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Phlebosclerosis of the colon with positive anti-centromere antibody
T Kitamura1, M Kubo, T Nakanishi
1Department of Internal Medicine, Sumitomo Hospital, Osaka.
Insights
This study links colon phlebosclerosis, a vein hardening condition, to CREST syndrome, a rare autoimmune disorder. This finding offers new insights into the gastrointestinal manifestations of systemic sclerosis.
Area of Science:
- Gastroenterology
- Rheumatology
- Pathology
Background:
- Chronic bowel disease can present with unusual vascular changes.
- Systemic sclerosis, particularly the CREST syndrome variant, affects multiple organ systems.
- Mesenteric vein calcification is a rare finding in gastrointestinal pathology.
Observation:
- A 56-year-old woman with chronic bowel disease exhibited mesenteric vein calcification in the colon.
- The resected colon appeared hardened and black.
- Histopathology revealed fibrous changes and calcification/hyaline deposition in the mesenteric vein without cellular infiltration.
Findings:
- The observed changes were consistent with phlebosclerosis and systemic sclerosis.
- The patient tested positive for anti-centromere antibody and had Raynaud's phenomenon, indicative of CREST syndrome.
- The unique colonic findings suggest a link between CREST syndrome and colonic phlebosclerosis.
Implications:
- This case suggests CREST syndrome may be a causative factor in colonic phlebosclerosis.
- Understanding this association could improve diagnosis and management of gastrointestinal issues in CREST syndrome patients.
- Further research is warranted to explore the pathogenesis of vascular calcification in systemic sclerosis variants.
Abstract:
A 56-year-old woman with symptoms of chronic bowel disease presented a peculiar calcification of the mesenteric vein of the ascending to transverse colon on barium enema study. The resected colon was hard and black. Histo-pathologic examinations demonstrated fibrous change of the colon with a calcified and hyaline-deposited mesenteric vein. No cell infiltration was observed. These findings were compatible with phlebosclerosis and also with systemic sclerosis. Positive anti-centromere antibody and Raynaud's phenomenon, hallmarks of a variant systemic sclerosis, the CREST syndrome were observed. We therefore speculated that the pathogenesis of the phlebosclerosis of the colon is related to the CREST syndrome.