Choi Yun Jung, Yoo Wan-Hee
Department of Internal Medicine, Chonbuk National University Hospital, Division of Rheumatology, Jeonju, South Korea.
Department of Internal Medicine, Chonbuk National University Medical School, Division of Rheumatology, Jeonju, South Korea.
Arch Rheumatol. 2017 Feb 12;32(3):253-256. doi: 10.5606/ArchRheumatol.2017.6182. eCollection 2017 Sep.
A 37-year-old male patient with adult-onset Still's disease (AOSD) developed ulcerative colitis (UC) during the course of treatment. He complained of abdominal pain, diarrhea, and frequent passage of blood-stained stool with peri-umbilical tenderness. The laboratory evaluation was significant only for a hemoglobin level of 11 g/dL. The patient underwent endoscopic and colonoscopic examination with the presumptive diagnosis of nonsteroidal anti-inflammatory drug-induced gastropathy. Unexpectedly, the colonoscopic and pathologic findings of the biopsy specimen were compatible with UC. To our knowledge, this is the first report of AOSD concurrently occurring with UC. In patients with AOSD, abdominal pain is likely to be mistaken for nonsteroidal anti-inflammatory drug-induced gastropathy. However, several studies imply the possibility of UC as an extra- articular manifestation of AOSD. Although coexistence of AOSD and inflammatory bowel disease is rare, timely diagnosis is important since this co-occurrence may aggravate this otherwise benign disease.
一名37岁成年起病的斯蒂尔病（AOSD）男性患者在治疗过程中并发了溃疡性结肠炎（UC）。他主诉腹痛、腹泻，频繁排出带血粪便，脐周有压痛。实验室检查仅显示血红蛋白水平为11 g/dL。患者接受了内镜和结肠镜检查，初步诊断为非甾体抗炎药所致胃病。出乎意料的是，活检标本的结肠镜检查和病理结果与UC相符。据我们所知，这是AOSD并发UC的首例报告。在AOSD患者中，腹痛很可能被误诊为非甾体抗炎药所致胃病。然而，多项研究提示UC作为AOSD关节外表现的可能性。虽然AOSD与炎症性肠病并存罕见，但及时诊断很重要，因为这种并存可能使原本良性的疾病加重。
