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An unusual presentation of ulcerative colitis
Praveen Kesav1, Dheeraj Khurana1
1Neurology, VSM Hospital, Mavelikkara, Kerala, India Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
BMJ Case Reports
|January 8, 2015
Summary
Ulcerative colitis (UC) can cause rare spinal cord issues. This case highlights posterolateral column disease as a potential extraintestinal manifestation of UC, improving with steroid treatment.
Area of Science:
- Neurology
- Gastroenterology
- Immunology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- UC can present with various extraintestinal manifestations (EIMs).
- Pathogenic mechanisms for EIMs include nutritional deficiencies, medications, and immune-mediated processes.
Observation:
- A 56-year-old woman developed progressive neurological symptoms including paresthesias, sensory ataxia, and quadriparesis.
- Urinary urgency and incontinence were also noted.
- Bloody diarrhea occurred one month after symptom onset, leading to a diagnosis of UC via colonoscopy and biopsy.
Findings:
- The patient's neurological condition, specifically posterolateral column disease, was attributed to an EIM of UC.
- No alternative etiology for the neurological symptoms was identified.
- The patient showed significant improvement with intravenous and oral steroid therapy.
Implications:
- This case suggests that spinal cord posterolateral column disease can be a rare EIM of UC.
- UC should be considered in the differential diagnosis for patients presenting with posterolateral column disease.
- Early recognition and appropriate treatment of UC-related neurological complications can lead to favorable outcomes.
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