Washed microbiota transplantation in refractory intestinal Behçet’s disease with trisomy 8/myelodysplastic features

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A 44-year-old woman, with refractory intestinal BD, trisomy 8 and MDS-like features, presented with progressive colonic ulcers and intractable abdominal pain. Over 20 months, nine pharmacological agents were discontinued due to toxicity or inefficacy, including thalidomide, lenalidomide, cyclophosphamide, cyclosporin, infliximab and so on. Methylprednisolone partially controlled oral ulcers but failed to ameliorate intestinal lesions lasting nineteen months. The dose of methylprednisolone was 12 mg per day for 1 year before the first course of WMT. Colonoscopy revealed a large ulcer (occupying one-third of the ileocecal valve circumference; Figure 1A). Transendoscopic enteral tubing (TET; Figure 1B) was placed during the colonoscopy, followed by daily WMT infusions through the TET tube for 3 days as our previous report.1 During the first follow-up period, the dose of methylprednisolone has been tapered to 8 mg/day successfully post-WMT. At 3-month follow-up, the ulcer had regressed to 0.7 × 0.5 cm, with complete resolution of abdominal pain. Nine months post-WMT, colonoscopy confirmed mucosal healing (Figure 1C).

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