| Sub-title | |
| Authors | L Micallef Grimaud M J Cachia |
| Abstract | Background: The incidence of immunological disorders is greater in patients with inflammatory bowel disease than among the general population. The association of ulcerative colitis and autoimmune haemolytic anaemia was first described in the early 1950's but no more than fifty cases have been documented. Detailed description of the pathogenic mechanisms involved is lacking. Case Report: A 46-year old lady with ulcerative colitis presented with an anaemia of 3 months. The patient had undergone a restorative proctocolectomy and ileal pouch reservoir in 1990. She had lately been suffering from pouchitis and had been prescribed mesalazine suppositories. These were discontinued when the patient was found to have a haemolytic anaemia. However, two months after withdrawing mesalazine, the patient's haemoglobin continued to drop to 6.2g/dL whilst the reticulocyte count increased further. There was no exacerbation of colitis during this time. Direct Coomb's test was positive. The patient was treated with prednisolone 60mg daily and within ten days of starting steroids, the haemoglobin had increased to 10.1g/dL. Steroids were gradually tailed down over a three month period and the patient's haemogloin level has remained stable. Conslusion: A review of cases of Coomb's positive haemolytic anaemia in association with ulcerative colitis shows that there is a marked preponderance of female patients (F:M = 7:1), the anaemia appearing at a mean of 10 years after the onset of the colitis, independent of the age of the patient. Although corticosteroids and/or immunosuppressive therapy are often successful, some patients require splenectomy and occasionally colectomy. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | case report, haemolytic anaemia, ulcerative colitis |