Bloody diarrhoea: a rare presentation of a systemic disease

Bloody diarrhoea in adolescents is usually due to enteric infection or inflammatory bowel disease. We describe a patient with bloody diarrhoea and endoscopic features of colitis in association with a systemic vasculitis. Positive anti-proteinase-3 antineutrophil cytoplasmic antibodies and cutaneous...

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Bibliographic Details
Published inInternational journal of clinical practice (Esher) Vol. 57; no. 5; p. 441
Main Authors Mann, S D, Young, A, Barrison, I G, Catnach, S M
Format Journal Article
LanguageEnglish
Published England 01.06.2003
Subjects
Adolescent
Cyclophosphamide - therapeutic use
Diarrhea - etiology
Granulomatosis with Polyangiitis - complications
Granulomatosis with Polyangiitis - therapy
Hemorrhage - etiology
Humans
Immunosuppressive Agents - therapeutic use
Male
Plasmapheresis - methods
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Summary:Bloody diarrhoea in adolescents is usually due to enteric infection or inflammatory bowel disease. We describe a patient with bloody diarrhoea and endoscopic features of colitis in association with a systemic vasculitis. Positive anti-proteinase-3 antineutrophil cytoplasmic antibodies and cutaneous vasculitis on biopsy confirmed the diagnosis of Wegener's granulomatosis. He was started on high dose steroids and cyclophosphamide but required plasmapheresis for a declining renal function. The case highlights the need for vigilance with common clinical problems, because a life-threatening condition may be averted by prompt recognition and urgent therapy with immunosuppressants.
ISSN:1368-5031
DOI:10.1111/j.1742-1241.2003.tb10525.x