Chronic Ulcerative Colitis with Systemic Lupus Erythematosus
CHARLES H. BROWN, M.D.
Department of Gastroenterology
JOHN R. HASERICK, M.D.
Department of Dermatology
EARL K. SHIREY, M.D.
THE occurrence of both chronic ulcerative colitis and systemic lupus erythematosus in the same patient has not to our knowledge been previously reported in the literature. At about the time we saw a patient in Cleveland with both diseases, Boone and McKee1 in Toronto reported to us that they had observed and treated a similar case.
There is some evidence that chronic ulcerative colitis may be one of the collagen diseases, similar to lupus erythematosus. Levine, Kirsner, and Klotz2 noted an absence of the homogeneous ground-glass substance of the basement membrane of the epithelial cells of the rectal mucosa in patients with chronic ulcerative colitis. They report: “The epithelial cells of the mucosa were morphologically intact . . ., but in many areas the mucosa had separated from the underlying connective tissue. In the intervening space a homogeneous, Hotch-kiss-positive, metachromatic material was observed. Such areas were often free of inflammatory response.” This metachromatic material was not present in a patient with active amebiasis and active inflammation or in a patient with lymphopathia venereum and active colitis. Finally, they found that biopsies in patients with ulcerative colitis who had received ACTH therapy showed areas in which the ground-glass substance of the basement membrane had returned. Warren and Sommers3 have described a vasculitis resembling periarteritis nodosa or thromboangiitis obliterans in some patients with chronic ulcerative colitis. These two studies2,3 suggest that chronic ulcerative colitis may be a systemetic, connective tissue or collagen disease similar to systemic lupus erythematosus, rather than a. . .