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Cyclosporine treatment of fulminant colitis.

Improved treatment of individuals with severe inflammatory bowel disease with potent immunosuppressive medications such as 6-mercaptopurine has been previously demonstrated. Unfortunately, the use of this medication in individuals with fulminant disease is often limited by its very slow onset of action. This has suggested a potential role for alternative immunosuppressive agents in selected patients with inflammatory bowel disease. We now describe the course of two adolescents with fulminant colitis who were being considered for colectomy and who were treated with oral cyclosporine. Each appeared to have a prompt response to this medication, and both entered into a complete clinical remission. A mild increase in serum creatinine and hirsutism were the only side effects noted. These observations suggest the need for controlled trials to define the potential role and long-term toxicity of cyclosporine in individuals with severe inflammatory bowel disease.