title: Orbital pseudotumour as a presentation of paediatric ulcerative colitis.
abstract: A 2-year-old girl presented with a one-day history of acute-onset bilateral painful, swollen eyes and a two‑month history of loose stools. Physical examination revealed a right eyelid swelling with proptosis. Magnetic resonance imaging revealed a right orbital pseudotumour. The patient responded well to treatment with intravenous antibiotics and nonsteroidal anti-inflammatory drugs. However, three weeks later, she was readmitted with a vasculitic lesion over her left upper chest, with mucous-bloody diarrhoea. Histopathology confirmed the diagnosis of ulcerative colitis. The patient was treated with intravenous pulse methylprednisolone and sulphasalazine. Two weeks after discharge, she was readmitted for cutaneous vasculitis and worsening diarrhoea. The patient's bowel and extraintestinal diseases resolved upon addition of infliximab to her treatment regimen. Her inflammatory markers also normalised. Azathioprine was subsequently added. Infliximab was discontinued after four doses and prednisolone was tapered off. The patient remained well without any flare-up after 24 months of follow-up.
authors: Rheumatology and Immunology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital,100 Bukit Timah Road, Singapore 229899. justin.tan.ht@kkh.com.sg.
authors: Justin Hung Tiong
authors: JH
authors: Tan
authors: Hui Ping
authors: HP
authors: Chu
authors: Lena
authors: L
authors: Das
authors: Thaschawee
authors: T
authors: Arkachaisri
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D000069285:Infliximab; D001379:Azathioprine
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