Vancomycin for the Induction and Maintenance of Remission in Biologics Refractory Patient with Ulcerative Colitis and Primary Sclerosing Cholangitis Post-Liver and Bone Marrow Transplantation
Bibliographic record
Abstract
Introduction: Inflammatory bowel disease-primary sclerosing cholangitis (IBD-PSC) is a unique disease entity that has very poorly understood pathogenesis and unique clinical presentation. Patients with this disease may eventually require liver transplantation as there is no current curative treatment for PSC to halt disease progression for liver failure. Thirty percent of patients with IBD may experience recurrence despite being on immunosuppression. Few studies have shown that vancomycin has been used as a salvage treatment for patients with refractory ulcerative colitis (UC) exacerbation refractory to conventional and biological agents. In this report, we discuss the case of 25-year-old female with a prior history of sickle cell disease (SCD), UC, post-liver transplant secondary to PSC, who developed UC exacerbation refractory to conventional therapies and most biological agents and was induced and maintained in remission with oral vancomycin (OV). Case Presentation: This is the case of 25-year-old female with a history of SCD, UC, and primary sclerosing cholangitis (PSC) who developed liver cirrhosis and underwent liver transplantation. Prior to liver transplantation, she had recurrent exacerbations of UC, refractory conventional therapies, and most biological agents. Post-liver transplantation, she developed another UC flare despite being treated with ustekinumab. OV 125 mg four times daily was used as salvage therapy post-liver transplantation to control her UC. Conclusion: This report supports the use of OV in patient with SCD who had UC exacerbation refractory to conventional and biological agents.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".