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[Kaposi disease, limited to the skin, in ulcerated hemorrhagic rectocolitis].

We report the first case of limited cutaneous Kaposi's sarcoma during ulcerative colitis, in a HIV-negative 68 year-old man without any risk factors for this tumor. In our case, the steroid-therapy necessitated by the colitis is the most important aetiological factor of the sarcoma and its withdrawal leads to a complete remission of the tumor. The link between steroid-therapy and Kaposi's sarcoma is well known. A link between ulcerative colitis and Kaposi's sarcoma can be discussed but not proven. The possible occurrence of this cutaneous tumor during ulcerative colitis is of interest.

Aged↗

[Bilateral pneumothorax and hemorrhagic rectocolitis].

BACKGROUND: Respiratory diseases associated with ulcerative colitis are rare. CASE REPORT: A 14-year-old girl with ulcerative colitis was admitted for a left pneumothorax. She was given corticoidsteroids and enemas of 5 aminosalicylic acid. The pneumothorax was not controlled by pleural drainage and a pleural irritation was performed under thoracoscopy. Recurrence of pneumothorax led to surgical pleurectomy. The following day, a right pneumothorax occurred, also requiring pleurectomy. The pulmonary biopsies showed constrictive bronchiolitis. A restrictive syndrome was confirmed by functional pulmonary examinations. Total colectomy was performed nine months later for the ulcerative colitis. COMMENTS: Ulcerative colitis can be associated with bronchial pathology (bronchitis, bronchiectasis). Occurrence of pneumothorax has never been described; it can be a fortuitous association, but the histological features are not very different from those described in association with ulcerative colitis. The treatment of pneumothorax is difficult if the ulcerative colitis requires corticosteroids.

Adolescent↗

Histologic studies of rectocolic aganglionosis and allied diseases.

It is well-known that some patients exhibiting the symptoms of Hirschsprung's disease are shown to have intramural ganglia in the distal myenteric plexus. Some of them have been described as "pseudo-Hirschsprung's disease". It is likely that a variety of conditions have been included in this group. Using a silver impregnation technique we have made a detailed histologic study of the rectum and large bowel in a number of cases with provisional clinical diagnosis of Hirschsprung's disease but in which rectal biopsy showed small ganglia in Meissner's plexus demonstrated by acetylcholinesterase (Ach-E) staining. Three histologic variations were shown that may be called hypoganglionosis, immaturity of ganglia, and hypogenesis. An attempt is made to relate their clinical picture to the histologic findings.

Colon↗

[Bronchiectasis following colectomy for hemorrhagic rectocolitis].

Pulmonary disease is an uncommon extraintestinal manifestation of inflammatory bowel disease. We report the case of a patient in whom colectomy for ulcerative colitis was followed by development of bronchiectasis. A discussion of the relation between ulcerative colitis and bronchial disease is presented.

Aged↗

[Respiratory manifestations of hemorrhagic rectocolitis].

The spectrum of respiratory diseases associated with ulcerative colitis. The respiratory diseases associated with ulcerative colitis have recently been recognized, and principally affect the bronchi. Both chronic bronchitis and bronchiectasis may develop after many years, some of the patients having already undergone colectomy. Chronic bronchitis is characterized by cough and chronic mucopurulent sputum, and these symptoms may be exacerbated during acute flare-ups of ulcerative colitis. The bronchial lesions are inflammatory and can be reversed by corticosteroid therapy. Bronchiectasis produces similar symptoms, but has distinctive radiological features. Corticosteroids may sometimes reduce the symptoms, but they have no effect on the bronchial lesions. Salicylazosulfapyridine might be responsible for hypersensitivity lung diseases with eosinophilia, but the drug does not seem to be involved in the genesis of these bronchial manifestations. There have been occasional reports of other respiratory diseases associated with ulcerative colitis, including obliterative bronchiolitis, isolated and asymptomatic airflow obstruction, inflammatory tracheal stenosis, pulmonary vasculitis, pleurisy and pleuropericarditis, chronic pneumonia and interstitial fibrosis which may be diffuse or localized to the apices.

Bronchiectasis↗

[Hypertrophic cardiomyopathy complicating a prolonged corticotherapy for hemorrhagic rectocolitis].

BACKGROUND: The cardiac side-effects of corticosteroid therapy are very uncommon. CASE REPORT: A girl with ulcerative colitis developed at the age of 8 years an acute digestive episode despite prednisolone and total parenteral nutrition. The patient was then given intravenous methylprednisolone (2 mg/kg/d). Polypnea appeared 25 days later while blood pressure remained normal. Echocardiography revealed a cardiac hypertrophy associated with a systolic anterior motion of the mitral valve. Cardiac symptoms and echography findings returned to normal after reduction of corticosteroid therapy and its administration via the oral route. CONCLUSION: Hypertrophic cardiomyopathy has been described in preterms treated with dexamethasone for bronchopulmonary dysplasia. It is exceptional in older children under corticosteroid therapy and its mechanism remains unknown.

Cardiomyopathy, Hypertrophic↗

[Treatment of unspecific ulcerative rectocolitis in a child with enemas containing butyrate. Case report].

OBJECTIVE: To report a promising therapy to ulcerative colitis in children. METHODS: We report a case of ulcerative colitis in 4 years old female, who had this diagnosis since she was 1 year old. The treatment of RCU1 had an unsatisfactory response to conventional therapies (rectal and oral corticosteroids and immunosuppressive agent). RESULTS: She showed improvement, using enemas containing butyrate, in clinical, endoscopic and histological parameters. CONCLUSIONS: Although the role of butyrate in the treatment of ulcerative colitis still remains to be determined, we find effective response in this case. Despite evidences that butyrate may be beneficial and safety in treating refractory distal ulcerative colitis, results of controlled trials, specially in children will be necessary to prove the efficacy of this therapy.

Administration, Oral↗