Enfermedades del Íleon/inmunología , Receptores de Interleucina-6/inmunología , Resultado del Tratamiento , Úlcera/diagnóstico , Úlcera/inmunologíaAsunto(s)
Dolor Abdominal/etiología , Hemorragia Gastrointestinal/etiología , Vasculitis por IgA/complicaciones , Enfermedades del Íleon/etiología , Intususcepción/etiología , Dolor Abdominal/diagnóstico , Preescolar , Humanos , Vasculitis por IgA/diagnóstico , Vasculitis por IgA/tratamiento farmacológico , Enfermedades del Íleon/diagnóstico por imagen , Enfermedades del Íleon/tratamiento farmacológico , Intususcepción/diagnóstico por imagen , Intususcepción/tratamiento farmacológico , Masculino , Índices de Gravedad del Trauma , UltrasonografíaRESUMEN
OBJECTIVE: Ileocecal endometriosis is rare. Symptoms range from no symptoms, cramps, vomiting, to acute intestinal obstruction. Our objective was to review our cases, clarify, and resume its most appropriate management focusing on the factors to determine diagnosis. This is a retrospective study by revision of medical charts of all ileal endometriosis cases of our unit from 2006 to 2014. CASE REPORT: Seven cases were found; three (43%) had previous endometriosis laparoscopic diagnosis, four (57%) had partial bowel obstruction episodes, three (43%) had chronic pelvic pain, and one developed acute intestinal obstruction in postoperative ileostomy closure. In three (43%), the diagnosis was made with magnetic resonance imaging (MRI) and double contrast barium enema, in one (14%) only with MRI, and the other three (43%) during surgery. All patients underwent resection of the ileum and evolved favorably. CONCLUSION: Variability in symptoms hinders diagnosis. The gold standard for diagnosis is MRI, but clinical suspicion optimizes imaging test diagnosis. Segmental resection should be indicated in the majority of the cases.
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Enfermedades del Ciego/diagnóstico , Enfermedades del Ciego/cirugía , Endometriosis/diagnóstico , Endometriosis/cirugía , Enfermedades del Íleon/diagnóstico , Enfermedades del Íleon/cirugía , Adulto , Enfermedades del Ciego/complicaciones , Enfermedades del Ciego/tratamiento farmacológico , Anticonceptivos Femeninos/uso terapéutico , Endometriosis/complicaciones , Endometriosis/tratamiento farmacológico , Femenino , Humanos , Enfermedades del Íleon/complicaciones , Enfermedades del Íleon/tratamiento farmacológico , Obstrucción Intestinal/etiología , Imagen por Resonancia Magnética , Dolor Pélvico/etiología , Estudios RetrospectivosRESUMEN
OBJECTIVE: To evaluate the mucosal healing in the terminal ileum, colon and small bowel in patients receiving infliximab treatment for small bowel Crohn's disease (SBCD). METHODS: The clinical data of 18 patients with SBCD treated with infliximab were analyzed for laboratory findings (routine blood tests, C-reative protein, and albumin), Crohn's disease activity index (CDAI), Lewis score (LS), Crohn's disease simplified endoscopic score (SES-CD) and adverse effects before and after 30 weeks of infliximab treatment. RESULTS: SES-CD, LS, CDAI and CRP were all decreased significantly, but the body mass index and albumin were significantly increased in the 18 patients after 30 weeks of IFX treatment. Sixteen (88.9%) of the patients were in clinical remission, 10 (58.8%) showed terminal ileum and colonic mucosal healing, 4 (22.2%) showed small bowel mucosal healing, and 3 (17.6%) were in deep remission. The 4 patients with small bowel mucosal healing all showed terminal ileum and colon mucosal healing, and 6 patients with terminal ileum and colon mucosal healing did not show small bowel mucosal healing. CONCLUSION: Infliximab treatment can effectively reduce inflammatory activity, induce and maintain clinical remission of SBCD and achieve mucosal healing; small bowel mucosal healing occurs later than terminal ileum and colonic mucosal healing, indicating the importance of small bowel mucosal healing in efficacy analysis of the treatment.
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Enfermedades del Colon/tratamiento farmacológico , Enfermedad de Crohn/tratamiento farmacológico , Fármacos Gastrointestinales/uso terapéutico , Enfermedades del Íleon/tratamiento farmacológico , Infliximab/uso terapéutico , Mucosa Intestinal/efectos de los fármacos , Humanos , Intestino Delgado , Inducción de Remisión , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
A 65-year-old woman presented to a nearby clinic with a painful mass in the right lower abdominal region. She was suspected of having an appendiceal tumor on abdominal computed tomography (CT) and was referred to our hospital for surgery. Blood testing revealed increased inflammatory markers. Contrast-enhanced abdominal CT revealed a mass with poorly defined margins in the ileocecal region, which was adjacent to the external iliac vessels. A barium enema revealed unilateral wall deformities in the cecum through to the terminal ileum, whereas lower gastrointestinal endoscopy showed no clear epithelial tumor component. The patient was clinically diagnosed with ileocecal actinomycosis and treated with high-dose penicillin G. On day 15 of treatment, contrast-enhanced abdominal CT showed a reduction in mass size. On day 26, right hemicolectomy (D3) with combined resection of the external iliac vein (which could not be separated from the mass) was performed. Pathological examination revealed granulation tissue with granules of actinomyces, with filamentous bacteria detected by Grocott staining. With no evidence of malignancy, the final diagnosis of ileocecal actinomycosis was made. This report presents a case of clinically suspected ileocecal actinomycosis treated by preoperative antibiotic treatment to reduce mass size, followed by surgical resection.
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Actinomicosis/tratamiento farmacológico , Actinomicosis/cirugía , Enfermedades del Ciego/tratamiento farmacológico , Enfermedades del Ciego/cirugía , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/cirugía , Penicilina G/administración & dosificación , Anciano , Femenino , Humanos , Cuidados PreoperatoriosAsunto(s)
Ascitis/etiología , Diarrea/etiología , Esofagitis Eosinofílica/complicaciones , Síndrome Hipereosinofílico/complicaciones , Enfermedades del Íleon/complicaciones , Adulto , Ascitis/diagnóstico , Ascitis/tratamiento farmacológico , Biopsia , Budesonida/uso terapéutico , Colonoscopía , Diarrea/diagnóstico , Diarrea/tratamiento farmacológico , Esofagitis Eosinofílica/diagnóstico , Esofagitis Eosinofílica/tratamiento farmacológico , Esofagoscopía , Glucocorticoides/uso terapéutico , Humanos , Síndrome Hipereosinofílico/diagnóstico , Síndrome Hipereosinofílico/tratamiento farmacológico , Enfermedades del Íleon/diagnóstico , Enfermedades del Íleon/tratamiento farmacológico , Masculino , Inducción de Remisión , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Background - Crohn's disease is a clinically heterogeneous condition. Our aim was to identify the phenotype evolution of Crohn's disease over time according to the Montreal Classification and to precise predictive factors of the need for immunosuppressant treatment or surgery. Methods - We included Crohn's disease patients who were followed up for at least 5 years. We excluded patients who were lost to follow up before five. Patients were classified according to the Montreal classification for phenotype at diagnosis and five years later. The evolution of phenotype over time and the need for surgery, immunosuppressive or immunomodulatory drugs were evaluated. Results - One hundred twenty consecutive patients were recruited: 70 males and 50 females. At diagnosis, 68% of patients belong to A2 as determined by the Montreal classification. Disease was most often localized in the colon. The disease location in Crohn's disease remains relatively stable over time, with 93.4% of patients showing no change in disease location. Crohn's disease phenotype changed during follow up, with an increase in stricturing and penetrating phenotypes from 6% to 11% after 5 years. The only predictive factor of phenotype change was the small bowel involvement (OR=3.7 [1.2-7.6]). During follow-up, 82% of patients have presented a severe disease as attested by the use of immunosuppressive drugs or surgery. The factors associated with the disease severity were: small bowel involvement (L1), the stricturing (B2) and penetrating (B3) phenotypes and perineal lesions (OR=17.3 [8.4-19.7]; 12 [7.6-17.2]; 3[1.7-8.3] and 2.8 [2.2-5.1] respectively), without association with age, sex or smoking habits. Conclusion - Crohn's disease evolves over time: inflammatory diseases progress to more aggressive stricturing and penetrating phenotypes. The ileal location, the stricturing and penetrating forms and perineal lesions were predictive of surgery and immunosuppressant or immunomodulatory treatment.
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Enfermedades del Colon/patología , Enfermedad de Crohn/patología , Fenotipo , Enfermedades del Colon/clasificación , Enfermedades del Colon/tratamiento farmacológico , Enfermedades del Colon/cirugía , Constricción Patológica/patología , Enfermedad de Crohn/clasificación , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/cirugía , Femenino , Estudios de Seguimiento , Humanos , Enfermedades del Íleon/clasificación , Enfermedades del Íleon/tratamiento farmacológico , Enfermedades del Íleon/patología , Enfermedades del Íleon/cirugía , Íleon , Inmunosupresores/uso terapéutico , Masculino , Factores de TiempoRESUMEN
OBJECTIVE: The aim of this study was to assess the impact of resveratrol (RST) on oxidative stress induced by methotrexate in rat ileum tissue. MATERIALS AND METHODS: Twenty-four rats were divided into 4 groups with 6 in each group. Each rat was orally administered the following every day for 30 days: group 1 (MTXG), methotrexate (MTX; 5 mg/kg); group 2 (RMTXG), MTX (5 mg/kg) plus RST (25 mg/kg/day); group 3 (RSTG), RST alone (25 mg/kg/day), and group 4 (controls), distilled water. After the rats had been sacrified, the ilea were removed for the assessment of malondialdehyde (MDA), total glutathione (tGSH) and glutathione peroxidase (GSH-Px). Gene expression analyses for interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α) and myeloperoxidase (MPO) were also performed. Hematoxylin and eosin-stained paraffin-embedded sections of the ileum were analyzed under a light microscope and the findings were recorded. Statistical analyses of the data were performed using one-way ANOVA. RESULTS: The administration of MTX in group 1 yielded a higher level of MDA (8.33 ± 2.5 µmol/g protein, p < 0.001) and lower levels of tGSH (0.97 ± 0.29 nmol/g protein) and GSH-Px (5.22 ± 0.35 U/g protein, p < 0.001) compared to the other groups. MTX also increased IL-1ß (40.33 ± 5.43 gene expression levels), TNF-α (6.08 ± 0.59) and MPO gene expression (9 ± 1.41) in group 1 compared to the controls (11.33 ± 2.07, 2.15 ± 0.33 and 3.43 ± 0.48, respectively, p < 0.001). The impact of RST on IL-1ß, TNF-α and MPO gene expression induced by MTX was observed as a reversal of these findings (p < 0.05). Severe inflammation, damage to the villus epithelium and crypt necrosis was observed histopathologically in the MTXG group, whereas only mild inflammation was seen in the RMTXG group. CONCLUSION: In this study, ileal damage caused by MTX was inhibited by RST.