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Editor’s quiz: GI snapshot
Hepatomegaly and ascites in a patient with UC
  1. Jintong Chen1,2,
  2. Ye Xu1,2,
  3. Yanjun Lin1,2,
  4. Chengdang Wang1,3
  1. 1Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
  2. 2Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, China
  3. 3Department of Gastroenterology, National Regional Medical Center, Fujian Medical University, Fuzhou, China
  1. Correspondence to Dr Chengdang Wang, Department of Gastroenterology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China; wangcdhl{at}fjmu.edu.cn

https://doi.org/10.1136/gutjnl-2024-333587

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    A 29-year-old Chinese man with a 6-year history of UC (Montreal classification E3) had achieved symptom remission 4 years ago after 1 year of treatment with infliximab (5 mg/kg at 0, 2 and 6 weeks, followed by every 8 weeks) combined with azathioprine (50 mg/day). He then self-switched to mesalazine (4 g/day). He returned to our hospital with severe bloody diarrhoea (over 20 bowel movements/day) for 1 week. On admission, he had a mild fever (37.8°C), tachycardia (120 bpm), pallor and pitting oedema in both lower extremities. Laboratory analysis revealed anaemia (7.5 g/dL), hypoalbuminaemia (2.8 g/dL), thrombocytosis (638 k/mm3), leucocytosis (23.71 k/mm3), elevated C reactive protein (112.3 mg/L), elevated erythrocyte sedimentation rate (55 mm/h) and mildly elevated GGT (80 U/L). Viral markers for HIV, HBV and HCV were negative. A colonoscopy revealed severe pancolitis with deep ulcers (figure 1A). Given the consideration of acute …

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    Footnotes

    • Contributors JC: conception and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content; YX: collection of data, critical revisions of the manuscript; YL: collection of data, critical revisions of the manuscript; CW: conception and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content. CW is the guarantor.

    • Funding This work was supported by the Natural Science Foundation of Fujian Province (No 2023Y9057 and 2022J01231).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.