The Demographic and Clinical Characteristics of Ulcerative Colitis in a Northeast Brazilian Population

Introduction. The purpose of this study was to describe the clinical and demographic characteristics of UC in Bahia, a Brazilian state, and to identify the variables associated with extensive colitis, steroid therapy, immunosuppression, and colectomy. Methods. In this cross-sectional study UC patients were interviewed, and additional information was collected from the medical records. Descriptive statistics and multivariate Poisson regression analysis were used. Results. This study included 267 individuals, the mean age of whom was 39.4 years at diagnosis. There was a predominance of females and left-side colitis. Extensive colitis was positively associated with male gender, diarrhea, weight loss, and a younger age at diagnosis. In contrast, active smoking and a family history of IBD were negatively associated with extensive colitis. Positive associations were observed between steroid therapy and diarrhea, weight loss, urban patients, extraintestinal manifestations (EIMs), and hospitalization. Younger age and weight loss at diagnosis, a family history of IBD, extensive colitis, EIMs, hospitalization, and steroid therapy were all positively associated with immunosuppression. In contrast, Caucasian individuals, smokers, patients with rectal bleeding, and rural patients areas were all observed to have a decreased likelihood of immunosuppression. Conclusions. Our results corroborate the association between higher prevalence of extensive colitis and younger age at diagnosis. An association between steroid therapy and clinical presentation at diagnosis was observed. The observation that white individuals and rural patients use less immunosuppressive drugs highlights the need to study the influence of environmental and genetic factors on the behavior of UC in this population

Mediastinal Tuberculosis Lymphadenitis during Anti-TNF Therapy - Case Report

Tuberculosis is described during the use of monoclonal antibodies against tumour necrosis factor (TNF) for Crohn’s disease treatment. We report a case of a 44 year old man that developed fever, night sweats and weight loss during immunosuppressive and anti-TNF therapy for Crohn’s disease. After extensive investigation we performed mediastinoscopy with biopsy of the paratracheal lymph node. A istopathological study revealed caseous necrosis. The patient improved after therapy against tuberculosis. During anti-TNF therapy, the diagnosis of tuberculosis may be mainly difficult when an atypical location is present. Clinical skills are important mainly in countries where tuberculosis is endemic.</p