Ulcerative Colitis as the Rarer Phenotype of Inflammatory Bowel Disease to Coexist with Psoriatic Arthritis: A Case Report

Authors

  • Eka Benhardi Layadi Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. http://orcid.org/0000-0001-5120-5848
  • Rabbinu Rangga Pribadi Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Ening Krisnuhoni Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Emiliana Kartika Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Friska Wilda Wijaya Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Oemar Ichsan Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Keywords:

inflammatory bowel disease, ulcerative colitis, psoriasis, psoriatic arthritis

Abstract

Psoriatic arthritis (PsA) has been linked to various diseases associated with immune dysregulation, such as Inflammatory Bowel Disease (IBD). Numerous studies have shown strong correlation between PsA and one of the phenotypes of IBD, Crohn’s disease. On the other hand, the studies regarding the association of PsA with ulcerative colitis (UC) are less robust and have conflicting findings. We herein report a case of 56-year-old woman with a history of psoriatic arthritis, who developed chronic diarrhea and significant weight loss. The colonoscopy and histopathologic findings were suggestive of pancolitis with backwash ileitis, from which the working diagnosis of ulcerative colitis was carried out. The patient fit the typical epidemiological profile of a PsA patient with concomitant UC, but some aspects of the clinical features observed in this case, such as the development of anterior uveitis was rarely documented in similar studies. A conducted bidirectional meta-analysis also showed that there were more cases where UC preceded the diagnosis of psoriasis, which makes the late development of UC in this case atypical. Due to the uncommon nature of the concurrent development of these two disease entities in this case, this study could provide additional insights to the association of PsA and UC.

Author Biographies

Eka Benhardi Layadi, Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

Rabbinu Rangga Pribadi, Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

Ening Krisnuhoni, Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Department of Anatomical Pathology, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

Emiliana Kartika, Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

Friska Wilda Wijaya, Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

Oemar Ichsan, Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia

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Published

2023-01-10

How to Cite

Layadi, E. B., Pribadi, R. R., Krisnuhoni, E., Kartika, E., Wijaya, F. W., & Ichsan, O. (2023). Ulcerative Colitis as the Rarer Phenotype of Inflammatory Bowel Disease to Coexist with Psoriatic Arthritis: A Case Report. Acta Medica Indonesiana, 54(4), 614. Retrieved from https://actamedindones.org/index.php/ijim/article/view/1755