Case Report: Systemic Small-Vessel Vasculitis in an Adolescent With Active Ulcerative Colitis
نویسندگان
چکیده
Introduction: Small-vessel vasculitis (SVV) is a rare immunological disease that affects arterioles, capillaries and venules. It causes purpura, but can also manifest in other organs, including the gastrointestinal tract. SVV inflammatory bowel (IBD) co-occur more frequently than would be expected by chance. Case description: A 16-year-old girl, who had been diagnosed with ulcerative colitis (UC) 2 years earlier at general hospital, developed progressive abdominal pain frequent bloody diarrhea frontotemporal headache swelling while on azathioprine mesalamine maintenance therapy. Serology was positive for perinuclear antineutrophil cytoplasmic antibodies (p-ANCA) without antiprotease- or myeloperoixidase antibodies. Endoscopy revealed active left-sided UC atypical ulcerations ascending colon. Biopsies of these affected skin leukocytoclastic vasculitis. Initially this interpreted as an extraintestinal manifestation subside when remission induced, consequently infliximab started. Over next 3 weeks she severe burning her right lower leg progressed to foot drop numbness purpura bullous lesions. The diagnosis adjusted ANCA-associated involvement skin, peripheral nerves. Infliximab discontinued induction treatment high-dose prednisolone cyclophosphamide given until achieved. Subsequently, re-introduced combination methotrexate. Remission has maintained successfully over now. only partly resolved necessitated use orthosis. Conclusion: Pediatric patients IBD present purpuric lesions should evaluated systemic SVV, which includes endoscopic evaluation We discuss practical approach diagnosis, management focus prompt recognition early aggressive therapy improve outcome.
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ژورنال
عنوان ژورنال: Frontiers in Pediatrics
سال: 2021
ISSN: ['2296-2360']
DOI: https://doi.org/10.3389/fped.2021.617312