Keywords
Case report; Sweet syndrome; Bleeding gastrointestinal tract; Iron deficiency anemia; Intestinal ulcers.
Abstract
Background: We report a rare case of a 50 year old Chinese female with cutaneous Sweet Syndrome (SS) presenting with iron deficiency anaemia who was subsequently found to have small bowel ulcers with a dense neutrophilic infiltrate on histology, with no evidence of Inflammatory Bowel Disease (IBD).
Case presentation: The 50 year old lady underwent an extensive workup including enteroscopy, blood investigations and exclusion of pertinent differentials, she was diagnosed with gut SS. After trying and failing various treatment modalities, she was successfully treated with a combination of subcutaneous adalimumab and oral Methotrexate (MTX). Gut SS is an extremely rare disease with only 2 published cases thus far and both were treated with mainly steroids. To our knowledge, this is the first reported case of this treatment combination of an anti TNF agent and MTX for recalcitrant gut and cutaneous SS.
Conclusion: A diagnosis of gut SS should be considered in the presence of gastrointestinal pathology such as ulcers, especially if histological features of inflammatory bowel disease are absent. In recalcitrant cases anti-TNF (tumor necrosis factor) agents may be an alternative treatment option.
Citation
Kaliyaperumal K, Ling HY, Au RTM, Chau CYP, Lim WC, et al. (2024) Reimagining Old Party Tricks: A Previously Unreported Successful Combination Treatment Regime for a Rare Case of Recalcitrant Gut and Cutaneous Sweet Syndrome. SM J Gastroenterol Hepatol 6: 5.