SummaryTwo cases of biopsy-proven ulcerative colitis are described, and both developed a leucoerythroblastic anaemia during the course of the acute illness. Despite intensive investigation for the presence of bone marrow infiltration, no neoplasm was demonstrated. The leucoerythroblastic anaemia remitted in each case on medical treatment of the ulcerative colitis. The possible mechanisms underlying the development of reversible leucoerythroblastic anaemia are discussed.
Case reportsA 58-year-old woman gave a six-month history of progressive anaemia, lethargy, increased stool frequency with watery diarrhoea and for 6 weeks had noticed rectal blood loss on defaecation. There was no weight loss, no other systematic symptoms and no family history of inflammatory bowel disease.On examination she was markedly pale with mild bilateral pitting ankle oedema. Abdominal examination was unremarkable but sigmoidoscopy revealed a friable, granular mucosa with contact bleeding and a moderate amount of blood in the bowel lumen. Rectal biopsy showed changes of acute ulcerative colitis.A blood count on presentation revealed a leucerythroblastic anaemia-(haemoglobin (Hb)