CASE REPORT
Ulcerative colitis accompanied by aseptic abscesses syndrome and small-vessel vasculitis
1
Chair and Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland
2
Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
3
II Department of Radiology, Medical University of Lublin, Poland
4
Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Poland
Corresponding author
Bartłomiej Wawrzycki
Chair and Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20–080, Lublin, Poland
Chair and Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Radziwiłłowska 13, 20–080, Lublin, Poland
J Pre Clin Clin Res. 2016;10(2):140–143
KEYWORDS
ABSTRACT
Introduction:
Cutaneous small-vessel vasculitis and aseptic abscesses syndrome are among the rarest extraintestinal manifestations of bowel inflammatory diseases.
Objective:
Presentation of a case of concomitance of cutaneous small vessel vasculitis and septic absecess, accompanied by inflammatory bowel disease.
Material and Methods:
The study describes the case of a 19-year-old female admitted to the Department of Dermatology due to cutaneous small-vessel vasculitis. In order to reach the final diagnosis, a wide spectrum of laboratory and diagnostic tests were performed. Three subsequent abdominal CT scans confirmed the presence of hypodense foci, initially in the spleen, and subsequently in the liver. The aseptic abscesses syndrome was diagnosed based on the radiological picture and the exclusion of infectious causes of the above-described foci.
Results:
During the hospitalisation, the patient developed symptoms of paralytic ileus. The results of colonoscopy and biopsy of intestinal mucous membrane were typical of ulcerative colitis.
Conclusions:
To the best of the authors’ knowledge, this is the first presentation of ulcerative colitis accompanied by aseptic abscesses syndrome concomitant with cutaneous small vessel vasculitis.
Cutaneous small-vessel vasculitis and aseptic abscesses syndrome are among the rarest extraintestinal manifestations of bowel inflammatory diseases.
Objective:
Presentation of a case of concomitance of cutaneous small vessel vasculitis and septic absecess, accompanied by inflammatory bowel disease.
Material and Methods:
The study describes the case of a 19-year-old female admitted to the Department of Dermatology due to cutaneous small-vessel vasculitis. In order to reach the final diagnosis, a wide spectrum of laboratory and diagnostic tests were performed. Three subsequent abdominal CT scans confirmed the presence of hypodense foci, initially in the spleen, and subsequently in the liver. The aseptic abscesses syndrome was diagnosed based on the radiological picture and the exclusion of infectious causes of the above-described foci.
Results:
During the hospitalisation, the patient developed symptoms of paralytic ileus. The results of colonoscopy and biopsy of intestinal mucous membrane were typical of ulcerative colitis.
Conclusions:
To the best of the authors’ knowledge, this is the first presentation of ulcerative colitis accompanied by aseptic abscesses syndrome concomitant with cutaneous small vessel vasculitis.
REFERENCES (21)
1.
Stone JH. The classification and epidemiology of systemic vasculitis. In: Firestein GS, Budd RC, Harris ED, McInnes IB Jr, Shaun R, Sergent JS (ed) Kelley’s Textbook of Rheumatology, 8th edn. Saunders, Philadelphia; 2009: pp 1401–1408.
2.
Stone JH. Immune Complex-Mediated Small Vessel Vasculitis. In: Firestein GS, Budd RC, Harris ED, McInnes IB Jr, Shaun R, Sergent JS (ed) Kelley’s Textbook of Rheumatology, 8th edn. Saunders, Philadelphia; 2009: pp 1465–1473.
3.
Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013; 65(1): 1–11.
4.
Sunderkötter C, Sindrilaru A. Clinical classification of vasculitis. Eur J Dermatol. 2006; 16 2): 114–24.
5.
Fiorentini DF. Cutaneous vasculitis. Jam Acad Dermatol. 2003; 48: 311–40.
6.
Xu LY, Esparza EM, MD, Anadkat MJ, Crone KG, Brasington RD. Cutaneous manifestations of vasculitis. Semin Arthritis Rheum. 2009; 38: 348–360.
7.
Iglesias-Gamarra A, Restrepo JF. Small-vessel vasculitis. Current Rheumatol Rep. 2007; 9: 304–311.
8.
Gonzalez-Hay MA, Garcia-Porrua C, Pujol RM. Clinical approach to cutaneous vasculitis. Curr Op In Rheumatology. 2005; 17: 56–61.
9.
Ekenstam Eaf, Callen JP. Cutaneous leukocytoclastic vasculitis. Clinical and laboratory features of 82 patients seen in private practice. Arch Dermatol. 1984; 120(4): 484–9.
10.
Stone JH, Nousari HC. ”Essential” cutaneous vasculitis: what every rheumatologist should know abort vasculitis of the skin. Curr Opinion in Rheumatology. 2001; 13: 23–34.
11.
André MF, Piette JC, Kémény JL, Ninet J, Jego P, Delèvaux I, Wechsler B, Weiller PJ, Francès C, Blétry O, Wismans PJ, Rousset H, Colombel JF, Aumaître O. Aseptic abscesses: a study of 30 patients with or without inflammatory bowel disease and review of the literature. Medicine (Baltimore). 2007; 86(3): 145–61.
12.
André M, Aumaître O. Aseptic abscesses syndrome. Rev Med Interne. 2011; 32(11): 678–88.
13.
Andre MF, Aumaitre O, Grateau G, Chamaillard M, Costedoat- Chalumeau N, Cardoso MC, et al. Longest form of CCTG microsatellite repeat in the promoter of the CD2BP1/PSTPIP1 gene is associated with aseptic abscesses and with Crohn disease in French patients Digestive Diseases & Sciences. 2010; 55(6): 1681–8.
14.
Andre MF, Aumaitre O, Piette JC, Grateau G, Cardoso MC, Ouchchane L, et al. Analysis of the NOD2/CARD15 gene in patients affected with the aseptic abscesses syndrome with or without inflammatory bowel disease Digestive Diseases & Sciences. 2008; 53(2): 490–9.
15.
Carlson JA. The histological assessment of cutaneous vasculitis. Histopathology. 2010; 56: 3–12.
16.
Kawakami T. New algorithm (KAWAKAMI algorithm) to diagnose primary cutaneous vasculitis. J Dermatol. 2010; 37: 113–124.
17.
Carlson JA, Cavaliere LF, Grant-Kels JM. Cutaneous vasculitis: diagnosis and management. Clin Dermatol. 2006; 24: 414–429.
18.
Chen K-R, Carlson JA. Clinical approach to cutaneous vasculitis. Am J Clin Dermatol. 2008; 9(2): 71–92.
19.
Ito T, Sato N, Yamazaki H, Koine T, Emura I, Saeki T. A case of aseptic abscesses syndrome treated with corticosteroids and TNF-alpha blockade. Mod Rheumatol. 2013; 23: 195–199.
20.
Bardy A, Guettrot-Imbert G, Aumaitre O, AndreMF. Efficacy of IL-1B blockade of refractory aseptic absecesses syndrome. Mod Rheumatol. 2013; DOI10.1007/s10165–012–0826–3.
21.
Fukuda S, Nanki T, Morio T, Hasegawa H, Koike R, Miyasaka N. Recurrent mitral valve regurgitation with neutrophil infiltration in a patient with multiple aseptic abscesses. Mod Rheumatol. 2012. DOI10.1007/s10165–012–0793–8.
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.