inflammatory bowel disease

Adult-onset immunoglobulin (IgA) vasculitis presenting as terminal ileitis is a rare clinical encounter which can mimic inflammatory bowel disease or infectious gastroenteritis. A high index of clinical suspicion is required to reach the correct diagnosis and to implement the appropriate management plans. Herein, we report a case of an elderly female presenting with a short history of abdominal pain, vomiting, bloody diarrhoea, fatigue and reduced appetite. Based on the blood tests and imaging, she was initially managed as having an infective or inflammatory bowel condition.

Azathioprine is the most common immunosuppressant used in the management of inflammatory bowel disease (IBD). Most of the available data on the effectiveness of this drug emerge from large university teaching hospitals, where there is a referral bias towards complex patients combined with a need for specialist expertise and early initiation of therapy.

Cytomegalovirus (CMV) colitis is rarely reported in the immunocompetent adult and is often associated with inflammatory bowel disease (IBD), particularly ulcerative colitis (UC). An index of suspicion in the appropriate setting is vital to diagnosing the condition. Undiagnosed CMV colitis has a significant morbidity. A review of the natural history and diagnosis of CMV is followed by a discussion of the incidence, outcome and possible treatment of CMV in the immunocompetent patient.

We report a case of unilateral eosinophilic pneumonia secondary to balsalazide monotherapy for ulcerative colitis. After commencing balsalazide, the patient presented with a history of cough, progressive dyspnoea and lethargy. Blood counts revealed peripheral eosinophilia. Her chest radiograph showed leftsided infiltration, and high-resolution computerised tomography demonstrated widespread nodular shadowing and ground glass opacifiction in the left lung. The right lung was normal. Transbronchial lung biopsy confirmed eosinophilic pneumonia.