In: Crohn's disease20 Aug 2012
At this time the paper by Wettstein and Meagher came to the author’s attention, and after some discussion with the patient he was placed on thalidomide at 100 mg/day. All other medication was discontinued. The patient returned to his home town and communication with his general practitioner revealed that the bleeding had ceased and his hemoglobin was finally beginning to rise. Six months later it reached a level of 156 g/L, the highest in many years. During this period of time the patient developed two side effects of the drug, which were headache and diplopia.
These side effects both subsided when the dose of thalidomide was reduced to 50 mg/day. Repeat colonoscopy revealed marked improvement of the ileal ulceration (Figure 2).
Figure 2) Colonoscopic demonstration of the reduction in size of ileal ulcers six months after initiation of thalidomide, January 1999
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