Vedolizumab for the Induction of Remission in Treatment-refractory Microscopic Colitis in a Pediatric Patient.

JPGN Volume 71, N assing the subtypes co M colon encomp llagenous colitis (CC) and lymphocytic colitis (LC), is an infrequent cause of watery diarrhea. In addition to diarrhea, MC is characterized by a grossly normal-appearing colonoscopy with typical histologic features. The American Gastroenterological Association (AGA) recommends budesonide as first-line therapy for induction and maintenance of remission in MC (1). Therapies for refractory disease have not, however, been well studied. Immunomodulators, 5-ASA compounds, and anti-TNF therapy have all been utilized with varying degrees of success (2). Rare adult case series have described the use of vedolizumab, a monoclonal antibody targeting the a4b7 integrin on T-lymphocytes, for patients who have failed first-line therapy (3–5). Here we report the first case in the pediatric literature of a patient responding to vedolizumab for refractory MC. Informed consent from the family was obtained before the submission of this manuscript.