Case Report
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2010; 16(19): 2440-2442
Published online May 21, 2010. doi: 10.3748/wjg.v16.i19.2440
Acute respiratory distress syndrome associated with severe ulcerative colitis
Shiho Sagara, Yasuo Horie, Yumiko Anezaki, Hideaki Miyazawa, Masahiro Iizuka
Shiho Sagara, Masahiro Iizuka, Health Care Center, Akita Red Cross Hospital, Akita 010-0001, Japan
Shiho Sagara, Yasuo Horie, Yumiko Anezaki, Masahiro Iizuka, Department of Internal Medicine, Akita University School of Medicine, Akita 010-8543, Japan
Hideaki Miyazawa, Department of Surgery, Akita University School of Medicine, Akita 010-8543, Japan
Author contributions: Sagara S, Horie Y, Anazaki Y and Iizuka M performed medical treatment of the case and designed the case report; Miyazawa H performed surgical treatment of the patient and designed the case report; Iizuka M and Sagara S wrote the paper.
Supported by (in part) Health and Labour Sciences Research Grants for Research on Intractable Diseases from Ministry of Health, Labour and Welfare of Japan
Correspondence to: Masahiro Iizuka, MD, PhD, Health Care Center, Akita Red Cross Hospital, 3-4-23 Nakadori, Akita 010-0001, Japan. maiizuka@woody.ocn.ne.jp
Telephone: +81-18-8321601 Fax: +81-18-8321603
Received: January 15, 2010
Revised: February 23, 2010
Accepted: March 2, 2010
Published online: May 21, 2010
Abstract

Various extraintestinal manifestations including pulmonary abnormalities have been reported in patients with ulcerative colitis. Acute respiratory distress syndrome (ARDS) is a serious and fatal pulmonary manifestation. We have experienced a 67-year-old male patient with ARDS associated with a severe type of ulcerative colitis (UC). Severe dyspnea symptoms occurred during the treatment of UC in a previous hospital and the patient was transferred to our hospital on June 27, 2007. Both blood and sputa cultures for bacteria and fungi were negative. Cytomegalovirus antigenemia was also not detected. From the clinical and radiological [Chest X-ray, computed tomography (CT)] findings, the patient was diagnosed with ARDS on the basis of the definition of ARDS developed by the European-American Consensus Conference on ARDS. Both colonic inflammations and ARDS symptoms of the patient were resistant to any medical treatment including corticosteroids and antibiotics. However, ARDS symptoms were dramatically improved after surgical colectomy. We believe that severe colonic inflammation from UC was closely associated with the onset of ARDS of the patient. Our case report suggests that a severe type of ulcerative colitis might be taken into consideration as one of the predisposing factors of ARDS.

Keywords: Acute respiratory distress syndrome; Ulcerative colitis; Inflammatory bowel disease; Extraintestinal manifestation