title: Association of pseudomembranous colitis with Henoch-Schönlein purpura.
abstract: A 79-year-old man was admitted because of cholecystitis that occurred about 40 days after sigmoidectomy had been performed for colonic cancer. Though antibiotics improved his condition, the patient had hematochezia, diarrhea, and left lower abdominal pain. Colonoscopic findings showed multiple ring-like areas of redness and petechiae in the rectosigmoid colon and marked edema from the descending to the transverse colon. The patient then developed purpura on the extensor surfaces of the legs and bilateral gonalgia, and exacerbation of the hematochezia. A second colonoscopy (CS) showed multiple ring-like areas of redness and ecchymosis throughout the colon. The patient was diagnosed with Henoch-Schönlein purpura (HSP), and the symptoms were attenuated after the administration of prednisolone. However, diarrhea recurred in about a week; stool culture confirmed Clostridium difficile, and a third CS revealed pseudomembranes throughout the colon. The patient was diagnosed with pseudomembranous colitis (PMC), and the administration of vancomycin attenuated the symptoms. In conclusion, we have reported a rare adult case of PMC that occurred during prednisolone treatment for HSP. The PMC may have been caused by changes in the intestinal bacterial flora after the sigmoidectomy and by the intestinal lesions of HSP, as well as by the administration of antibiotics after the sigmoidectomy and for the treatment of cholecystitis, and by the use of prednisolone for the treatment of the HSP.
authors: Department of Internal Medicine, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan.
authors: Takehiko
authors: T
authors: Hayakawa
authors: Hiroyuki
authors: H
authors: Imaeda
authors: Mitsuyasu
authors: M
authors: Nakamura
authors: Shunsuke
authors: S
authors: Komoto
authors: Kazuo
authors: K
authors: Maruta
authors: Hidetoshi
authors: H
authors: Shiozu
authors: Haruhiko
authors: H
authors: Ogata
authors: Yasushi
authors: Y
authors: Iwao
authors: Hiromasa
authors: H
authors: Ishii
authors: Toshifumi
authors: T
authors: Hibi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003106:Colon / Q000382:microbiology / Q000473:pathology; D003113:Colonoscopy; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000188:drug therapy; D008297:Male; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D014640:Vancomycin; D011239:Prednisolone