Skip to main content
PMC home page
Gut logoLink to Gut
. 1994 Aug;35(8):1141–1144. doi: 10.1136/gut.35.8.1141

'Conversion' from ulcerative colitis to Crohn's disease associated with corticosteroid treatment.

A D Dwarakanath 1, J Nash 1, J M Rhodes 1
PMCID: PMC1375072  PMID: 7926921

Abstract

A man who was a non-smoker presented with clinical, histological, and radiological features typical of distal ulcerative colitis. Prolonged treatment with corticosteroids was associated with the development of numerous granulomata, stricturing, and perianal disease. It is speculated that the immunosuppression associated with the corticosteroid treatment may have induced a change from ulcerative colitis to Crohn's disease of the colon. This case report lends support to the hypothesis that these conditions may just represent different forms of a continuum of inflammatory bowel disease.

Full text

PDF
1141

Images in this article

1141Figure 1
on p.1141
1142Figure 2
on p.1142
1142Figure 4
on p.1142

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baltch A. L., Hammer M. C., Smith R. P., Bishop M. B., Sutphen N. T., Egy M. A., Michelsen P. B. Comparison of the effect of three adrenal corticosteroids on human granulocyte function against Pseudomonas aeruginosa. J Trauma. 1986 Jun;26(6):525–533. doi: 10.1097/00005373-198606000-00006. [DOI] [PubMed] [Google Scholar]
  2. Capsoni F., Meroni P. L., Zocchi M. R., Plebani A. M., Vezio M. Effect of corticosteroids on neutrophil function: inhibition of antibody-dependent cell mediated cytotoxicity (ADCC). J Immunopharmacol. 1983;5(3):217–230. doi: 10.3109/08923978309039107. [DOI] [PubMed] [Google Scholar]
  3. D'Amelio R., Pallone F., Le Moli S., Pontesilli O., Ricci R., Montano S., Rossi P. Humoral inhibition of neutrophil chemotaxis in Crohn's disease. Scand J Immunol. 1985 Dec;22(6):597–602. doi: 10.1111/j.1365-3083.1985.tb01921.x. [DOI] [PubMed] [Google Scholar]
  4. Davies J., Sheppard K., Fletcher J. Inhibition of human neutrophil secondary granule discharge by antiinflammatory agents. Inflammation. 1984 Dec;8(4):343–351. doi: 10.1007/BF00918211. [DOI] [PubMed] [Google Scholar]
  5. Elmgreen J. Subnormal activation of phagocytes by complement in chronic inflammatory bowel disease? Neutrophil chemotaxis to complement split product C5a. Gut. 1984 Jul;25(7):737–742. doi: 10.1136/gut.25.7.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. GONZALEZ ANGULO A., CORRAL E., GARCIA TORRES R., QUIJANO M. MALAKOPLAKIA OF THE COLON. Gastroenterology. 1965 Mar;48:383–387. [PubMed] [Google Scholar]
  7. Kirk A. P., Cason J., Fordham J. N., Brown K. A., Goddard D. H., Holborow E. J., Lennard-Jones J. E. Polymorphonuclear leukocyte function in ulcerative colitis and Crohn's disease. Dig Dis Sci. 1983 Mar;28(3):236–248. doi: 10.1007/BF01295119. [DOI] [PubMed] [Google Scholar]
  8. LENNARD-JONES J. E., MISIEWICZ J. J., CONNELL A. M., BARON J. H., JONES F. A. PREDNISONE AS MAINTENANCE TREATMENT FOR ULCERATIVE COLITIS IN REMISSION. Lancet. 1965 Jan 23;1(7378):188–189. doi: 10.1016/s0140-6736(65)90973-6. [DOI] [PubMed] [Google Scholar]
  9. Lee K. S., Medline A., Shockey S. Indeterminate colitis in the spectrum of inflammatory bowel disease. Arch Pathol Lab Med. 1979 Apr;103(4):173–176. [PubMed] [Google Scholar]
  10. Logan R. F., Edmond M., Somerville K. W., Langman M. J. Smoking and ulcerative colitis. Br Med J (Clin Res Ed) 1984 Mar 10;288(6419):751–753. doi: 10.1136/bmj.288.6419.751. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Monsén U., Broström O., Nordenvall B., Sörstad J., Hellers G. Prevalence of inflammatory bowel disease among relatives of patients with ulcerative colitis. Scand J Gastroenterol. 1987 Mar;22(2):214–218. doi: 10.3109/00365528708991882. [DOI] [PubMed] [Google Scholar]
  12. Nambuya A., Sewankambo N., Mugerwa J., Goodgame R., Lucas S. Tuberculous lymphadenitis associated with human immunodeficiency virus (HIV) in Uganda. J Clin Pathol. 1988 Jan;41(1):93–96. doi: 10.1136/jcp.41.1.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. O'BRIEN J. R. Non-reactive tuberculosis. J Clin Pathol. 1954 Aug;7(3):216–225. doi: 10.1136/jcp.7.3.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Price A. B. Overlap in the spectrum of non-specific inflammatory bowel disease--'colitis indeterminate'. J Clin Pathol. 1978 Jun;31(6):567–577. doi: 10.1136/jcp.31.6.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Purrmann J., Bertrams J., Borchard F., Miller B., Cleveland S., Stolze T., Strohmeyer G. Monozygotic triplets with Crohn's disease of the colon. Gastroenterology. 1986 Dec;91(6):1553–1559. doi: 10.1016/0016-5085(86)90215-5. [DOI] [PubMed] [Google Scholar]
  16. Raouf A. H., Hildrey V., Daniel J., Walker R. J., Krasner N., Elias E., Rhodes J. M. Enteral feeding as sole treatment for Crohn's disease: controlled trial of whole protein v amino acid based feed and a case study of dietary challenge. Gut. 1991 Jun;32(6):702–707. doi: 10.1136/gut.32.6.702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Rhodes J. M., Bartholomew T. C., Jewell D. P. Inhibition of leucocyte motility by drugs used in ulcerative colitis. Gut. 1981 Aug;22(8):642–647. doi: 10.1136/gut.22.8.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Rhodes J. M., Potter B. J., Brown D. J., Jewell D. P. Serum inhibitors of leukocyte chemotaxis in Crohn's disease and ulcerative colitis. Gastroenterology. 1982 Jun;82(6):1327–1334. [PubMed] [Google Scholar]
  19. Ryder S. D., Walker R. J., Jones H., Rhodes J. M. Rectal bismuth subsalicylate as therapy for ulcerative colitis. Aliment Pharmacol Ther. 1990 Aug;4(4):333–338. doi: 10.1111/j.1365-2036.1990.tb00480.x. [DOI] [PubMed] [Google Scholar]
  20. Schachter H., Goldstein M. J., Rappaport H., Fennessy J. J., Kirsner J. B. Ulcerative and "granulomatous" colitis--validity of differential diagnostic criteria. A study of 100 patients treated by total colectomy. Ann Intern Med. 1970 Jun;72(6):841–851. doi: 10.7326/0003-4819-72-6-841. [DOI] [PubMed] [Google Scholar]
  21. TRUELOVE S. C., WITTS L. J. Cortisone and corticotrophin in ulcerative colitis. Br Med J. 1959 Feb 14;1(5119):387–394. doi: 10.1136/bmj.1.5119.387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Verspaget H. W., Elmgreen J., Weterman I. T., Peña A. S., Riis P., Lamers C. B. Impaired activation of the neutrophil oxidative metabolism in chronic inflammatory bowel disease. Scand J Gastroenterol. 1986 Nov;21(9):1124–1130. doi: 10.3109/00365528608996432. [DOI] [PubMed] [Google Scholar]
  23. Verspaget H. W., Mieremet-Ooms M. A., Weterman I. T., Peña A. S. Partial defect of neutrophil oxidative metabolism in Crohn's disease. Gut. 1984 Aug;25(8):849–853. doi: 10.1136/gut.25.8.849. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Verspaget H. W., Peña A. S., Weterman I. T., Lamers C. B. Diminished neutrophil function in Crohn's disease and ulcerative colitis identified by decreased oxidative metabolism and low superoxide dismutase content. Gut. 1988 Feb;29(2):223–228. doi: 10.1136/gut.29.2.223. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES