Ulcerative Colitis Clinical Case Review

Sujaata Dwadasi, MD, an IBD Specialist at Carle Foundation Hospital in Illinois, discusses the baseline characteristics of the case:

“It starts with a 35-year-old female with no significant past medical history, who presents to the clinic after newly diagnosed moderate to severe pan-ulcerative colitis during a recent colonoscopy.

She’s also complaining of severe joint pains in her knees and wrist. These pains started about a month ago. Her bowel symptoms have been intermittently there — on and off for about a year — but really worsened over the last few months. She has about five to six bloody bowel movements daily, with abdominal pain, urgency and nocturnal symptoms.

She has never been on any therapies, including steroids, for her UC or her joint pains.

All her labs are normal, except for her CRP was 30, platelets 425, hemoglobin was 10.8, albumin 3.1 and fecal calprotectin 800. Her C. difficile study was negative.

Physical exam of her wrist, fingers and knees showed that there was some redness, some mild swelling and limited range of motion of these joints. Her recent colonoscopy, as you can see from these pictures, showed that there was severe inflammation with ulcerations and friability.

The pathology from her colonic biopsies showed both active and chronic colitis, and her CMV infection staining was negative.”