A Case of Cerebral Vasculitis Associated with Ulcerative Colitis

Ulcerative colitis (UC) is a chronic, debilitating condition characterized by inflammation of the colonic mucosa. It is regarded as a systemic inflammatory disorder that can affect a number of organ systems. Central nervous system disease associated with UC is a rare sequela of inflammatory bowel disease, occurring in less than 5% of cases. These manifestations include arterial and venous thrombosis, leukoencephalitis, seizures, and vasculitis. We present a case of a 61-year-old female with a two-year history of well-controlled ulcerative colitis, who developed altered mental status and weakness. On brain imaging, she was found to have cerebral lesions which were biopsied. Histopathology subsequently revealed coagulative necrosis and inflammation characteristic of vasculitis. Rheumatology serologies were negative, and the patient was started on steroids that dramatically improved her neurological function, with no residual deficits, and led to resolution of the brain lesions.

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Mo1375 Prevalence of Family History of Inflammatory Bowel Disease Among Ulcerative Colitis Patients

Gastroenterology ◽

10.1016/s0016-5085(13)62406-3 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-649-S-650

Author(s):

Ryan E. Childers ◽

Swathi Eluri ◽

Christine Vazquez ◽

Theodore M. Bayless ◽

Susan Hutfless

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Family History ◽

Bowel Disease ◽

History Of ◽

Inflammatory Bowel

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Ulcerative Colitis and Sweet’s Syndrome: A Case Report and Review of the Literature

Canadian Journal of Gastroenterology ◽

10.1155/2008/960585 ◽

2008 ◽

Vol 22 (3) ◽

pp. 296-298 ◽

Cited By ~ 22

Author(s):

Massud Ali ◽

Donald R Duerksen

Keyword(s):

Ulcerative Colitis ◽

Immunosuppressive Therapy ◽

Neutrophilic Dermatosis ◽

Sweet’S Syndrome ◽

Review Of The Literature ◽

Neutrophilic Infiltration ◽

Drug Induced ◽

Sweet's Syndrome ◽

History Of ◽

Inflammatory Bowel

A 47-year-old man with a history of ulcerative colitis on prednisone and azathioprine was admitted to the hospital with a four-day history of fever, skin rash, arthralgias and leukocytosis. A skin biopsy demonstrated neutrophilic infiltration of the dermis that was consistent with Sweet’s syndrome. He improved after several days with an increase in his prednisone and azathioprine. Sweet’s syndrome is a rare cutaneous manifestation of inflammatory bowel disease, with approximately 40 cases reported in the literature. In a previously reported case of a patient with ulcerative colitis-associated Sweet’s syndrome who was on azathioprine at the time of the skin eruption, the azathioprine was stopped, raising the possibility of drug-induced Sweet’s syndrome. In the present case, the azathioprine was actually increased with complete resolution of the skin manifestations. This would support the theory that immunosuppressive therapy is the mainstay of therapy for this condition. In conclusion, Sweet’s syndrome is a neutrophilic dermatosis that is rarely associated with ulcerative colitis. It may occur while on immunosuppressive therapy and responds to an intensification of immunosuppression.

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Socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2021-25(1)-12 ◽

2021 ◽

Vol 25 (1) ◽

pp. 65-69

Author(s):

I. V. Oleksiienko

Keyword(s):

Ulcerative Colitis ◽

Health Care ◽

Inflammatory Bowel Disease ◽

Pregnant Women ◽

Bowel Disease ◽

Clinical Analysis ◽

Chronic Inflammatory Bowel Disease ◽

Care Providers ◽

History Of ◽

Inflammatory Bowel

Annotation. At the turn of the 21st century, chronic inflammatory bowel disease (CIBD) has become a global disease with accelerating morbidity in industrialized countries with a prevalence exceeding 0.3%. These data underscore the need for research into the prevention of inflammatory bowel disease and innovations in health care systems to manage this complex and costly disease. The information from a personal anamnesis of 40 women patients with ulcerative colitis (clinical group (main). In the second group (control), 30 practically healthy pregnant women with a physiological course of gestation were included, which did not have in their history of inflammatory intestinal diseases. Statistical processing of research results was performed using the software package Statistica 6.0. The arithmetic mean (M) and the standard deviation error (± m) (p<0.05) were determined, as well as the odds ratio (OR), confidence interval (CI) at p=95%. It was found that for women with ulcerative colitis is characterized by the presence of a history of obstetric pathology, such as: spontaneous miscarriage of OR 3.33, 95% CI [1.06-10.53], p=0.04 and blood secretions of OR 3.0, 95% CI [1.00-8.98], p=0.0496; among extragenital pathology in the anamnesis: children's infectious diseases of OR 4.85, 95% CI [1.25-18.85], p=0.02, chronic bronchitis of OR 7.54, 95% CI [1,56-36, 41], p=0.01, varicose veins OR 4.33, 95% CI [1.11-16.95], p=0.035, chronic gastritis OR 6.0, 95% CI [1,23-29, 31], p=0.03, anemia of OR 15.0, 95% CI [4.53-49.68], p<0.0001, allergy history of OR 6.65, 95% CI [1.73-25.60], p=0.006; among gynecological complications – premenstrual syndrome OR 6.0, 95% CI [1.55-23.15], p=0.009, algomenorrhea OR 8.14, 95% CI [2.12-31.24], p=0.002 , salpingo-oophoritis, OR 7.54, 95% CI [1.56-36.41], p=0.01. Because CIBD during pregnancy is associated with an increased risk of adverse effects on the mother and fetus, information on socio-anamnestic and clinical analysis of pregnant women with ulcerative colitis will be useful to health care providers in making decisions about CIBD during pregnancy.

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Articular manifestations in patients with inflammatory bowel disease treated with vedolizumab

Rheumatology ◽

10.1093/rheumatology/keaa107 ◽

2020 ◽

Vol 59 (11) ◽

pp. 3275-3283 ◽

Cited By ~ 1

Author(s):

Anastasia Dupré ◽

Michael Collins ◽

Gaétane Nocturne ◽

Franck Carbonnel ◽

Xavier Mariette ◽

...

Keyword(s):

Risk Factors ◽

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Inflammatory Bowel Diseases ◽

Bowel Disease ◽

Bowel Diseases ◽

History Of ◽

Musculoskeletal Manifestations ◽

Inflammatory Bowel

Abstract Objective Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors. Methods In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared. Results Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007]. Conclusion Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.

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Natural History of Very Early Onset Inflammatory Bowel Disease in North America: A Retrospective Cohort Study

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa080 ◽

2020 ◽

Cited By ~ 2

Author(s):

Basavaraj Kerur ◽

Eric I Benchimol ◽

Karoline Fiedler ◽

Marisa Stahl ◽

Jeffrey Hyams ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Bowel Disease ◽

Early Onset ◽

Bowel Surgery ◽

Age Of Diagnosis ◽

History Of ◽

Inflammatory Bowel

Abstract Background The incidence of very early onset inflammatory bowel disease (VEOIBD) is increasing, yet the phenotype and natural history of VEOIBD are not well described. Methods We performed a retrospective cohort study of patients diagnosed with VEOIBD (6 years of age and younger) between 2008 and 2013 at 25 North American centers. Eligible patients at each center were randomly selected for chart review. We abstracted data at diagnosis and at 1, 3, and 5 years after diagnosis. We compared the clinical features and outcomes with VEOIBD diagnosed younger than 3 years of age with children diagnosed with VEOIBD at age 3 to 6 years. Results The study population included 269 children (105 [39%] Crohn’s disease, 106 [39%] ulcerative colitis, and 58 [22%] IBD unclassified). The median age of diagnosis was 4.2 years (interquartile range 2.9–5.2). Most (94%) Crohn’s disease patients had inflammatory disease behavior (B1). Isolated colitis (L2) was the most common disease location (70% of children diagnosed younger than 3 years vs 43% of children diagnosed 3 years and older; P = 0.10). By the end of follow-up, stricturing/penetrating occurred in 7 (6.6%) children. The risk of any bowel surgery in Crohn’s disease was 3% by 1 year, 12% by 3 years, and 15% by 5 years and did not differ by age at diagnosis. Most ulcerative colitis patients had pancolitis (57% of children diagnosed younger than 3 years vs 45% of children diagnosed 3 years and older; P = 0.18). The risk of colectomy in ulcerative colitis/IBD unclassified was 0% by 1 year, 3% by 3 years, and 14% by 5 years and did not differ by age of diagnosis. Conclusions Very early onset inflammatory bowel disease has a distinct phenotype with predominantly colonic involvement and infrequent stricturing/penetrating disease. The cumulative risk of bowel surgery in children with VEOIBD was approximately 14%–15% by 5 years. These data can be used to provide anticipatory guidance in this emerging patient population.

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Immune Response-Mediated Protection of Adult but Not Neonatal Mice from Neuron-Restricted Measles Virus Infection and Central Nervous System Disease

Journal of Virology ◽

10.1128/jvi.73.3.1795-1801.1999 ◽

1999 ◽

Vol 73 (3) ◽

pp. 1795-1801 ◽

Cited By ~ 55

Author(s):

Diane M. P. Lawrence ◽

Melinda M. Vaughn ◽

Alec R. Belman ◽

Joan S. Cole ◽

Glenn F. Rall

Keyword(s):

Central Nervous System ◽

Immune Response ◽

Nervous System ◽

Neurological Disease ◽

Measles Virus ◽

Central Nervous System Disease ◽

Nervous System Disease ◽

Antiviral Immune Response ◽

System Disease ◽

The Brain

ABSTRACT In many cases of neurological disease associated with viral infection, such as measles virus (MV)-induced subacute sclerosing panencephalitis in children, it is unclear whether the virus or the antiviral immune response within the brain is the cause of disease. MV inoculation of transgenic mice expressing the human MV receptor, CD46, exclusively in neurons resulted in neuronal infection and fatal encephalitis within 2 weeks in neonates, while mice older than 3 weeks of age were resistant to both infection and disease. At all ages, T lymphocytes infiltrated the brain in response to inoculation. To determine the role of lymphocytes in disease progression, CD46+ mice were back-crossed to T- and B-cell-deficient RAG-2 knockout mice. The lymphocyte deficiency did not affect the outcome of disease in neonates, but adult CD46+RAG-2− mice were much more susceptible to both neuronal infection and central nervous system disease than their immunocompetent littermates. These results indicate that CD46-dependent MV infection of neurons, rather than the antiviral immune response in the brain, produces neurological disease in this model system and that immunocompetent adult mice, but not immunologically compromised or immature mice, are protected from infection.

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Epstein-Barr Virus Encephalitis in a Patient with Rheumatoid Arthritis

Modern Rheumatology Case Reports ◽

10.1093/mrcr/rxab045 ◽

2021 ◽

Author(s):

Jun Nakamura ◽

Mai Yanagida ◽

Keisuke Saito ◽

Yasuyuki Kamata ◽

Takao Nagashima ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Epstein Barr Virus ◽

Altered Mental Status ◽

Cerebellar Hemisphere ◽

Cerebral White Matter ◽

Barr Virus ◽

History Of ◽

Ebv Dna ◽

Epstein Barr ◽

The Brain

Abstract A 53-year-old woman with a 6-year history of rheumatoid arthritis (RA) presented with pharyngeal pain, fever, and altered mental status. The patient had been treated with methotrexate (MTX) 12 mg/week, baricitinib 4 mg/day, and tacrolimus 2 mg/day. Magnetic resonance imaging of the brain revealed diffuse high-intensity lesions in the cerebral white matter, basal ganglia, brainstem, and right cerebellar hemisphere. She was diagnosed with Epstein-Barr virus (EBV) encephalitis due to elevated levels of EBV-DNA in the cerebrospinal fluid and serum. Although MTX-associated lymphoproliferative disorders are well-known complications in patients with RA, EBV encephalitis requires careful attention for such patients undergoing treatment with multiple potent immunosuppressants.

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Answering the Call: The Influence of Neuroimaging and Electrophysiological Evidence on Rehabilitation

Physical Therapy ◽

10.2522/ptj.20060164 ◽

2007 ◽

Vol 87 (6) ◽

pp. 684-703 ◽

Cited By ~ 31

Author(s):

Lara A Boyd ◽

Eric D Vidoni ◽

Janis J Daly

Keyword(s):

Functional Recovery ◽

Diffusion Tensor ◽

Central Nervous System Disease ◽

Neurological Injury ◽

Cortical Injury ◽

Electrophysiological Data ◽

Damage Models ◽

System Disease ◽

Positron Emission ◽

The Brain

Functional recovery after brain damage or disease is dependent on the neuroplastic capability of the cortex and the nonaffected brain. Following cortical injury in the motor and sensory regions, the adjacent spared neural tissues and related areas undergo modifications that are required in order to drive more normal motor control. Current rehabilitation models seek to stimulate functional recovery by capitalizing on the inherent potential of the brain for positive reorganization after neurological injury or disease. This article discusses how neuroimaging and electrophysiological data can inform clinical practice; representative data from the modalities of functional magnetic resonance imaging, diffusion tensor imaging, magnetoencephalography, electroencephalography, and positron emission tomography are cited. Data from a variety of central nervous system disease and damage models are presented to illustrate how rehabilitation practices are beginning to be shaped and informed by neuroimaging and electrophysiological data.

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Family history of inflammatory bowel disease among patients with ulcerative colitis: A systematic review and meta-analysis

Journal of Crohn s and Colitis ◽

10.1016/j.crohns.2014.05.008 ◽

2014 ◽

Vol 8 (11) ◽

pp. 1480-1497 ◽

Cited By ~ 23

Author(s):

Ryan E. Childers ◽

Swathi Eluri ◽

Christine Vazquez ◽

Rayna Matsuno Weise ◽

Theodore M. Bayless ◽

...

Keyword(s):

Systematic Review ◽

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Family History ◽

Bowel Disease ◽

Meta Analysis ◽

History Of ◽

Inflammatory Bowel

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Rasmussen's Syndrome: Intractable Epilepsy and Progressive Neurological Deterioration From a Unilateral Central Nervous System Disease

CNS Spectrums ◽

10.1017/s1092852900021775 ◽

2001 ◽

Vol 6 (5) ◽

pp. 398,409-416 ◽

Cited By ~ 2

Author(s):

Paul R. Carney

Keyword(s):

Central Nervous System ◽

Cerebral Hemisphere ◽

Antiviral Agents ◽

Intractable Epilepsy ◽

Central Nervous System Disease ◽

System Disease ◽

Chronic Encephalitis ◽

Rasmussen’S Syndrome ◽

The Brain ◽

Severe Epilepsy

AbstractRasmussen's syndrome (chronic encephalitis with epilepsy) is a rare neurological disorder of unknown cause characterized by severe epilepsy, hemiplegia, dementia, and inflammation of the brain, and progressive functional and structural destruction of a single cerebral hemisphere. While one mechanism underlying the pathogenesis of Rasmussens encephalitis has been hypothesized to be mediated by production of excitotoxic GluR3 autoantibodies to the a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor, other neuropathological etiologies have also been indicated. Proposed therapies have included antiepileptics, steroids, antiviral agents, alpha-interferon, and immunoglobulin. The mainstay of therapy is surgical hemispherectomy. To date, no medical therapies have permanently halted neurologic deterioration.

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