JPGN Reports · 4 authors, 2 centres
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A case report describes a previously healthy 16-year-old female who developed new-onset ulcerative colitis and antiphospholipid antibody syndrome with venous thromboembolism and hemorrhagic stroke following childbirth. Treatment with immunosuppressive therapy achieved clinical remission of IBD after 7 months.
A 16-year-old previously healthy female presented 8 days postpartum with right-sided weakness and speech inability, diagnosed as left cerebral vein thrombosis causing hemorrhagic stroke with subsequent DIC. Antiphospholipid antibody syndrome was confirmed by positive lupus anticoagulant on repeated testing. Two weeks later she developed voluminous bloody diarrhea; colonoscopy with histopathology showed diffuse active chronic pancolitis consistent with new-onset ulcerative colitis. Abdominal CT angiography excluded mesenteric ischemia. She was treated with intravenous methylprednisolone, then transitioned to adalimumab and methotrexate. After 7 months, follow-up colonoscopy showed mildly active pancolitis improved from prior, and she achieved clinical remission. This case highlights that pregnancy may precipitate both IBD and APLS in previously asymptomatic individuals, and underscores elevated VTE risk in pregnant patients with IBD. Limitations include single-patient design, absence of pre-pregnancy serological data, and no small bowel enterography performed.
