Colitis, Lupus, Auto-Immune, Positive ANA

19 year old female - Had colonoscopy a week ago after bleeding on/off with normal stool since November and a bout of bloody diarhhea in April that lasted a few days. Photos showed ulceration in descending colon and ulcers in the Ilium. Pathology results revealed acute irritation with increased eosinophils. Did not look like chronic colitis, Crohns disease or ulcerative colitis, although possible it's an early presentation. It looks like "acute colitis" which could be from an infection or possibly an allergy-like disorder.

Other past history: Positive ANA 1:1280 (no other tests supporting lupus), Low IgA 43 (66-344), Hemoglobin normal, CBC shows normal WBC and normal RBC but high Segs 89 (35-65%) and low Lymphs 9 (23-53%) and low ABS Lymbhs .76 (1.2-5.4 K/uL)

Puzzled where to go from here.  Gastro. says we can stry a short course of seroids vs. treating for an allergic type discorder with medicine Gastrochrom????

[Kevin Pho, MD]

I would exclude infection.  This can be done be sending the stool off for analysis and culture.  Antibiotics would be necessary if the tests confirm an infection.

If an allergy is suspected, steroids can help.  You may also want to consider a referral to an allergist to remove exacerbating factors.  

I would discuss these options with a GI physician, or obtain another opinion at a major academic medical center.



This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Daisylouu]

She is also Celiac and has been gluten free 7 years.

[Daisylouu]

pANCA positive