Multiple Cerebral Infarction Associated with Cerebral Vasculitis in a Patient with Ulcerative Colitis

A 40-year-old man was admitted to the hospital due to both a worsening of symptoms associated with ulcerative colitis (UC), which had been diagnosed 3 years previously, and limb paralysis. Colonoscopy revealed severe pancolitis-type UC. He was diagnosed with cerebral vasculitis with multiple white m...

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Bibliographic Details
Published in:Internal Medicine 2021/01/01, Vol.60(1), pp.59-66
Main Authors: Yasuda, Takeshi, Takagi, Tomohisa, Hasegawa, Daisuke, Hirose, Ryohei, Inoue, Ken, Dohi, Osamu, Yoshida, Naohisa, Kamada, Kazuhiro, Uchiyama, Kazuhiko, Ishikawa, Takeshi, Konishi, Hideyuki, Naito, Yuji, Itoh, Yoshito
Format: Article
Language:English
Subjects:
Adult
Case Report
Cerebral infarction
Cerebral Infarction - diagnostic imaging
Cerebral Infarction - etiology
cerebral vasculitis
Colitis, Ulcerative - complications
Colitis, Ulcerative - diagnosis
Colitis, Ulcerative - drug therapy
Colon
Humans
Inflammatory bowel disease
Internal medicine
Magnetic resonance imaging
Male
Mesalamine
Paralysis
Prednisolone
Prednisolone - therapeutic use
Remission
Substantia alba
Ulcerative colitis
Vasculitis
Vasculitis, Central Nervous System - complications
Vasculitis, Central Nervous System - diagnosis
Vasculitis, Central Nervous System - drug therapy
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Summary:A 40-year-old man was admitted to the hospital due to both a worsening of symptoms associated with ulcerative colitis (UC), which had been diagnosed 3 years previously, and limb paralysis. Colonoscopy revealed severe pancolitis-type UC. He was diagnosed with cerebral vasculitis with multiple white matter infarctions associated with the disease activity of UC by contrast-enhanced head magnetic resonance imaging. Mesalazine at 4,000 mg/day and prednisolone at 60 mg/day were started, and the prednisolone dosage was thereafter gradually reduced and switched to golimumab. He achieved a long-term remission from UC, and thereafter his neurological abnormalities improved significantly. He had no recurrence of cerebral infarction.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.4951-20