Intest Res.  2017 Apr;15(2):255-259. 10.5217/ir.2017.15.2.255.

Coexistence of ulcerative colitis and Sjögren's syndrome in a patient with Takayasu's arteritis and Hashimoto's thyroiditis

• Park HW
• Lee HS
• Hwang S
• Lee HS
• Bae HI
• Yoon G

• KMID: 2425170
• DOI: http://doi.org/10.5217/ir.2017.15.2.255

Abstract

A 31-year-old woman with a 15-year history of Takayasu's arteritis (TA) and a 13-year history of Hashimoto's thyroiditis presented with hematochezia. She received a diagnosis of Sjögren's syndrome at 1 month before her visit to Kyungpook National University Medical Center. Her colonoscopic findings were compatible with a diagnosis of ulcerative colitis (UC). She was treated with oral mesalazine, and her hematochezia symptoms subsequently disappeared. The coexistence of UC and TA has been reported; however, reports on the coexistence of UC and Sjögren's syndrome, or of UC and Hashimoto's thyroiditis are rare. Although the precise etiologies of these diseases are unknown, their presence together suggests that they may have a common pathophysiologic background. Furthermore, in patients with autoimmune or vascular diseases, including TA, systemic manifestations should be assessed with consideration of inflammatory bowel diseases including UC in the presence of gastrointestinal symptoms such as diarrhea and hematochezia.

Keyword

Takayasu arteritis; Colitis, ulcerative; Sjogren's syndrome; Hashimoto disease

MeSH Terms

Academic Medical Centers
Adult
Colitis, Ulcerative*
Diagnosis
Diarrhea
Female
Gastrointestinal Hemorrhage
Gyeongsangbuk-do
Hashimoto Disease
Humans
Inflammatory Bowel Diseases
Mesalamine
Sjogren's Syndrome
Takayasu Arteritis*
Thyroid Gland*
Thyroiditis*
Ulcer*
Vascular Diseases
Mesalamine

Figure

• 

  Fig. 1 Neck and chest CT angiography finding. CT angiography showing a narrowing of both the common carotid artery and a complete occlusion of the left subclavian vein (arrow) just after the branching of the vertebral artery.

• 

  Fig. 2 Thyroid ultrasonotraphic finding. Ultrasonography showing a diffuse enlargement with heterogeneous echogenicity without any definite focal lesions of both thyroid glands.

• 

  Fig. 3 Histopathological finding. Labial salivary gland biopsy exhibiting a few lymphoplasma cells (arrows) in the minor salivary gland (H&E, ×200).

• 

  Fig. 4 Colonoscopic and histopathologic findings. (A-C) Colonoscopy showing decreased vascular patterns, and erythematous mucosa with exudates that started in the rectum and extended to the cecum. (D) Microscopic examination of biopsy specimens from the colon revealing moderately chronic active colitis with cryptitis, as well as crypt abscesses (arrowhead), crypt distortion (thin arrows), and branching crypts (thick arrows) (H&E, ×40).

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