title: Achilles tendinitis as a rare extraintestinal manifestation of ulcerative colitis.
abstract: Patients with inflammatory bowel disease often have extraintestinal manifestations (EIMs) involving almost all organ systems, but little has been reported on Achilles tendinitis. Herein, we present a unique case of Achilles tendinitis, which manifested shortly after initiation of mesalazine therapy for ulcerative colitis. A 26-year-old Japanese woman with bloody diarrhea and abdominal cramps lasting for 7 days was referred to our hospital. The Lichtiger clinical activity index (CAI) score was 9 at the first visit. Based on the clinical symptoms and examination results, she was diagnosed with ulcerative pancolitis in the active phase, and treatment with mesalazine (2.4 g/day) and probiotics was initiated. Her symptoms resolved within 7 days of treatment (CAI 3). However, she then developed bilateral Achilles tendinitis without any apparent cause. The Achilles tendinitis subsided with conservative management within 2 weeks, despite continuation of mesalazine therapy. This case instructively suggests that Achilles tendinitis should be noted as an EIM of ulcerative colitis.
authors.affiliation: Department of Internal Medicine, Asanogawa General Hospital, Kosaka-Naka 83, Kanazawa, 920-8621, Japan. araki@asanogawa-gh.or.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Zenda
authors.affiliation: Department of Internal Medicine, Asanogawa General Hospital, Kosaka-Naka 83, Kanazawa, 920-8621, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Araki
authors.affiliation: Department of Radiology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Otoyuki
authors.initials: O
authors.lastname: Nakamiya
authors.affiliation: Department of Orthopedics, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tokuumi
authors.affiliation: Department of Dermatology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Shimada
authors.affiliation: Department of Clinical Pathology, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Komai
authors.affiliation: Department of Pharmacy, Asanogawa General Hospital, Kanazawa, Japan.
authors.forename: Yukie
authors.initials: Y
authors.lastname: Taniuchi
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D012809:Colon, Sigmoid / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D019804:Mesalamine / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D011859:Radiography; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D014463:Ultrasonography
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine
keywords: Achilles tendinitis; Extraintestinal manifestation of inflammatory bowel disease; Mesalazine; Ulcerative colitis