Abstract

A 17-year-old girl having no remarkable past history was admitted to our hospital because of abdominal pain, pyrexia and mucosanguinous diarrhea. Blood chemistory findings on admission were all within normal limits exept for incresed CRP level and white blood cell count, indicating an acute inflammatory reaction. A few stool cultures yielded no enteric pathogens. Colonoscopy demonstrated diffuse multiple aphthoid lesions with circumferential redness in the enteric colon and rectum, being compatible with aphthoid colitis proposed by K. Yoshikawa. She was treated by antibiotics and bowel rest, which have been reported to be effective to aphthoid colitis but were not in this case. Her symtoms and the increased inflammatory reactions improved soon after the administration of Sarazosulfapiridine (SASP) , and colonoscopy done 3 weeks later revealed that aphthoid lesions were healed. Since colonic aphthous ulcer can be an early phase paradigm of inflammatory bowel diseased such as Crohn's disease, we need further observation, but no evidence of recurrence has been noticed for 8 months. This case suggests that SASP can be one of therapeutic options to an aggressive case of so-called aphthoid colitis.

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