Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

OBJECTIVE: To investigate the frequency of gut inflammation in the ankylosing spondylitis and the role of gut lesion in the pathogenesis of the ankylosing spondylitis. METHODS: Ileocolonoscopy and biopsy were performed in 24 patients with. ankylosing spondylitis. RESULTS: 1) Endoscopic lesions were observed in 7 patients(29.2%) of 24 patients and more often in the terminal ileum(6/7) than in the colon(I/7). Among 7 patients with endoscopic lesions, 5 patients were presented as juvenile chronic arthritis. 2) Histologic signs of gut inflammation were detected in 14 patients(58. 3%). Actue lesions were seen in 2 patients (8. 3%) and chronic lesions were seen in 12 patients (50%). 3) In 12 patients without the involvement of peripheral joints, acute lesion was not seen(0%), and chronic lesions were seen in 6 patients(50%). In 12 patients with the involvement of peripheral joints, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 6 patients(50%). Gut inflammations were more frequent in patients with the involvement of peripheral joints than in those without the involvement of peripheral joints. 4) In 12 patients without the administration of sulfasalazine, acute lesion was not seen(0%), and chronic lesions were seen in 7 patients(58.7%) In 12 patients with the administration of sulfasalazine, acute lesions were seen in 2 patients (16.7%), and chronic lesions were seen in 5 patients(41.6%). The frequency of gut lesions in patients without the administration of sulfasalazine was not different from that in patients with the administration. of sulfasalazine (p<0.05). CONCLUSION: Gut inflammation was frequently found in patients with ankylosing spondylitis. Chronic gut inflammation could play a role in the pathogenesis of the ankylosing spondylitis.
Arthritis, Juvenile ; Biopsy ; Humans ; Inflammation ; Joints ; Spondylitis, Ankylosing* ; Sulfasalazine

PURPOSE: To seek the role of nuclear factor kappa B (NF-kB) on the corneal epithelial cell death after ultraviolet (UV) irradiation. METHODS: Human corneal epithelial cells transfected by Simian Virus 40 were used in this study. UVB(312 nm) located at 10cm distance from bottom (0.6 mW/cm2 ) was irradiated for 10, 20, 30, and 40 seconds. To measure the cytotoxicity, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) method was used. Translocation of NF-KB was examined by immunocytochemistry with anti NF-K B p65 antibody and Electrophoretic Mobility Shift Assay (EMSA). To confirm the role of NF-KB , sulfasalazine, a specific inhibitor of NF-KB (0.5 mmole), was pretreated for 30 minutes before irradiatrion, and cytotoxicity and translocation of NF-KB was evaluated. RESULTS: UV irradiation resulted in a significant decrease in viability of cultured human corneal epithelial cells, especially after 20 second duration. When HCECs were irradiated with UVB, the translocation of N F -KB was observed in immunocytochemistry. These translocation was peaked 2 hours after UV irradiation in EMSA. In HCECs pretreated with sulfasalazine, either the cellular death or the translocation of NF-KB was blocked. CONCLUSION: UV irradiation can translocate NF-KB on the cultured human corneal epithelial cells. The cellular death after UV irradiation was blocked by sulfasalazine, a potent inhibitor of translocation of NF-KB. These findings suggest that NF-KB plays an important role in cellular death after UV irradiation.
Electrophoretic Mobility Shift Assay ; Epithelial Cells* ; Humans ; Immunohistochemistry ; NF-kappa B ; Simian virus 40 ; Sulfasalazine

Nonspecific ulcer of the small bowel is rare in children. Nonspecific ulcer of the colon or small bowel is clinically and pathologically recognized as a disease related to intestinal Behcet's disease. Differentiation of nonspecific ulcers from Behcet's ulcer by pathologic findings is often impossible and the clinical course is similar. A 13-year-old boy was admitted due to massive lower gastrointestinal bleeding with an intractable tongue ulcer. Colonoscopic findings revealed a well demarcated deep ulcer on the terminal ileum. The patient was treated with steroids and sulfasalazine and the response was favorable. We report a case of nonspecific ulcer of terminal ileum with massive rectal bleeding in a 13-year-old boy.
Adolescent ; Child ; Colon ; Hemorrhage* ; Humans ; Ileum* ; Male ; Steroids ; Sulfasalazine ; Tongue ; Ulcer*

Behcet's disease is a chronic polysymptomatic disease of recurrent systemic vasculitis. The etiology remains unclear. This disease affects several organs of the body concurrently or consecutively and sometimes has a serious outcome, depending upon the system involved. Though gastrointestinal symptoms are relatively common in Behcet's disease, ulcerative change of the intestine is infrequent. The most common sites for the intestinal Behcet's disease are terminal ileum and cecum. Only a few literatures report the esophageal ulcers in Behcet's disease. We describe 2 cases of Behcet's disease who have multiple ulcers in esophagus and terminal ileum. Esophageal ulcers have improved with low-dose prednisolone, colchicine and sulfasalazine in these patients.
Cecum ; Colchicine ; Esophagus* ; Humans ; Ileum* ; Intestines ; Prednisolone ; Sulfasalazine ; Systemic Vasculitis ; Ulcer*

A 50-year-old woman presented with a 4-day history of apathy, perseveration, and confusion. These symptoms appeared 16 days after she had started taking sulfasalazine for rheumatoid arthritis. Brain MRI showed bilateral symmetrical discoid lesions involving the corona radiata. She fully recovered 7 days after stopping the medications. Follow-up brain MRI revealed remarkable improvement of the lesions. The pathomechanisms related to sulfasalazine-induced leukoencephalopathy may be demyelinating processes due to impaired T-cell-mediated immunity.
Apathy ; Arthritis, Rheumatoid ; Brain ; Female ; Follow-Up Studies ; Humans ; Leukoencephalopathies ; Middle Aged ; Sulfasalazine

Ulcerative colitis is chronic inflammatory disease of bowel without definite cause. Standard therapy of ulcerative colitis consists of aminosalicylates and glucocorticoid. In recent years, the effectiveness of cyclosporine in inflammatory bowel disease has been reported. Cyclosporine is useful in inducing remission in patients with acute exacervation phase who do not achieve remission with an intensive intravenous steroid therapy. We report a case of steroid-resistnat ulcerative colitis, treated with cyclosporine in 45-year-old man. Remission was not achieved with treatment of sulfasalazine and intensive intravenous glucocorticoid therapy for 10 days. We administered cyclosporine parenterally in dose of 4 mg/kg/day for 10 days. He improved dramatically without significant side effects of drug and avoided colectomy. He was discharged with oral cyclosporine and azathioprine and has been followed up outpatients department remained in clinically remission. Cyclosporine seems to be an effective treatment for patients with steroid-resistnat severe ulcerative colitis in whom colectomy seems inevitable.
Azathioprine* ; Colectomy ; Colitis, Ulcerative* ; Cyclosporine* ; Humans ; Inflammatory Bowel Diseases ; Middle Aged ; Outpatients ; Sulfasalazine ; Ulcer*

Sulfasalazine produces a varied spectrum of adverse reactions on the hematopoietic system. Sulfasalazine-induced megaloblastic anemia is very rare and a few cases have been reported in patients with inflammatory bowel disease. Most of them show a low serum folate level. The pathogenesis is known as folate deficiency by intestinal folate malabsorption, inhibition of folate enzyme, or hemolysis. We experienced a 43-year old female with Behcet's disease, who presented with megaloblastic anemia having normal serum folate level after treatement of sulfasalazine (2 g/day for 3 months). Megaloblastic anemia recovered after withdrawal of the drug only.
Adult ; Anemia, Megaloblastic* ; Female ; Folic Acid* ; Hematopoietic System ; Hemolysis ; Humans ; Inflammatory Bowel Diseases ; Megaloblasts* ; Sulfasalazine

Bullous pemphigoid (BP) is an acquired autoimmune disease that's characterized by subepidermal vesicles and bullae. The etiology for BP is mostly idiopathic, but numerous observations have suggested the role of certain drugs in the occurrence of bullous pemphigoid. Drugs such as penicillamine, furosemide, captopril, enalapril, sulfasalazine and ampicilline have been reported to be associated with bullous pemphigoid. We report here on a new case of bullous pemphigoid that was probably induced by ticlopidine (thienopyridine, adenosine diphosphate receptor inhibitor) in a 78 year old female patient.
Adenosine Diphosphate ; Ampicillin ; Autoimmune Diseases ; Blister ; Captopril ; Enalapril ; Female ; Furosemide ; Humans ; Pemphigoid, Bullous ; Penicillamine ; Sulfasalazine ; Ticlopidine

A 38-year-old man, with recurrent oral ulcers for 10 years, was admitted because of recent aggravation of odynophagia and sore throat. About 4 years earlier, he had been performed abdominal surgery for intestinal perforation. Gastrofiberscopic examination showed small round ulcers at hypiopharynx and 6cm sized longitudinal linear ulcer at mid esophagus. Biopsy specimens at mid-esophagus showed chronic inflammation. Besides oral ulcer, he had perianal ulcers and skin rashes. He was managed with steroid, colchicine and sulfasalazine under the diagnosis of esophageal involvement in Behcet's disease. After 3 months from discharge, esophagogram and gastrofiberscopic examination showed some improved appearance, but symptoms recurred for steroid tapering. He has been followed in much improved status for 8 months after discharge.
Adult ; Biopsy ; Colchicine ; Diagnosis ; Esophagus ; Exanthema ; Humans ; Inflammation ; Intestinal Perforation ; Oral Ulcer ; Pharyngitis ; Sulfasalazine ; Ulcer*