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Case Reports
. 2019 Jan 31:2019:5163213.
doi: 10.1155/2019/5163213. eCollection 2019.

Unusual Manifestation of Ulcerative Colitis

Amna Basheer M Ahmed  1 , Badr M Rasheed Alsaleem  1
Affiliations
Case Reports

Unusual Manifestation of Ulcerative Colitis

Amna Basheer M Ahmed et al. Case Rep Pediatr. .

Abstract

The relationship of inflammatory bowel disease (IBD) and chronic recurrent multifocal osteomyelitis (CRMO) is understood as extraintestinal rheumatic manifestations. CRMO is a chronic, relapsing, inflammatory, noninfectious disorder of the skeletal system of unknown origin. The disease course is not always recurrent. The association of CRMO and ulcerative colitis (UC) is very rarely reported. We report a case of a 10-year-old Saudi female who was diagnosed with CRMO, when she developed fever in association with left foot pain, and ulcerative colitis was confirmed endoscopically and histologically based on a previous settled diarrheal illness and severe iron deficiency anemia which required blood. Both conditions responded well to IBD therapy. To the best of our knowledge, this is the first reported case of chronic, multifocal osteomyelitis associated with pediatric UC in Saudi Arabia. This report supports the use of IBD therapy in treating CRMO.

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Figures

Figure 1
Figure 1
MRI of distal left fibula (green arrow) and tibia (red arrow) showing multifocal chronic osteomyelitis.
Figure 2
Figure 2
Histopathology of descending colon biopsy, showing UC picture: distorted crypts (red arrow) with lamina propria chronic mononuclear inflammatory cells infiltrate (blue arrow) (H&E stain, ×40).
See this image and copyright information in PMC

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