Ulcerative colitis associated with vitiligo and IgA deficiency in a young girl

Abstract

Ulcerative colitis (UC) is a chronic inflammatory disease of non-infectious and plurifactorial etiology, exclusively affecting the colon, with variable expansion. The selective deficiency of immunoglobulin A (IgA) can be frequently associated with UC, as well as with recurrent respiratory tract infections, autoimmune diseases, atopy. The incidence of vitiligo among UC patients is significantly higher compared to the general population. At the same time, recent studies proved a higher incidence of Clostridium difficile infections in patients with inflammatory bowel disease (Crohn’s disease and ulcerative colitis) compared to the general population. We are presenting the case of a 9 year old girl, where UC associated with selective deficiency of IgA and vitiligo hampered the diagnosis and therapeutic approach, particularly in the conditions of a preexisting Clostridium difficile infection. The association of these entities is rare in the pediatric population and a multidisciplinary team approach (gastroenterology, dermatology and immunology) can ensure an effective therapeutic management in the case of such patients.