Ulcerative colitis presenting as pyrexia of unknown origin (PUO) without bowel symptoms

Shpilberg, Raya; Hadjiyiannis, Demetra; Khan, SA

doi:10.7861/clinmedicine.12-4-389

Cited by 5 publications

(3 citation statements)

References 4 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only a few case reports in the literature link IBD and PUO together, however these were mainly in paediatric [7] or elderly populations. Shpilberg presented a case of a 71-year-old gentleman with PUO, who was diagnosed as ulcerative colitis (UC) following a PET scan showing significant uptake in the left colon [8]. This report advises that in the elderly population, ulcerative colitis (UC) should be considered as a cause of PUO, even in the absence of gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Pyrexia of Unknown Origin

Soliman¹,

Shirazi-Nejad²,

Bullas³

et al. 2021

Cureus

View full text Add to dashboard Cite

A previously fit and well 29-year-old man with no significant recent travel or contact history presented to the hospital with 11 days of feeling unwell, intermittent diarrhea, abdominal pain and a skin rash that was consistent with folliculitis. Despite resolution of these index symptoms he continued with recurring fever of 38.5 degrees centigrade and weight loss of six Kilograms over the next three weeks. Extensive investigations to find a cause for the unexplained persistent fever failed to reveal an etiology, hence fulfilling pyrexia of unknown origin definition (PUO). None of the three main causes of PUO, namely infections, autoimmune diseases or underlying malignancy, were confidently found. Colonoscopy was suggested following a review of the abdominal CT scan to investigate possible thickening of the bowel wall. A diagnosis of atypically presenting Crohn's disease was eventually made and confirmed by colonoscopy and histology. The fever responded promptly to treatment of the Crohn's disease and he remained well at follow-up at six and 12 months after the initial presentation. In conclusion, it is important to keep in mind that PUO can be a rare initial presentation of inflammatory bowel disease in young adults with little or no gastrointestinal symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Pyrexia of Unknown Origin

Soliman¹,

Shirazi-Nejad²,

Bullas³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Pet scanning revealed foci of active inflammation in the ascending and the sigmoid colon in consistence with the history of inflammatory bowel disease. Therefore, ulcerative colitis was considered as the cause of the fever [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Voukelatou

Sfendouraki

Karianos

et al. 2016

Case Reports in Medicine

View full text Add to dashboard Cite

Background. The presence of ulcerative colitis (UC) with no bowel symptoms, as fever of unknown origin (FUO), is uncommon. Objective. To describe the case of an 80-year-old woman who presented with fever, with a history of UC under treatment with mesalazine. Case Presentation. She was admitted due to fever lasting for 12 days with no associated symptoms. Seven years earlier, she was diagnosed with UC. After an extended workup for FUO that failed to reach the diagnosis, she underwent a gallium-67 scintigraphy. This revealed a persistent diffuse concentration of gallium-67 in the ascending colon at 24-hour imaging that remained stable at 48- and 72-hour imaging without any topographic change after the use of laxatives. Considering the results and in the absence of another diagnosis, the patient was treated with 30 mg prednisone daily and mesalazine, as treatment of active UC. Subsequently, the patient's condition improved markedly and the fever retreated. One month later, she was reevaluated with a gallium-67 scintigraphy with total absence of gallium-67 concentration in the ascending colon. Conclusion. UC activity must be included in the differential diagnosis of FUO in patients with longstanding disease, since fever may present alone, with no other manifestations.

show abstract

“…Actually, the symptoms for the first two months after initiation of dialysis were nonspecific, including fever and fatigue, with no gastrointestinal symptoms and bloody diarrhea developing about three months after the onset of fever. Interestingly, a recent report described a patient with UC who presented with fever without gastroduodenal symptoms [ 14 ]. Although we could not completely rule out the possibility that fever at dialysis initiation was mediated by other causes, that finding and those shown here indicate the possibility of UC as a cause of fever even in dialysis patients without gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 99%

Ulcerative Colitis Presented as Fever and Bloody Diarrhea at Initiation of Dialysis in an Elderly Patient with End-Stage Kidney Disease

Yamada

Kanazawa

Nakamura

et al. 2015

Case Reports in Medicine

View full text Add to dashboard Cite

Ulcerative colitis (UC) is a chronic inflammatory bowel disorder that mainly affects the colon and rectum. Immunological derangements are associated with the pathogenesis of UC. Many patients with UC also have chronic kidney disease, associated with immunological disorders and/or pharmacotherapy for UC. Some patients with UC may develop end-stage renal disease (ESRD) and require renal replacement therapy. However, little is known clinically about ESRD patients who develop UC or about patients with UC who develop ESRD. This report describes an elderly patient with ESRD who presented with fever and bloody diarrhea and was finally diagnosed as UC (pancolitis type) at dialysis initiation. The patient was successfully treated with a series of immunosuppressive agents. This report highlights the importance of considering UC as a potential cause of bloody stool and fever in patients with ESRD.

show abstract

Ulcerative colitis presenting as pyrexia of unknown origin (PUO) without bowel symptoms

Cited by 5 publications

References 4 publications

An Unusual Case of Pyrexia of Unknown Origin

An Unusual Case of Pyrexia of Unknown Origin

Ulcerative Colitis Activity Presenting as Fever of Unknown Origin, in a Patient with Longstanding Disease under Continuous Treatment with Mesalazine

Ulcerative Colitis Presented as Fever and Bloody Diarrhea at Initiation of Dialysis in an Elderly Patient with End-Stage Kidney Disease

Contact Info

Product

Resources

About