Internal Medicine

0521779407-21 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:59

Ulcerative Colitis Unstable Hemoglobins 1481

complications and prognosis

■Extra-intestinal manifestations:

■Colitis-related: correlates with inflammatory activity of the bowel

➣arthritis:

peripheral

central – follows an independent course

associated with HLA haplotype B27

sacro-iliitis

ankylosing spondylitis

➣skin:

erythema nodosum

pyoderma gangrenosum

➣eye:

episcleritis

uveitis – may follow an independent course

often clusters with AS and SI

often associated with HLA-B27

■Not related to activity of colitis:

➣Hepatobiliary complications:

fatty infiltration

pericholangitis

chronic active hepatitis

cirrhosis

primary sclerosing cholangitis

cholangiocarcinoma

UNSTABLE HEMOGLOBINS

AKIKO SHIMAMURA, MD, PhD

history & physical

■Family history of anemia, jaundice, splenomegaly, gallstones (usu-

ally autosomal dominant inheritance)

■Pallor, jaundice, dark urine, often precipitated by infection or oxidant

drugs

Signs & Symptoms

■Pallor

■Jaundice

■Splenomegaly

■Cardiac flow murmur if anemic