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Orbital pseudotumour as a presentation of paediatric ulcerative colitis

Justin Hung Tiong Tan1, Hui Ping Chu, Lena Das

  • 1Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital,100 Bukit Timah Road, Singapore 229899. justin.tan.ht@kkh.com.sg.

Singapore Medical Journal
|January 30, 2015
PubMed

Insights

A pediatric case of orbital pseudotumor and ulcerative colitis highlights the effectiveness of infliximab in treating severe pediatric inflammatory bowel disease and associated extraintestinal manifestations, leading to disease resolution.

Area of Science:

  • Pediatric Ophthalmology
  • Pediatric Gastroenterology
  • Rheumatology

Background:

  • Orbital pseudotumor and ulcerative colitis are rare in children.
  • Co-occurrence of these conditions presents diagnostic and therapeutic challenges.

Observation:

  • A 2-year-old girl presented with acute bilateral painful, swollen eyes and chronic diarrhea.
  • Initial symptoms suggested orbital pseudotumor, treated with antibiotics and NSAIDs.
  • Recurrence with vasculitis and bloody diarrhea led to ulcerative colitis diagnosis.

Findings:

  • The patient initially responded to antibiotics and NSAIDs for orbital pseudotumor.
  • Ulcerative colitis was diagnosed based on histopathology and clinical presentation.
  • Combination therapy with infliximab, azathioprine, and corticosteroids effectively resolved both bowel and extraintestinal disease.

Implications:

  • Early recognition and aggressive management are crucial for pediatric patients with coexisting orbital pseudotumor and ulcerative colitis.
  • Infliximab demonstrates significant efficacy in managing severe pediatric inflammatory bowel disease and its extraintestinal manifestations.
  • This case underscores the importance of a multidisciplinary approach in managing complex pediatric inflammatory conditions.

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