Stroke in inflammatory bowel disease: a report of two cases and review of the literature
- PDF / 470,235 Bytes
- 4 Pages / 610 x 792 pts Page_size
- 88 Downloads / 229 Views
BioMed Central
Open Access
Case report
Stroke in inflammatory bowel disease: a report of two cases and review of the literature Deepak Joshi*, Tobias Dickel, Rakesh Aga and Gray Smith-Laing Address: Department of Gastroenterology, Medway Maritime Hospital, Kent, UK Email: Deepak Joshi* - [email protected]; Tobias Dickel - [email protected]; Rakesh Aga - [email protected]; Gray Smith-Laing - [email protected] * Corresponding author
Published: 21 March 2008 Thrombosis Journal 2008, 6:2
doi:10.1186/1477-9560-6-2
Received: 4 December 2007 Accepted: 21 March 2008
This article is available from: http://www.thrombosisjournal.com/content/6/1/2 © 2008 Joshi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Thrombosis is a recognised complication of inflammatory bowel disease (IBD), in particular venous thrombosis. Arterial thrombosis, especially stroke is rare. There is a paucity of information regarding stroke in IBD and its management. The authors describe two cases of stroke in patients with IBD during periods of increased disease activity. The literature regarding this devastating complication and the procoagulant state that exists in IBD are reviewed.
Background Thrombosis is a well-recognised complication of inflammatory bowel disease (IBD) and is an important cause of morbidity and mortality. The commonest are deep vein thrombosis and pulmonary emboli [1]. Arterial thrombosis, in particular stroke, is rare in IBD. No guidelines are available at present to help manage this severe complication. The authors describe two cases of stroke in patients with ulcerative colitis (UC). Patient 1 A 55 year old, non-smoker, Caucasian man presented to the emergency room with left sided hemiparesis. The patient also had bloody diarrhoea (12 times a day). A diagnosis of ulcerative colitis had been made five years previously and the patient had been maintained on mesalazine only. The patient had been evaluated in the out-patient department three days earlier with an exacerbation of his UC and was started on prednisolone 40 mg daily only. There was no history of vascular disease. On examination the patient was normotensive (blood pressure 111/80 mmHg) and afebrile. Cardiovascular examination revealed normal heart sounds, and no carotid
bruits. Abdominal examination revealed tenderness in the left iliac fossa and reduced bowel sounds. A dense left sided hemiplegia was noted. Blood tests showed a raised white cell count of 11.5 × 109/L (NR 4–11) and C-reactive protein (CRP) of 29.6 mg/L (NR 0–5) and a thrombocytosis of 566 × 109/L (NR 150–400). Fasting cholesterol of 3.3 mmol/L (NR 1.3–5.2) and blood glucose of 3.3 mmol/L (NR 3.3–5.8) were both normal. Stool cultures were negative. An electrocardiogram demonstrated normal sinus rhythm.
Data Loading...
