Sweet’s Syndrome – An Extraintestinal Manifestation in Inflammatory Bowel Disease

Abstract

Background/Aims: Sweet’s syndrome (SS) is a severe dermatosis that may be an extraintestinal manifestation of inflammatory bowel disease (IBD). Worldwide, 35 cases of SS associated with IBD have been reported. We present the first case of severe, recurrent SS in combination with amebic infection and ulcerative colitis complicated with multiple other extraintestinal manifestations. Methods: Disease course was monitored by serum YKL-40 and C-reactive protein (CRP), white blood cell count, albumin and the Simple Clinical Colitis Activity Index (SSCAI). The amebic infection was diagnosed by direct microscopy of wet mount scrapings sampled by repetitive sigmoidoscopies. Results: The patient was diagnosed with left-sided ulcerative colitis and SS combined with extraintestinal manifestations: arthropathies, iridocyclitis and erythema nodosum. Cysts of Entamoeba histolytica were detected in the stools in two separate periods of time. Serum YKL-40 increased prior to CRP and correlated with disease activity, SCCAI, CRP, white blood cell count and inversely with serum albumin. Conclusion: This case gives further support for SS being an extraintestinal manifestation of ulcerative colitis. YKL-40 may be useful in monitoring the disease course of IBD.

Severe Sweet's Syndrome with Elevated Cutaneous Interleukin-1β after Azathioprine Exposure: Case Report and Review of the Literature

“…The association of SS with Crohn's disease is less common, with fewer than 40 cases described in the literature. SS associated with IBD tends to be more common in women (87%) and is usually associated with active disease [47]. The presence of extraintestinal symptoms, such as joint symptoms and other skin manifestations, is frequent in patients with IBD-associated SS [48].…”

A Case of Neutrophilic Myositis

“…The clinical features described above are also commonly seen in AFND, also known as Sweet syndrome, which is characterized by skin infiltration with neutrophils. Sweet syndrome is frequently associated with inflammatory bowel disease [9], AML [10], and the use of granulocyte colony stimulating factor [11], the association of which has also been reported in NM. Sweet syndrome also shows dramatic responses to glucocorticoids [12].…”

Hauterscheinungen bei chronisch entzündlichen Darmerkrankungen

“…Abb. 3 [21]). Klinisch imponieren bis walnussgroße, entzünd-lich gerötete, oft pseudovesikulöse/-bullöse Knoten, die solitär oder multipel, v. a. disseminiert am Stamm (.…”