SEVERE ULCERATIVE-COLITIS, DURAL SINUS THROMBOSIS, AND THE LUPUS ANTICOAGULANT

Thromboembolic disease is a well-recognized but very uncommon complica tion of inflammatory bowel disease, The mechanisms of the increased ri sk of thrombosis are not well understood: although several coagulation abnormalities have been described in inflammatory bowel disease patie nts, it is not clear whether they actually contribute to hypercoagulat ion or whether they are nonspecific markers of inflammation. Antiphosp holipid antibodies (anticardiolipin antibodies and/or lupus anticoagul ant) have recently been associated with an increased risk of thrombosi s, particularly cerebrovascular disease in young patients, We report t he case of a 33-yr-old female with severe ulcerative colitis at first attack who developed thrombosis of the superior and inferior longitudi nal dural sinuses. No risk factors for thrombosis or coagulation abnor malities were observed; however, lupus anticoagulant was detected in t he serum. The patient was successfully treated with osmotic agents, pr ophylactic anticonvulsant, and antiplatelet therapy, combined with i.v . steroids. After 6 months, the colitis is in remission, and the neuro logical recovery is good even if not yet complete.