Fig. 1.

Colonoscopy findings of cecum, ascending colon, and descending colon.

(a) Before HTx, there was only nonspecific erythema at rectum, possibly due to the drug, and no malignant findings.

(b) Six months after HTx, first admission, small ulcers throughout the colon except the terminal ileum were detected.

(c) Seventeen months after HTx, second admission, small colonic ulcers gradually increased.

(d) Twenty-one months after HTx, third admission, colonic ulcers increased and fused together to form longitudinal ulcers.

(e) After administration of 5-ASA for treatment of de novo CD, colonic ulcers were almost healed.

(f) The small ulcers had reappeared, which suspected exacerbation of the de novo CD.

(g) Ulcers were generally improved after introduction of ustekinumab.

(h) Ulcers have maintained remission for >1 year after introduction of ustekinumab.

HTx, heart transplantation; 5-ASA, 5-aminosalicylic acid; CD, Crohn's disease.