1/18. Cerebral thrombosis and vasculitis: an uncommon complication of ulcerative colitis.Cerebral thrombotic disease is a rare and nearly always fatal complication of ulcerative colitis. It is associated with a necrotizing vasculitis. We report a fatal case with a confusing neurologic picture arising from this complication. autopsy revealed necrosis and hemorrhages affecting both cortical grey and white matter. Microscopic examination showed thrombosis of small and medium size vessels associated with hemorrhages and a necrotizing angiitis. Ulcerations, hemorrhages, pseudopolyps, and cryptic abscesses were found in the rectosigmoid region of the colon compatible with active ulcerative colitis. A sudden neurologic deficit in a patient with ulcerative colitis should direct attention to the consideration of a cerebral thrombotic event and the possibility of an associated cerebral vasculitis. diagnosis may be strongly suggested by MRI or arteriography, but it may require confirmation by biopsy of the brain parenchyma and leptomeninges. A hypercoagulable state has been associated with the thrombosis. Anticoagulation has yielded successful results in some patients with cerebral thrombosis but the risk of massive intracranial and gastrointestinal bleeding preclude to establish clear indications. Neurologic improvement has been obtained with the use of steroids and cyclophosphamide.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/18. Newly-formed lymph nodes in the submucosa in chronic inflammatory bowel disease.BACKGROUND AND AIMS: Routine diagnostic work revealed cell aggregates reminiscent of lymph nodes in the bowel submucosa in occasional cases of chronic inflammatory bowel disease. We therefore investigated whether they fulfill criteria for classification as lymph nodes. methods: Colon with terminal ileum from a patient with florid Crohn's disease and a colectomy specimen from a patient with ulcerative colitis were investigated. Sections were immunostained with antibodies that recognize endothelial and sinus-lining cells, immune-accessory cells, and lymphoid cells. RESULTS: Circumscribed collections of cells that fulfill all the major criteria for classification as lymph nodes were found in the large and small bowel. They had marginal and intermediate sinuses (positive for BMA 120, CD34, CD31, X-11, and von Willebrand's factor), afferent lymph vessels, T- and B-regions, and a capsule. Small collections composed predominantly of B cells that had only a marginal sinus were also occasionally observed. CONCLUSION: Secondary mucosa-associated lymphoid tissue, typically seen as follicular lymphoid hyperplasia, also appears to occur as secondary submucosal lymph nodes. This phenomenon seems inconsistent with the notion that lymph nodes do not develop after birth. We have also noted secondary development of lymph nodes in lymphangioma and lymphangioleiomyomatosis. It is possible that local lymph vessel proliferation, possibly with chronic lymphedema of the tissue involved, is an important prerequisite for lymph node neogenesis.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
3/18. Perinuclear antineutrophil cytoplasmic antibody myeloperoxidase-positive vasculitis in association with ulcerative colitis.We describe a patient with ulcerative colitis (UC) who developed small vessel vasculitis. Perinuclear antineutrophil cytoplasmic antibody myeloperoxidase (p-ANCA-MPO) positivity was detected along with a highly elevated titer of anticardiolipin antibodies. A total proctocolectomy was undertaken and the patient, more than 5 years later, remains in very good condition. The possible causative association between the UC, the p-ANCA-MPO-positive small vessel vasculitis, and the anticardiolipin antibodies is discussed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/18. Myeloradiculitis caused by cryptococcus neoformans infection in a patient with ulcerative colitis: a neuropathological study.meningitis is the most common feature of cryptococcal infection of the nervous system. We herein describe the case of a 48-year-old man with fulminant cryptococcal myeloradiculitis, whose initial symptoms were impotence, dysuria and weakness of the lower extremities. He had been administered prednisolone and azathioprine for 7years for ulcerative colitis before onset of myeloradiculitis. He finally developed meningoencephalitis and died 2 months after onset despite treatment with amphotericin b and flucytosine. Post-mortem examination revealed numerous infiltrations of cryptococci in the spinal roots as well as in the meninges and subarachnoid space. Inflammatory cells and cryptococci had infiltrated the vessel walls in the spinal cord, and this was accompanied by necrotizing myelopathy. Myeloradiculitis is rare in cryptococcal infection, and this is the first case report to demonstrate direct cryptococcal infection in the spinal roots. Cryptococcal infection should be considered while managing myeloradiculopathy of unknown etiology, especially in immunocompromised patients.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/18. A case of classical polyarteritis nodosa complicated by ulcerative colitis.Classical polyarteritis nodosa (PAN) is a term that includes patients with necrotizing inflammation of medium-sized arteries and excludes those with microscopic vessel involvement. Although gastrointestinal manifestations are not unusual in patients with classical PAN, the association with ulcerative colitis has been reported only rarely. We describe a patient with classical PAN complicated by bilateral renal artery aneurysms with subsequent rapture and perirenal hemorrhages. He was successfully treated, and the bilateral renal aneurysms resolved with steroid therapy. Two years later, the patient presented with hematochezia. colonoscopy revealed inflamed rectal mucosa with bleeding ulcers. Histologic findings of biopsy specimens showed severe mucosal inflammation and crypt abscess. The patient was diagnosed with ulcerative colitis, and the symptoms attenuated after meselazine therapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/18. liver transplantation in a patient with cholangiocarcinoma and ulcerative colitis.A 39 year-old patient with cholangiocarcinoma and pre-existing ulcerative colitis was successfully treated by orthotopic liver transplantation. He was given low doses of prednisone and azathioprine and survived for more than 9 months, dying with tumour metastases, thrombosis of the inferior vena cava and an intra-abdominal abscess. At autopsy the homograft showed little evidence of rejection. Preoperatively the patient had septicemia. Removal of his liver was difficult. The discrepancy between donor and recipient in size of blood vessels and the presence of two hepatic arteries in the donor caused problems during the vascular anastomoses. During the operation cardiac arrest occurred. Postoperatively there were several medical and surgical problems, including intraperitoneal and gastrointestinal hemorrhage, paralysis of the right dome of the diaphragm, sinus bradycardia, massive diuresis, peroneal nerve palsy, and one major and three minor episodes of rejection, which were reversed by giving pulse doses of methylprednisolone intravenously.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/18. erythema elevatum diutinum--an unusual association with ulcerative colitis.We report the association of erythema elevatum diutinum (EED) with ulcerative colitis (UC). The patient, whose history included rheumatoid disease, diabetes mellitus (type I) and hypothyroidism developed EED during a severe acute exacerbation of UC which resolved following colectomy. To our knowledge this is the first report of such an association. Also of interest was the observation of Koebner phenomenon occurring at the sites where blood vessels were damaged.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/18. Takayasu's arteritis associated with idiopathic ulcerative colitis.Two patients with ulcerative colitis associated with Takayasu's arteritis are described. gangrene of a limb was the presenting feature in one patient and renovascular disease in the other. angiography showed vascular occlusions affecting several medium or large sized vessels in both patients.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/18. Giant inflammatory polyps associated with idiopathic inflammatory bowel disease. An ultrastructural study of five cases.Five cases of giant inflammatory polyps associated with idiopathic inflammatory bowel disease are reported. polyps produced intestinal obstruction in three cases; consequently, surgery was performed. In a further two cases, intestinal bleeding was improved by endoscopic polypectomy. Electron microscopy showed fibroblasts, myofibroblasts, mast cells, lymphocytes, collagen fibers, capillaries, and venules. Remnants of the original mucosal epithelial cells, smooth muscle cells, and hypertrophic autonomous nerve plexuses were noted. nerve fibers were interwoven with the matrix of the polyps. mast cells were closely linked with vessels, nerves, and collagen fibers. They may have an important role in the excessive granulation, angiogenesis, and fibrotic process in giant inflammatory polyps.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/18. Ulcerative colitis in association with Takayasu's disease.A case of total ulcerative colitis associated with large-vessel disease consistent with a diagnosis of Takayasu's disease is described in a 21-year-old Pakistani female. The possible relationship between the two disorders is discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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