An 18-year-old woman was admitted to our hospital with fever, abdominal pain and bloody stool. Colonoscopy revealed severe ulcerative colitis. She was treated with prednisolone (70 mg/day) and sessions of granulocyte/monocyte apheresis (GMA) , which induced remission. However, the symptoms returned following the start of oral intake. Prednisolone and GMA treatment were not effective this time, and the patient was started on treatment with tacrolimus, which successfully induced remission. During treatment with tacrolimus, blood trough level control is important. By using rapid induction therapy and adjusting the tacrolimus dose according to the formula in the package insert, we were able to treat the intractable ulcerative colitis safely. Tacrolimus is thought to be an effective treatment agent for intractable ulcerative colitis in ordinary hospitals like ours.
