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1.
Unusual pulmonary complication of ulcerative colitis with a rapid response to corticosteroids: case report. 总被引:1,自引:0,他引:1 下载免费PDF全文
Extraintestinal features of ulcerative colitis are well recognised. Pulmonary complications include pulmonary vasculitis, fibrosing alveolitis, asthma, and chronic bronchial suppuration. A case is described of a patient with longstanding quiescent ulcerative colitis who developed a life threatening pulmonary complication, which is extremely sensitive to corticosteroid treatment. 相似文献
2.
Tomohiro Terai Mitsushige Sugimoto Satoshi Osawa Ken Sugimoto Takahisa Furuta Shigeru Kanaoka Mutsuhiro Ikuma 《Clinical journal of gastroenterology》2011,4(3):151-156
Ulcerative colitis is occasionally complicated by dermatological disorders presenting as extra-intestinal manifestations,
including erythema nodosum and pyoderma gangrenosum. Sweet’s syndrome is considered to be a rare cutaneous disease in patients
with ulcerative colitis. To date, only 17 cases of Sweet’s syndrome complicating ulcerative colitis have been reported in
the English literature. Here, we report a case of a 41-year-old male who had been suffering from ulcerative colitis for 20 years.
He was admitted to hospital with hematochezia, diarrhea and fever, and painful erythematous nodules on the face and arms.
Histological examination of skin biopsies showed inflammatory cell infiltration composed mainly of neutrophils without evidence
of necrotizing vasculitis, and the condition was diagnosed as Sweet’s syndrome. The patient was treated with prednisolone
and leukocytapheresis and the erythematous nodules on the skin, as well as the abdominal symptoms and endoscopic findings
of ulcerative colitis, immediately improved. In this paper we report on this case and review the literature concerning ulcerative
colitis and Sweet’s syndrome. 相似文献
3.
We describe 2 patients with quiescent ulcerative colitis who developed clinical syndromes suggesting Wegener's granulomatosis. Both patients had features of systemic illnesses, nodular lung lesions, and antineutrophil cytoplasmic antibodies. Although the inflammatory bowel disease of both patients was quiescent at the time of their pulmonary presentations, lung biopsy results were consistent with pulmonary complications of ulcerative colitis, an unusual manifestation of that disorder. These cases illustrate that pathological confirmation of the diagnosis is essential in cases of suspected vasculitis. The patients' pulmonary lesions resolved promptly after treatment with corticosteroids. 相似文献
4.
Yasser EMAD Yasser RAGAB Ahmed EL‐MARAKBI Salama MOHAMED HANFI 《International journal of rheumatic diseases》2007,10(4):326-329
A 48‐year‐old male patient with long‐standing ulcerative colitis since February 2001 which was diagnosed by endoscopy, developed acute digital ischemia affecting both hands with fixed colour changes in the left index finger which was followed shortly by digital ulceration. Magnetic resonance angiography (MRA) of both upper limbs showed evidence of vasculitis affecting digital arterioles on both sided and right subclavian occlusion. The patient received pulse methylprednisolone followed by cyclophosphamide pulse therapy, the latter continuing on a monthly basis for 6 months with appreciable improvement and remission of the vasculitic process; follow‐up MRA showed reperfusion of the previously occluded subcalvian artery. To the authors’ knowledge vasculitis complicating the course of ulcerative colitis is a rare association and is only sporadically reported in the literature. This rare entity should be diagnosed early and aggressively treated; MRA is a very promising diagnostic tool that is suitable for both diagnosis and follow‐up of patients with this rare entity. 相似文献
5.
P. De Cruz M. Lust N. Trost A. Wall R. Gerraty W. R. Connell 《Internal medicine journal》2008,38(11):865-867
Thromboembolic complications, such as deep venous thrombosis and pulmonary embolism, are well recognized in patients with inflammatory bowel disease (IBD). We describe three cases of cerebral venous thrombosis complicating ulcerative colitis. Cerebral venous thrombosis is a rare but potentially devastating complication of IBD, and the diagnosis needs to be considered in any patient with IBD presenting with neurological symptoms. 相似文献
6.
The authors present an illustrative case of progressive and severe shortening of the colon complicating chronic ulcerative colitis. The term brachycolon is defined and proposed as a useful differential diagnostic sign of ulcerative colitis. 相似文献
7.
P Camus A Fur G Gonzalez L Jeannin 《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》1989,10(2):96-100
The spectrum of respiratory diseases associated with ulcerative colitis. The respiratory diseases associated with ulcerative colitis have recently been recognized, and principally affect the bronchi. Both chronic bronchitis and bronchiectasis may develop after many years, some of the patients having already undergone colectomy. Chronic bronchitis is characterized by cough and chronic mucopurulent sputum, and these symptoms may be exacerbated during acute flare-ups of ulcerative colitis. The bronchial lesions are inflammatory and can be reversed by corticosteroid therapy. Bronchiectasis produces similar symptoms, but has distinctive radiological features. Corticosteroids may sometimes reduce the symptoms, but they have no effect on the bronchial lesions. Salicylazosulfapyridine might be responsible for hypersensitivity lung diseases with eosinophilia, but the drug does not seem to be involved in the genesis of these bronchial manifestations. There have been occasional reports of other respiratory diseases associated with ulcerative colitis, including obliterative bronchiolitis, isolated and asymptomatic airflow obstruction, inflammatory tracheal stenosis, pulmonary vasculitis, pleurisy and pleuropericarditis, chronic pneumonia and interstitial fibrosis which may be diffuse or localized to the apices. 相似文献
8.
Dr. Mitsuru Seo M.D. Tsukane Nakahara M.D. Mitsuo Okada M.D. Hiroshi Murayama M.D. Mikitoshi Hashimoto M.D. Hisami Umeno M.D. Kiyomi Hoshiko M.D. Yoshihiro Horinouchi M.D. Tsuneyoshi Yao M.D. 《Diseases of the colon and rectum》1995,38(3):313-317
PURPOSE: This study was designed to clarify the importance of detecting small, depressed colorectal cancer complicating ulcerative colitis. METHODS: A 39-year-old Japanese male, who had an 18-year history of left-sided ulcerative colitis, was admitted to Fukuoka University Hospital for further evaluation of his colitis. Colonoscopy with a dye spraying method clearly revealed a small, depressed lesion and flat plaque-like lesions in the rectum. Biopsies taken from a depressed lesion and plaque-like lesions revealed a signet-ring cell carcinoma and dysplasia, respectively. Total colectomy was performed. RESULTS: Sections from the depressed rectal lesion, measuring 7X8 mm in size, revealed a signet-ring cell carcinoma that diffusely invaded the muscularis propria. Lymph node metastasis was evident. Flat plaques and mucosa around the depressed lesion were positive for dysplasia. CONCLUSION: This is the first report of a case of small, depressed rectal cancer complicating ulcerative colitis diagnosed by preoperative colonoscopy. To improve outcome of colonoscopic surveillance in ulcerative colitis, detecting such small, depressed lesions are important, and colonoscopy with a dye spraying method would be useful in detecting them. 相似文献
9.
Vasculitis in many forms has been reported rarely in association with ulcerative colitis. We report the occurrence of necrotizing vasculitis in a 48-year-old man 19 years after the onset of ulcerative colitis and 5 years after total colectomy with rectal preservation. The disease was limited to small arteries of skin and muscle consistent with the syndrome of cutaneous polyarteritis nodosa that has been reported with regional enteritis but not previously with ulcerative colitis. 相似文献
10.
J Munchar H A Rahman M M Zawawi 《European journal of gastroenterology & hepatology》2001,13(11):1385-1387
Localized giant pseudopolyposis is an interesting but unusual manifestation of both ulcerative colitis and Crohn's disease. The purpose of this report is to present a case of localized giant pseudopolyposis complicating an ulcerative colitis, and review other cases reported in the literature. The clinical and pathological findings are described. The authors also discuss the possible aspect of proper management in this type of lesion. 相似文献
11.
Hajime Futami Makoto Kodaira Takahisa Furuta Hiroyuki Hanai Eizo Kaneko 《Journal of gastroenterology》1998,33(3):408-411
A 32-year-old woman with ulcerative colitis had a relapsed of pyoderma gangrenosum during puerperium. Both the pyoderma gangrenosum
and ulcerative colitis had been well controlled with oral prednisolone, but ulcerative colitis relapsed in pregnancy, and
pyoderma gangrenosum relapsed in the puerperium. The pyoderma gangrenosum responded to methylprednisolone pulse therapy initially,
but relapsed when prednisolone was tapered. A second trial of pulse therapy combined with cyclosporine resulted in complete
remission of the pyoderma gangrenosum, and no recurrence was recognized after prednisolone was tapered. This is a very rare
case of successful treatment with methylprednisolone pulse therapy combined with cyclosporine for pyoderma gangrenosum complicating
ulcerative colitis.
(Received May 6, 1997; accepted Sept. 26, 1997) 相似文献
12.
Summary
A child with ulcerative colitis is described in whom many unusual complications of the disease occurred. Arthritis was present and preceded the onset of the colitis. The patient also developed vasculitis, hepatitis, pleuritis, pericarditis, cryoglobulinemia, and disseminated intra-vascular coagulopathy. A review of the literature on ulcerative colitis revealed the relative infrequent occurrence of many of these manifestations in the pediatric age group. 相似文献
13.
Philip S. Feldman M.D. 《Diseases of the colon and rectum》1975,18(7):601-612
Carcinoma complicating idiopathic ulcerative colitis is well known. Conversely, acute colitis complicating obstructing carcinomas and other partially obstructing lesions of the colon has not been recognized until recently. The present study reports two cases of colitis secondary to obstruction: 1) a giant ulcer with colitis proximal to partially obstruction diverticulitis of the sigmoid colon, and 2) colitis proximal to obstructing carcinoma of the sigmoid colon. The purpose of this report is to document these cases and review the literature on this variety of colitis to facilitate its recognition and subsequent correct treatment. An unawareness of this entity prejudices the anastomosis and results in anastomotic complications (approximately 25 per cent), with significant morbidity and mortality. 相似文献
14.
Shuichi Sano Isao Nishimori Satoru Tamura Saburo Onishi Chikako Yamauchi Hajime Tanaka Masanori Morita 《Digestive endoscopy》2000,12(2):172-176
We report a case of ulcerative colitis complicating ileitis that endoscopically and histologically resembled a colonic lesion. Eight years prior to the time of writing, the patient had undergone proctosigmoidectomy and ileocecal resection because of severe hemorrhagic lesions of ulcerative colitis. A month prior to the time of writing, bleeding from the stoma occurred. Endoscopy revealed erosions on easy‐bleeding mucosa in the ileum but no active inflammatory lesions in colonic mucosa except for small erosions in the descending colon beneath the stoma. Histologic findings of biopsy specimens from the ileal mucosa showed marked inflammation including neutrophile infiltration and crypt abscesses. This is a rare case of ulcerative colitis showing ileitis as a main recurrent lesion, suggesting that careful observation of the small intestine will be required after ileocecal resection in ulcerative colitis patients. 相似文献
15.
Netto C Vergara M Calvet X Brullet E Bella R Musulén E 《Gastroenterologia y hepatologia》2005,28(5):285-288
We report a patient who, 3 months after being diagnosed with ulcerative colitis, was admitted to hospital because of malaise and right lower abdominal pain. An open appendectomy was performed. Histological study showed ulcerative colitis affecting the appendix. After surgery, the patient presented a refractory outbreak of ulcerative colitis requiring treatment with steroids and cyclosporin A. Despite this treatment, the patient continued to pass abundant fresh blood associated with severe anemia. Colonoscopy showed only granular and congestive cecal mucosa. Biopsies showed intracytoplasmic inclusion bodies with immunohistochemical stains positive for cytomegalovirus (CMV) infection. Rectorrhagia and anemia quickly disappeared after beginning treatment with ganciclovir. Appendicular ulcerative colitis is not uncommonly associated with distal colitis. In addition, diffuse CMV infection complicating ulcerative colitis treatment is not unusual. By contrast, isolated, segmentary infection by CMV in the proximal colon is extremely rare. Until now, only three patients with localized CMV infection have been described, and all three cases occurred in the context of ileoanal anastomosis. 相似文献
16.
《Scandinavian journal of gastroenterology》2013,48(7):601-604
On long-term follow-up of 9 patients who had colonic or rectal carcinoma in association with ulcerative colitis treated by limited resection or colectomy and ileo-rectal anastomosis, 3 were found to have subsequently developed a further primary carcinoma in the remaining colon or rectum. It is strongly recommended, therefore, that cases of intestinal carcinoma complicating ulcerative colitis should always be managed by complete proctocolectomy and ileostomy rather than by more limited surgery. 相似文献
17.
Jae Han Park Gueng Sung Choi Myoung Seok Kim Hyung Keun Kim Young Seok Cho Seong Hyun Son Chang Wook Kim Hiun Suk Chae Chang Don Lee Kyu Young Choi In Sik Chung 《Taehan Sohwagi Hakhoe chi》2005,45(4):301-305
Thromboembolic disease is a significant cause of morbidity and mortality in patients with inflammatory bowel disease. The reported incidence is 1-6%. The most common thromboembolic complications are deep venous thrombosis of legs and pulmonary thromboembolism. Cerebral thrombosis, portal vein thrombosis, retinal venous thrombosis and arterial thrombosis were also reported. We experienced a case of ulcerative colitis complicated with pulmonary thromboembolism. The patient was a 70-year-old woman who was diagnosed as ulcerative colitis on colonoscopy. We used prednisolone and sulfasalazine for the treatment of ulcerative colitis. Twenty five days later, she complained of abrupt dyspnea and chest pain. Chest CT and ventilation-perfusion scan revealed a thromboembolism in both lung. After the treatment of heparin & warfarin therapy, follow-up chest CT showed much regressed pulmonary thromboembolism. We report a 70-year-old woman with ulcerative colitis complicated with pulmonary thromboembolism and treated with heparin & warfarin therapy successfully. 相似文献
18.
S. Dorudi F.R.C.S. R. W. Chapman M.D. M.R.C.P. M. G. W. Kettlewell M.Chir. F.R.C.S. 《Diseases of the colon and rectum》1991,34(9):827-828
The authors present the cases of two patients with carcinoma of the gallbladder complicating chronic ulcerative colitis. Both patients had concomitant primary sclerosing cholangitis. Twelve such cases of gallbladder carcinoma have been reported in the literature. The presence of primary sclerosing cholangitis in patients with ulcerative colitis is associated with malignancy of the extrahepatic biliary tree. It is suggested that, if colectomy is necessary, the liver should be biopsied and a cholecystectomy performed if the gallbladder is deemed abnormal. 相似文献
19.
Mr. A. M. Abulafi F.R.C.S. F.R.C.S. R. V. Fiddian M.Ch. F.R.C.S. 《Diseases of the colon and rectum》1990,33(7):615-618
The authors present the case of a 40-year-old woman with primary malignant lymphoma complicating chronic ulcerative colitis. Twentyone cases reported in the literature are reviewed and the various available data analyzed. Variations in the distribution of lymphoma in both the normal and colitic bowel supports a relationship between both conditions. Any lymphocytic infiltrate seen in biopsies obtained from ulcerative colitis should be assessed to exclude associated lymphoma. The prognosis is poor. 相似文献
20.
Akbulut S Ozaslan E Topal F Albayrak L Kayhan B Efe C 《World journal of gastroenterology : WJG》2008,14(15):2448-2450
A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD), including pyoderma gangrenosum, erythema nodosum, perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions. 相似文献