Ulcerative colitis
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Ulcerative colitis
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Laboratory value | Results |
Complete blood count | |
Hemoglobin | 9.8 g/dL |
Platelet count | 460,000/mm3 |
Leukocyte count | 8,000/mm3 |
Plain radiographs show signs of sacroiliac joint inflammation. Which of the following is the most likely cause of this patient’s joint pain?
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First Aid
2024
2023
2022
2021
Arthritis p. 472
ulcerative colitis p. 389
Bloody diarrhea p. 176
ulcerative colitis p. 389
Digestion
ulcerative colitis and p. 389
Infliximab p. 120, 497
for ulcerative colitis p. 389
ulcerative colitis p. 723
p-ANCA
ulcerative colitis p. 389
Primary sclerosing cholangitis p. 402
ulcerative colitis p. 389
Sclerosing cholangitis p. 400, 402
ulcerative colitis association p. 389
6-mercaptopurine p. 444
for ulcerative colitis p. 389
ulcerative colitis p. 723
Ulcerative colitis p. 389
autoantibody p. 113
spondyloarthritis p. 475
sulfasalazine for p. 407
treatment p. 723
Transcript
Content Reviewers
Inflammatory bowel disease can cause inflammation in the small and large intestine, in other words...inflammation of the bowel.
Colitis refers specifically to inflammation in the colon, or the large intestine. Ulcerative colitis is a type of inflammatory bowel disease that tends to form ulcers along the inner-surface or lumen of the large intestine, including both the colon and the rectum.
These ulcers are spots in the mucosa where the tissue has eroded away and left behind open sores or breaks in the membrane.
Sometimes there is a flare which means that new damage has occurred, and then there are periods of remission when the tissue starts to heal up.
Ulcerative colitis is actually the most common type of inflammatory bowel disease, not that there are that many, but this one causes inflammation and ulcers in the mucosa and submucosa of the large intestine only, which is an important point that sets it apart from Crohn disease, another inflammatory bowel disease.
Now although certain environmental factors like diet and stress were once thought to be the culprit behind these ulcers forming in the gut, now it’s thought that these are more secondary, meaning they seem to make symptoms worse, but ulcerative colitis is now ultimately thought to be autoimmune in origin.
In fact, cytotoxic T cells from the immune system are often found in the epithelium lining the colon, so the thought is that inflammation and ulceration in the large intestine is caused by T cells destroying the cells lining the walls of the large intestine, leaving behind these eroded areas or ulcers.
It’s unclear what exactly these T cells are meant to be targeting though.
Some patients have p-ANCAs in their blood, or perinuclear antineutrophilic cytoplasmic antibodies, which are a kind of antibodies that target antigens in the body’s own neutrophils.
Although not completely understood, some theories suggest this may be partly due to an immune reaction to gut bacteria that have some structural similarity to our own cells, allowing antibodies to those gut bacteria, or p-ANCAs, to “cross-react” with neutrophils.
Summary
Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and ulcers in the mucosa and submucosa of the large intestine, specifically in the colon and rectum. The cause of the disease is believed to be autoimmune in origin, with cytotoxic T cells destroying the cells lining the walls of the large intestine, leaving behind eroded areas or ulcers. Environmental stimuli and genetic predisposition also play a role. Diagnosis typically requires colonoscopy and radiological imaging. Treatment includes anti-inflammatory medications, drugs that suppress the immune system, and biologic treatments. In severe cases, colectomy may be necessary.