20 year old female. Blood in stool, abdominal pain. ANA+,(all other lupus panel negative) joint pain, mouth ulcers, blood in urine off and on(1mm kidney stone) All other blood work normal. Was on steroids and Asacol last summer for 5 months...weaned off
Current CT scan: Mildly prominent fluid filled small bowel loops with no evidence of obstruction. Suggestion of mild wall thickening involving the terminal ileum. Focal area of mild wall thickening involving a small bowel loop in the left lower quadrant. No significant inflammatory changes.
Colonoscopy May 2008 - Duodenal mucosa increased numbers of lymphocytes. Acute inflammation, villous atrophy, eosinophilia. Terminal ileal mucosa increased eosinophils up to 30. Occasional eosinophilic cryptitis. Actule inflammation, villous atrophy, granulomas, and dysplasia. Portions of colonic mucosa with focal acute cryptitis, crypt abscess, infiltration of chronic inflammatory cells and eosinophils. Scatter neutrophils in lamina propria.
Colonoscopy biopsy May 2008 : 1st pathologist - acute colitis; 2nd pathologist - UC; 3rd pathologist - not sure, most likely UC
Colonoscopy 3 months later August 2008: Normal
Capsule endoscopy July 2008 - showed one area of ulcer in small intestine and 3 possible polyps
Double baloon endoscopy through mouth showed nothing, but as he was going deep into small intestine, it became stiff and unpliable and darker in color - couldn't go any further - biopsies all normal.
Advice please ........More likely Crohns? UC? Lupus?
Started again recently with blood in stool.
Started on Pentasa - 1 pill 250mg 4x a day. - is this dose too low?