A 27-year-old patient diagnosed 10 years ago with ulcerative pancolitis. Clinically stable and subjected to maintenance therapy with azathioprine (2.5 mg/kg) for over three years. On occasion of the last controls the patient claimed to feel worse, with an increase in the number of blood-containing stools, associated to asthenia and loss of appetite. The laboratory tests evidenced mild ferropenic anemia and increased C-reactive protein.
Treatment was started with infliximab, followed by a very good clinical-laboratory test response. Maintenance therapy was continued every 8 weeks. One year later the patient was in clinical remission and subjected to endoscopic monitoring.
A prolonged duration of ulcerative colitis increases the possibility of dysplastic lesions and neoplasms associated to the disease. Endoscopic disease, with sustained histological inflammation, a short and rectified colon, and pseudo-polypoid lesions or strictures increase the risk of developing lesions of this kind.