Pleuropericarditis and Disseminated Intravascular Coagulation in Ulcerative Colitis

Abstract

We report a 30-year-old woman with pleuropericarditis, cardiac tamponade, and disseminated intravascular coagulation complicating active ulcerative colitis (UC). Other autoimmune diseases were not present. She responded to pulsed steroid therapy and anticoagulant with resolution of the complication and UC. We reviewed the literature and found 27 cases of pleuropericarditis associated with idiopathic inflammatory bowel disease (IBD). It has been reported that pleuropericarditis associated with IBD responds well to nonsteroidal antiinflammatory drugs, as well as steroids. The causes of cardiac involvement in IBD remain unclear, but the pleuropericarditis must be recognized as a potential extraintestinal manifestation of IBD.

Chronic Pericarditis and Pericardial Tamponade Associated with Ulcerative Colitis

“…Third, this case report confirms and extends eight previous cases of pericardial tamponade associated with ulcerative colitis ( [20][21][22][23][24][25][26][27]; Table 1), and one case associated with Crohn's colitis [28]. In the currently reported case pericardiectomy reversed the life-threatening cardiac tamponade from the pericarditis [29,30].…”

Severe ulcerative colitis: Prospective study of parameters determining outcome

“…This is not entirely unexpected. Disseminated intravascular coagulation is known in patients with an acute attack of UC 15,22 . Prolongation of prothrombin time and reduction of serum fibrinogen may represent an advanced stage of disseminated intravascular coagulation resulting from consumptive coagulopathy 23 .…”

“…Patients who had only a limited examination at presentation underwent a full‐length colonoscopy after remission of the acute attack. The disease was defined as extensive if the involvement extended up to or beyond the hepatic flexure 15 …”

Immunosuppressant-Responsive Idiopathic Lymphocytic Pleuritis

“…Corticosteroid-responsive pleuritis may exist in association with many conditions, including adult-onset primary hyperoxaluria, retroperitoneal fibrosis, inflammatory bowel disease, systemic lupus erythematosis, mixed connective tissue disease and sarcoidosis [3, 4, 5]. In contrast, in patients with tuberculous pleurisy, there is no convincing evidence that corticosteroids are of benefit [6].…”