Common Sign but a rare cause - Ulcerative Colitis A case report

Ulcerative Colitis (UC) is an idiopathic chronic inflammatory disorder localized to colon, especially involving rectum sparing upper GIT. Proportion of UC is 0.003 per year in South Indian Paediatric population (1). It is characterized by bloody or mucoid diarrhoea, tenesmus, urgency, crampy abdominal pain which is relieved by defecation and nocturnal bowel movements, with anorexia and loss of weight. This is a case report of 12 years old boy who presented as anaemia with congestive cardiac failure. On probing he had frequent semisolid stools with occasional frank blood for past 2 years. Multiple dark pigmentations over the tongue were noticed. On evaluation he had a blood picture of iron deficiency anemia ,stool for occult blood was positive and inflammatory markers such as CRP and ESR were raised. Colonoscopy showed multiple aphthoid ulcers suggesting inflammatory bowel disease. Biopsy confirmed the diagnosis of ulcerative colitis. Child was treated with blood transfusion initially and later on started with mesalamine (5-aminosalicylic acid) and probiotics. This case is reported because anemia, the common presenting sign was found to have an uncommon cause, Ulcerative colitis. UC is a rare disease of South Indian paediatric population as compared to the west.