Cargando…

Focal Active Colitis Presented With Chronic Diarrhea

There are various etiologies of colonic injury and inflammation. The most commonly described colitides in clinical practice are associated with infection, inflammatory bowel disease, ischemia, radiation and medications. The colonic wall has a limited set of responses to different types of injury; th...

Descripción completa

Detalles Bibliográficos
Autores principales: Mandzhieva, Bayarmaa, Taylor, John, Zafar, Hammad, Rashid, Mamoon Ur, Khan, Abu H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294873/
https://www.ncbi.nlm.nih.gov/pubmed/32550060
http://dx.doi.org/10.7759/cureus.8140
_version_ 1783546557214228480
author Mandzhieva, Bayarmaa
Taylor, John
Zafar, Hammad
Rashid, Mamoon Ur
Khan, Abu H
author_facet Mandzhieva, Bayarmaa
Taylor, John
Zafar, Hammad
Rashid, Mamoon Ur
Khan, Abu H
author_sort Mandzhieva, Bayarmaa
collection PubMed
description There are various etiologies of colonic injury and inflammation. The most commonly described colitides in clinical practice are associated with infection, inflammatory bowel disease, ischemia, radiation and medications. The colonic wall has a limited set of responses to different types of injury; therefore, there is overlap between many of these disorders. Focal active colitis is characterized by isolated neutrophilic cryptitis with the background mucosa displaying normal crypt architecture. This inflammatory pattern can be easily unnoticed by pathologists because on low-power examination the mucosa may have almost normal appearance. General practitioners also may not be familiar with this term, underlying etiologies, associated risk factors, course, available therapies and follow up.  We present a case of an 82-year-old female with chronic diarrhea and weight loss. She had a negative infectious workup and normal radiology series. She subsequently underwent endoscopic evaluation in lieu of persistent and debilitating symptoms which revealed nonspecific macroscopic findings with pathology noting focal active colitis. She was empirically treated with a 14-day course of Xifaxan and responded well to management with almost complete resolution of her symptoms and no recurrence on six-month follow-up.
format Online
Article
Text
id pubmed-7294873
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-72948732020-06-16 Focal Active Colitis Presented With Chronic Diarrhea Mandzhieva, Bayarmaa Taylor, John Zafar, Hammad Rashid, Mamoon Ur Khan, Abu H Cureus Internal Medicine There are various etiologies of colonic injury and inflammation. The most commonly described colitides in clinical practice are associated with infection, inflammatory bowel disease, ischemia, radiation and medications. The colonic wall has a limited set of responses to different types of injury; therefore, there is overlap between many of these disorders. Focal active colitis is characterized by isolated neutrophilic cryptitis with the background mucosa displaying normal crypt architecture. This inflammatory pattern can be easily unnoticed by pathologists because on low-power examination the mucosa may have almost normal appearance. General practitioners also may not be familiar with this term, underlying etiologies, associated risk factors, course, available therapies and follow up.  We present a case of an 82-year-old female with chronic diarrhea and weight loss. She had a negative infectious workup and normal radiology series. She subsequently underwent endoscopic evaluation in lieu of persistent and debilitating symptoms which revealed nonspecific macroscopic findings with pathology noting focal active colitis. She was empirically treated with a 14-day course of Xifaxan and responded well to management with almost complete resolution of her symptoms and no recurrence on six-month follow-up. Cureus 2020-05-15 /pmc/articles/PMC7294873/ /pubmed/32550060 http://dx.doi.org/10.7759/cureus.8140 Text en Copyright © 2020, Mandzhieva et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Mandzhieva, Bayarmaa
Taylor, John
Zafar, Hammad
Rashid, Mamoon Ur
Khan, Abu H
Focal Active Colitis Presented With Chronic Diarrhea
title Focal Active Colitis Presented With Chronic Diarrhea
title_full Focal Active Colitis Presented With Chronic Diarrhea
title_fullStr Focal Active Colitis Presented With Chronic Diarrhea
title_full_unstemmed Focal Active Colitis Presented With Chronic Diarrhea
title_short Focal Active Colitis Presented With Chronic Diarrhea
title_sort focal active colitis presented with chronic diarrhea
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294873/
https://www.ncbi.nlm.nih.gov/pubmed/32550060
http://dx.doi.org/10.7759/cureus.8140
work_keys_str_mv AT mandzhievabayarmaa focalactivecolitispresentedwithchronicdiarrhea
AT taylorjohn focalactivecolitispresentedwithchronicdiarrhea
AT zafarhammad focalactivecolitispresentedwithchronicdiarrhea
AT rashidmamoonur focalactivecolitispresentedwithchronicdiarrhea
AT khanabuh focalactivecolitispresentedwithchronicdiarrhea