• Yoriaki Komeda, Toshiharu Sakurai, Kazuko Sakai, Yasuyoshi Morita, Arito Hashimoto, Tomoyuki Nagai, Satoru Hagiwara, Itaru Matsumura, Kazuto Nishio, and Masatoshi Kudo.
• Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan.
• World J Clin Cases. 2020 Dec 26; 8 (24): 6389-6395.

BackgroundConcomitant ulcerative colitis (UC) and idiopathic thrombocytopenic purpura (ITP) is a rare phenomenon. The management of UC with ITP can be challenging, since a decreased platelet count augments UC.Case SummaryA 24-year-old man with UC and steroid-resistant ITP experienced UC flare. Although continuous infusion of cyclosporine was initiated, UC did not improve. The administration of tofacitinib subsequently led to the induction of remission. The patient has maintained remission of UC and ITP for over one year on tofacitinib treatment. Whole transcriptomic sequencing was performed for inflamed rectal mucosae obtained before and after the initiation of Janus kinase (JAK) inhibitor, suggesting that distinct molecular signatures seemed to be regulated by JAK inhibitors and other conventional therapies including tumor necrosis factor lockers.ConclusionTofacitinib should be considered in refractory cases of UC with ITP.©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

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