ELEVATED SERUM-LIPOPROTEIN (A) LEVELS ASSOCIATED WITH ULCERATIVE-COLITIS IN A YOUNG JAPANESE PATIENT

Thromboembolism has been shown to play a role in the pathogenesis of i nflammatory bowel disease (IBD), A possibility exists that lipoprotein (a) [Lp(a)], a newly-discovered prothrombotic factor, also participat es in the development of at least some cases of IBD, Marked elevation of serum Lp(a) levels was observed in a young patient with ulcerative colitis, A biopsy specimen of the rectal mucosa showed findings compat ible with ulcerative colitis, as well as small vessel thrombus occurri ng within the muscularis mucosa in the rectum. Serum Lp(a) levels were markedly elevated on admission (71 mg/dl), with a gradual decrease to 46 mg/dl on discharge, Moreover, serum Lp(a) levels decreased in para llel with clinical improvement, In the quiescent clinical stage, no sm all vessel thrombus was observed in the mucosa on follow-up colonoscop y. The association between IBD and hyper-Lp(a)-emia would be presumabl e but it has been, to our knowledge, previously unreported, The case r eported here would be the first young patient, suggesting the presence of hyper-Lp(a)-emia and small vessel thrombus formation occurring in association with the development of ulcerative colitis.