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Association of
pseudomembranous colitis with Henoch-Schönlein purpura.J
Gastroenterol. 2005 Jun;40(6):641-5.
A 79-year-old man
was admitted because of cholecystitis that occurred about 40 days
after sigmoidectomy had been performed for colonic cancer. Though
antibiotics improved his condition, the patient had hematochezia,
diarrhea, and left lower abdominal pain. Colonoscopic findings showed
multiple ring-like areas of redness and petechiae in the rectosigmoid
colon and marked edema from the descending to the transverse colon.
The patient then developed purpura on the extensor surfaces of the
legs and bilateral gonalgia, and exacerbation of the hematochezia. A
second colonoscopy (CS) showed multiple ring-like areas of redness and
ecchymosis throughout the colon. The patient was diagnosed with
Henoch-Schönlein purpura (HSP), and the symptoms were attenuated after
the administration of prednisolone. However, diarrhea recurred in
about a week; stool culture confirmed Clostridium difficile, and a
third CS revealed pseudomembranes throughout the colon. The patient
was diagnosed with pseudomembranous colitis (PMC), and the
administration of vancomycin attenuated the symptoms. In conclusion,
we have reported a rare adult case of PMC that occurred during
prednisolone treatment for HSP. The PMC may have been caused by
changes in the intestinal bacterial flora after the sigmoidectomy and
by the intestinal lesions of HSP, as well as by the administration of
antibiotics after the sigmoidectomy and for the treatment of
cholecystitis, and by the use of prednisolone for the treatment of the
HSP. |