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Pancolitis


Presentation

  • Both diseases can present with involvement of the entire colon (pancolitis) with ulceration, diffuse polyposis, a (pseudo) tumoural mass, or a combination of these. Footnotes Contributors: JC wrote the manuscript.[ncbi.nlm.nih.gov]
  • Susceptibility Such susceptibility has been suggested for many years in light of the high number of patients in specific ethnic groups, the rare association with genetic diseases and especially the observation of family cases (where similarities in disease presentation[digestscience.com]
Splenomegaly
  • Cervicothoracoabdominopelvic CT showed extensive lymphadenopathy and splenomegaly, and a lymph node biopsy confirmed the diagnosis. The patient was started on chemotherapy and is currently alive, 6 months after diagnosis, despite the poor prognosis.[ncbi.nlm.nih.gov]
Inflammation
  • Pancolitis, in its most general sense, refers to inflammation of the entire colon. This can be caused by a variety of things.[en.wikipedia.org]
  • […] tomographic clinical and pathological parameters with regards to the evolution of chronic pouchitis. 201 patients who underwent a pouch were followed up in a comprehensive pouch clinic and were examined to risk factors including presence of appendiceal inflammation[bdrf.org.uk]
  • In animal models for IBDs, administration of these bacteria or of the molecules released by these bacteria reduced intestinal inflammation and significantly improved survival.[digestscience.com]
Pain
  • He also referred mild abdominal pain, constipation and tenesmus intermittently in the past 4 months. He had been submitted to a colonoscopy 1 year before, and it was unremarkable.[ncbi.nlm.nih.gov]
  • Symptoms: pain and severity The most frequently observed symptom in UC is the presence of blood in stools (rectorrhagias). It may be associated with mucus discharges, diarrhea, abdominal pains, etc.[digestscience.com]
Fatigue
Lymphadenopathy
  • Cervicothoracoabdominopelvic CT showed extensive lymphadenopathy and splenomegaly, and a lymph node biopsy confirmed the diagnosis. The patient was started on chemotherapy and is currently alive, 6 months after diagnosis, despite the poor prognosis.[ncbi.nlm.nih.gov]
Fatigue
Abdominal Pain
  • He also referred mild abdominal pain, constipation and tenesmus intermittently in the past 4 months. He had been submitted to a colonoscopy 1 year before, and it was unremarkable.[ncbi.nlm.nih.gov]
  • It may be associated with mucus discharges, diarrhea, abdominal pains, etc. Severe flare-ups may result in weight loss, severe fatigue and fever.[digestscience.com]
Abdominal Pain
  • He also referred mild abdominal pain, constipation and tenesmus intermittently in the past 4 months. He had been submitted to a colonoscopy 1 year before, and it was unremarkable.[ncbi.nlm.nih.gov]
  • It may be associated with mucus discharges, diarrhea, abdominal pains, etc. Severe flare-ups may result in weight loss, severe fatigue and fever.[digestscience.com]
Hematochezia
  • Description A 63-year-old Caucasian man was admitted to the emergency department due to hematochezia. He also referred mild abdominal pain, constipation and tenesmus intermittently in the past 4 months.[ncbi.nlm.nih.gov]
Tenesmus
  • He also referred mild abdominal pain, constipation and tenesmus intermittently in the past 4 months. He had been submitted to a colonoscopy 1 year before, and it was unremarkable.[ncbi.nlm.nih.gov]
Constipation
  • He also referred mild abdominal pain, constipation and tenesmus intermittently in the past 4 months. He had been submitted to a colonoscopy 1 year before, and it was unremarkable.[ncbi.nlm.nih.gov]
Ulcer
  • Colonoscopy showing pancolitis with areas of linear ulcers with cobblestone appearance (A), multiple pseudopolyps (B) and deep ulceration of the ileocaecal valve (C).[ncbi.nlm.nih.gov]
  • Pancolitis or universal colitis is frequently used in a more specific fashion to denote a very severe form of ulcerative colitis.[en.wikipedia.org]
  • Definition Ulcerative colitis is one of the inflammatory bowel diseases (IBDs).[digestscience.com]
  • Colitis-associated colorectal carcinoma; Kolitis-assoziiertes kolorektales Karzinom; carcinome; carcinome colorectal associé à une colite; chronisch-entzündliche Darmerkrankung; colite ulcéreuse; inflammatory bowel disease; maladies inflammatoires chroniques; ulcerative[ncbi.nlm.nih.gov]
Arthralgia
  • Extra-intestinal symptoms may appear: in the joints (arthralgia, low back pain), on the skin (erythema nodosum), sometimes in the eyes or the liver. In children, ulcerative colitis leads to malnutrition, which may cause severe failure to thrive.[digestscience.com]
Suggestibility
  • […] to adenomatous polyposis), or a combination of these. 2 3 Learning points Mantle cell lymphoma is a cause of pancolitis, and its differential diagnosis including IBD can be challenging, mainly if symptoms, patient's age and endoscopic appearance are suggestive[ncbi.nlm.nih.gov]
  • The Environmental Factor Variations of IBD incidence (number of new cases per year) and prevalence (number of persons affected) over time and space suggest a major environmental factor. IBDs are primarily environmental diseases.[digestscience.com]

Workup

Colitis
  • Pancolitis or universal colitis is frequently used in a more specific fashion to denote a very severe form of ulcerative colitis.[en.wikipedia.org]
  • […] patients who underwent a pouch were followed up in a comprehensive pouch clinic and were examined to risk factors including presence of appendiceal inflammation, backwash ileitis, gender, ethnicity, age of disease onset, disease deviation, extent of colitis[bdrf.org.uk]
  • Main risk factors for colitis-associated CRC are pancolitis, duration of colitis and presence of primary sclerosing cholangitis.[ncbi.nlm.nih.gov]
  • Definition Ulcerative colitis is one of the inflammatory bowel diseases (IBDs).[digestscience.com]
Lymphocytic Infiltrate
  • Biopsies were performed, which showed a dense lymphocytic infiltrate with small and medium size cells D20 , CD5 , BCL2 , cyclin D1 , CD3 and CD 10 , compatible with a mantle cell lymphoma in colonic mucosa with areas of blastoid variant cells ( figure[ncbi.nlm.nih.gov]

Treatment

  • As their onset of action occurs within a few months, they cannot be used as a monotherapy for the treatment of flare-ups. They are used in progressive forms or challenging treatment.[digestscience.com]

Prognosis

  • The patient was started on chemotherapy and is currently alive, 6 months after diagnosis, despite the poor prognosis.[ncbi.nlm.nih.gov]
  • Particularly patients with chronically active pancolitis should undergo regular surveillance colonoscopy, since prognosis of colitis-associated CRC is poor.[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiology shows a higher incidence in industrialized countries and an increasing incidence in westernizing countries.[digestscience.com]
Sex distribution
Age distribution

Pathophysiology

  • The role of these risk genes, their interactions and the consequences of their mutations are researched intensively, but their burden in the pathophysiology of IBDs remain moderate and IBDs are never hereditary diseases.[digestscience.com]

Prevention

  • All these observations pave the way for new research prospects, the implementation of new diagnostic tools and new hopes for treatment and prevention.[digestscience.com]

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