Uremic Pancolitis in an Adult Patient with Newly Diagnosed, Rapidly Progressive Crescentic Immunoglobulin A Nephropathy

Abstract

Uremic gastroenteropathy is a well-accepted but less often described sequelae of an underlying renal disease. With the advent of modern dialysis treatments, rarer manifestations, such as pancolitis, may go overlooked in the evaluation, pursuing more common diagnoses. The underlying pathophysiology of uremic gastroenteropathy is not completely understood; however, several underlying mechanisms have been identified to play a role. Here, we present an exceptionally rare case of uremic pancolitis in a Hispanic male who presented with clinical, imaging, and pathological findings consistent with newly diagnosed, rapidly progressive crescentic IgA nephropathy (IgAN).

An unexpected cause of colitis

“…5 Recently, a case report described uremic pancolitis in a patient with severe kidney injury which was related to IgA nephropathy. 6 This reported case was similar to ours in that abdominal pain improved significantly following the intiation of hemodialysis.…”

“…Nevertheless, in patients treated with chronic hemodialysis, colitis, but not pseudomembranous lesions and ulcerations, were described in postmortem examination 5 . Recently, a case report described uremic pancolitis in a patient with severe kidney injury which was related to IgA nephropathy 6 . This reported case was similar to ours in that abdominal pain improved significantly following the intiation of hemodialysis.…”