Extraintestinal Complication Of Ulcerative Colitis Research Articles

S3939 Unveiling the Uncommon: Pyoderma Gangrenosum as an Extraintestinal Complication of Ulcerative Colitis

S3939 Unveiling the Uncommon: Pyoderma Gangrenosum as an Extraintestinal Complication of Ulcerative Colitis

Myositis as a de-novo extraintestinal manifestation of ulcerative colitis in a pediatric patient developing post-colectomy: a case report

This report presents the case of a 13-year-old female with a history of ulcerative colitis who underwent ileostomy closure after total colectomy. Postoperatively, she developed right leg paresis and extensive swelling of the lower extremities. Imaging investigations revealed myositis with avascular necrosis in the distal femoral condyles. These findings were consistent with myositis as an extraintestinal complication of ulcerative colitis.

BUDD-CHIARI SYNDROME IN PATIENTS WITH ULCERATIVE COLITIS: A SYSTEMATIC LITERATURE REVIEW

Objective Budd-Chiari syndrome (BCS) is characterized by hepatic venous outflow obstruction that can lead to hepatic congestion, portal hypertension, ascites, esophageal varices, and liver failure. This syndrome is deeply associated with acquired or inherited hypercoagulation states; such as myeloproliferative disorders, factor V Leiden, deficiency of protein C, pregnancy, and systemic inflammation. Ulcerative colitis (UC) is an inflammatory bowel disease that leads to chronic systemic inflammation. Therefore, the aim of this study was to conduct a systematic literature review to analyze the association between Budd-Chiari syndrome and ulcerative colitis. Materials and methods A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Papers were selected searching PubMed/Medline, SciELO, and LILACS databases in August 2021 using the search terms [Budd-Chiari syndrome] AND [ulcerative colitis]. The inclusion criterion was limited to observational studies, case reports, or case series that reported an association between Budd-Chiari syndrome and ulcerative colitis. Language was restricted to English, Spanish or Portuguese. Results Among the 33 papers initially identified, 17 were eligible for this review after full texts were read. The selected studies were all case reports or case series. Budd-Chiari syndrome has been described as a rare extraintestinal complication of ulcerative colitis. Regarding gender, 12 patients were female and 5 were male. Seven articles reported cases of BCS in pediatric patients with UC. Three articles reported the diagnosis of BCS before the clinical manifestations and diagnosis of UC. Two cases also described the occurrence of severe thrombotic storm (development of multiple thrombi in different sites in quick succession) in patients with UC and no other coagulopathy. Discussion The studies suggest that patients with ulcerative colitis have a higher risk of Budd-Chiari syndrome and thromboembolic events. This risk can be eight times higher during a flare-up, which can be explained by the increased systemic levels of cytokines (e.g. IL-1, 1L-6, and TNF-alpha) that can modulate the coagulation cascade leading to a hypercoagulation state. In addition, the increased intestinal epithelial permeability can promote bacterial translocation and systemic endotoxemia, which further accelerates the coagulation cascade activation. Still, studies have shown that patients with UC have higher rates of thrombocytosis, fibrinogen levels, and low antithrombin levels. Conclusion Budd-Chiari syndrome can be a rare extraintestinal complication of ulcerative colitis in pediatric and adult patients. This complication can occur even before the diagnosis of inflammatory bowel disease.

A decrease in the tear secretion volume in a mouse model with ulcerative colitis

Purpose Dry eye syndrome is known to develop from several systemic inflammatory diseases. Although dry eye may develop due to extraintestinal complications of ulcerative colitis (UC), the pathogenesis is not well-known. This study aimed to investigate whether there was decrease in the tear secretion volume in a mice model with UC; the difference between the control and dextran sodium sulphate (DSS)-treated group was also determined. Materials and methods This study included a mice model with UC induced by the oral administration of 5.0% DSS for 7 days. Following the DSS treatment, the tear volume was measured using the Schirmer’s test. The colon and ocular tissues, including the lacrimal gland, were evaluated using histological and protein analyses. Additionally, tumour necrosis factor (TNF)-α and interleukin (IL)-6 in the plasma were determined. Differences between groups (DSS-treated versus control mice) were determined using Student’s t-test. Results The tear volume in DSS-treated mice was decreased compared to that in the control mice. Plasma levels of TNF-α and IL-6 in DSS-treated mice was higher than that of control. Morphological change was observed with the invasion of the inflammatory cell in the lacrimal gland of DSS-treated mice. Terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labelling (TUNEL)-positive cells were increased in the lacrimal glands of DSS-treated mice compared with control group. The distribution of aquaporin-5 expressed in the lacrimal gland of DSS-treated mice was decreased compared to that in the control group. Conclusions These findings suggest that a decrease in the tear volume in UC was associated with a functional decline in the inflamed lacrimal gland. This result therefore provides useful information that could contribute to the development of treatment approaches for dry eye associated with UC.

顆粒球吸着療法が奏効した壊疽性膿皮症合併潰瘍性大腸炎の一例

A 30-years-old woman was admitted due to chronic diarrhea and foot ulcer. Her clinical grounds and colonoscopic findings were compatible with ulcerative colitis (UC) . The foot ulcer was aseptic, and histopathological examination of the ulcer base showed nonspecific inflammation with neutrophil infiltration and pseudovasculitis ; pyoderma gangrenosum (PG) was hence diagnosed as an extraintestinal complication of UC. We initiated treatment with 5-aminosalicylate (5-ASA) 4,000 mg/day and granulocyte and monocyte adsorption apheresis (GMA) . The response to the treatment was favorable and rapid-acting. After 10 GMA sessions she achieved remission from UC and PG was completely epithelized. We reduced 5-ASA to 3,000 mg/day and continued observation. This report demonstrates the efficacy of GMA for PG in line with recent studies.

Double trouble: Cerebral vein thrombosis in a young female with ulcerative colitis

Cerebral venous thrombosis is an uncommon disorder in the general population. Venous and arterial thrombosis is a rare but well-recognized extraintestinal complication of ulcerative colitis. Venous thromboembolic events commonly involve deep peripheral veins, and cerebral venous thrombosis is less common. We report a case of cerebral vein thrombosis associated with ulcerative colitis managed successfully with anticoagulant therapy.

Rare and New Extraintestinal Complication of Ulcerative Colitis: Nasal Septal Perforation

Rare and New Extraintestinal Complication of Ulcerative Colitis: Nasal Septal Perforation

(095). Chronic renal failure: A rare extraintestinal complication of ulcerative colitis

We apply a zero inefficiency stochastic frontier model to a longitudinal panel dataset describing the operations of all 50 US state park systems between 1984 and 2014. The purpose being to identify which state park systems have been most, and least, cost efficient in producing outdoor recreation opportunities over the 31-year period. The following states' park systems have become less inefficient over time: Alabama, Arkansas, Florida, Mississippi, New Jersey, New York, Oklahoma, Oregon, Rhode Island, South Dakota, Vermont, Virginia, West Virginia, Wisconsin and Wyoming. The state park system directors and managers in these states have truly been able to “do more with less.” Conversely, the following states' park systems have gradually become more inefficient over time: Colorado, Hawaii, Montana, Nevada, New Mexico, Texas and Washington. Possible explanations for these state park systems' poor performance include stagnant attendance levels, a general unwillingness to invest in capital improvements and an unwillingness to employ more resource management personnel.1.State park systems with long-term reductions to operating inefficiencies tend to make management decisions that generate greater amounts of visitation per acre, allow for more investments in non-recurring capital expenditures per acre for park improvements and enable more employees to be employed for maintaining and servicing the states' parklands.2.State park systems exhibiting long-term increases in operating inefficiency should use these findings to inform planning and management decisions if they want to become more efficient in the future.

Prevalence and outcomes of anemia in inflammatory bowel disease: a systematic review of the literature

The prevalence of anemia in patients with inflammatory bowel disease ranges from 8.8% to 73.7% depending on the patient subpopulation. Anemia, one of many extraintestinal complications of ulcerative colitis and Crohn disease, is generally defined as a hemoglobin value <120 g/L or hematocrit <0.4; severe anemia is defined as a hemoglobin level <100 g/L. Many patients have been shown to be intolerant of oral iron replacement therapy or their anemia was refractory to such supplementation. Correction of anemia through the administration of intravenous iron saccharate and/or supplemental erythropoietin has been shown to improve patient hematologic indices and quality of life. Future studies are needed to determine the type of patients at highest risk of developing severe anemia as well as the treatment interventions with the most beneficial effect.

Takayasu's Arteritis After Total Proctocolectomy for Ulcerative Colitis

Although coexistence of Takayasu's arteritis with ulcerative colitis is often reported, all these cases have been in patients whose colons were in situ. The aim of the present study was to describe a patient who developed Takayasu's arteritis after total proctocolectomy for ulcerative colitis. The clinical course of a 42-year-old female who developed Takayasu's arteritis after total proctocolectomy for ulcerative colitis is described and the literature reviewed. Symptomatic arteritis developed in the left carotid artery four months after total proctocolectomy with ileal J-pouch-anal anastomosis for ulcerative colitis. Peristomal pyoderma gangrenosum, multiple ulcers in the oral cavity, and leakage at the ileoanal anastomosis were observed simultaneously. High-dose therapy with steroids proved effective for the arteritis, pyoderma gangrenosum, and multiple oral ulcers. We finally excised the ileal pouch with anus because of the intractable leakage three years after the occurrence of Takayasu's arteritis. This patient illustrates the possibility that Takayasu's arteritis is an extraintestinal complication of ulcerative colitis even after surgical removal of the colon.

Treatment of extraintestinal complications of ulcerative colitis.

Extraintestinal complications affect 25-30% of patients with ulcerative colitis. These extraintestinal disorders significantly contribute to morbidity and mortality of ulcerative colitis patients. While some disorders parallel the activity of the colitis, other abnormalities run a clinical course independent of the bowel disease. The pathogenesis of these disorders is unknown, but the variable relationships to the severity of colitis and the variable responses to a proctocolectomy suggest considerable heterogeneity. The present therapy for the various manifestations is reviewed in depth. In this respect it is important to note that colectomy should never be mandated by the extraintestinal complications of ulcerative colitis.

A Japanese case of ulcerative colitis associated with dermatitis herpetiformis and primary sclerosing cholangitis

: A number of extraintestinal complications of ulcerative colitis have been described. However, only a few cases of ulcerative colitis associated with dermatitis herpetiformis have been documented. We report a case of ulcerative colitis associated with dermatitis herpetiformis and primary sclerosing cholangitis in a Japanese woman. The patient first developed exanthema on the extremities at the age of 18 years. Subsequently, her skin disease was diagnosed as dermatitis herpetiformis with linear IgA deposits at the dermoepidermal junction. A biopsy specimen from the jejunum did not show villous atrophy. Subsequently, she was diagnosed with primary sclerosing cholangitis at age 34 years, and with ulcerative colitis 2 years later. The patient died of hepatic failure at age 40 years. Bile duct cancer was found at autopsy. Both dermatitis herpetiformis and primary sclerosing cholangitis are diseases of the immune system that are associated with HLA-B8 and -DR3 in whites. Our patient had neither of these serotypes. The immune mechanisms involved in the extraintestinal complications of inflammatory bowel disease are briefly discussed.

Chronic Pancreatitis as a Complication of Ulcerative Colitis —Report of 2 Cases—

Abstract: We report on two patients with chronic pancreatitis associated with ulcerative colitis. Both patients had ulcerative colitis involving the entire colon and rectum. The diagnosis of chronic pancreatitis was based on the typical findings of endoscopic retrograde cholangiopancreatography (ERCP) and episodes of hyperamylasemia. The changes in the levels of serum pancreatic enzymes are considered to have paralleled the activity of the colitis. None of the classical etiologies for pancreatitis was found in either case. The time sequence and exclusion of known causes of pancreatitis suggest an association between these two conditions.These two cases, together with other reported cases, provide some evidence for the hypothesis that chronic pancreatitis may be one of the extraintestinal complications of ulcerative colitis. The symptoms of ulcerative cblitis, such as diarrhea and abdominal pain, may mimic the symptoms of chronic pancreatitis. Pancreatitis and ulcerative colitis are probably mutually exacerbating factors. Therefore, the recognition of this phenomenon contributes substantially to the management of ulcerative colitis. (Dig Endosc 1994; 6 : 59–65)

Studies on Extra-Intestinal Complications of Ulcerative Colitis

Studies on Extra-Intestinal Complications of Ulcerative Colitis