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Published on: September 20, 2018
Neonatal ulcerative colitis associated with Familial Mediterranean fever: a case report
Elif Sag1, Ferhat Demir2, Mustafa Emre Ercin3
1Department of Pediatric Gastroenterology Hepatology and Nutrition, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
Insights
Neonatal ulcerative colitis, a rare IBD in infants, was treated with colchicine after genetic analysis revealed a mutation linked to Familial Mediterranean Fever. This case highlights early autoinflammatory disease diagnosis for better outcomes.
Area of Science:
- Pediatrics
- Gastroenterology
- Genetics
Background:
- Neonatal inflammatory bowel disease (IBD) presents before one month of age, often with monogenetic causes and resistance to standard treatments.
- Ulcerative colitis (UC) in neonates is rare and presents unique diagnostic and therapeutic challenges.
- Familial Mediterranean Fever (FMF) is an autoinflammatory disorder typically presenting with recurrent fevers and serositis.
Abstract:
Neonatal inflammatory bowel disease (IBD) is a subclass of very early onset IBD that includes children younger than 1 month. It is characterized by more colonic involvement and monogenetic etiology, resistance to classical anti-inflammatory/immunomodulatory treatments and associated with colitis in first-degree family members. Herein we report a 3 month-old girl who was admitted with bloody diarrhea since 10 days of age. Her symptoms persist despite diet elimination. She was diagnosed with neonatal ulcerative colitis (UC) based on clinical, laboratory and histopathological examination. But, she was unresponsive to the immunosuppressive therapy. On the follow-up, she was hospitalized for the high fever two times. Genetic analysis revealed homozygote M694 V mutation. Bloody diarrhea and other clinical findings were improved after colchicine therapy. Neonatal UC associated with Familial Mediterranean fever is an extremely rare condition and to the best of our knowledge our case is the first case in literature. Early diagnosis autoinflammatory disease may prevent complications related to unnecessary immunosuppressive drug usage and the risk of development of amyloidosis associated with autoinflammatory disorders.
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