RT Journal Article SR Electronic T1 Successful use of TNFα blockade in a severe case of idiopathic non-granulomatous ulcerative jejunoileitis associated with thrombotic thrombocytopenic purpura JF BMJ Open Gastroenterology FD BMJ Publishing Group Ltd SP e000252 DO 10.1136/bmjgast-2018-000252 VO 6 IS 1 A1 Fabian Braun A1 Victor Suarez A1 Johanna Dinter A1 Stefan Haneder A1 Alexander Quaas A1 Thomas Benzing A1 Dirk Nierhoff A1 Roman-Ulrich Müller YR 2019 UL http://bmjopengastro.bmj.com//content/6/1/e000252.abstract AB We describe the case of 50-year-old female patient who presented with severe gastrointestinal symptoms and progressive weight loss of unknown origin. Shortly after admission, she developed an acute flare of thrombotic thrombocytopaenic purpura (TTP) that had to be treated by plasma exchange therapy and rituximab administration. While the signs of TTP subsided, the gastrointestinal symptoms worsened with abdominal cramps, massive gastric retention, malnourishment and a stenosis due to extensive inflammation and wall thickening of the small bowel. Extensive diagnostic efforts yielded no specific cause, so the patient—based on the histopathological findings—was diagnosed with idiopathic non-granulomatous ulcerative jejunoileitis. Following a highly complicated clinical course over several months, successful remission of the inflammatory activity and recovery of the patient could be obtained by TNF-alpha blockade.