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

Intern Med. 2021 Jan 1;60(1):59-66. doi: 10.2169/internalmedicine.4951-20. Epub 2020 Aug 22.

Abstract

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.

Keywords: cerebral infarction; cerebral vasculitis; ulcerative colitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / etiology
  • Colitis, Ulcerative* / complications
  • Colitis, Ulcerative* / diagnosis
  • Colitis, Ulcerative* / drug therapy
  • Humans
  • Male
  • Mesalamine
  • Prednisolone / therapeutic use
  • Vasculitis, Central Nervous System* / complications
  • Vasculitis, Central Nervous System* / diagnosis
  • Vasculitis, Central Nervous System* / drug therapy

Substances

  • Mesalamine
  • Prednisolone