ABSTRACT
Ulcerative colitis is a chronic inflammatory disease of unknown etiology. It is localized to the colon and spares the upper gastrointestinal tract. Ulcerative colitis can occur at any age, the peak incidence is among the age group 15-25 years and in 55-65 years. The first pediatric case was reported by Helmholz. The purpose of reporting this case of 17 year old girl with ulcerative colitis who presented with severe anemia is, to not only create awareness of ulcerative colitis among pediatric age group but also to discuss the challenges facing the diagnosis and management of the disease in a developing country like India.
ABSTRACT
D-pencillamine and zinc remains the first line of treatment for Wilson’s disease in India. Membranous glomerulopathy is most commonly associated with nephrotic syndrome secondary to d penicillamine but isolated cases of minimal change lesions are rarely reported. We report a pediatric patient with Wilson’s disease who developed nephrotic syndrome 9 months after starting D-pencillamine. After stopping D-pencillamine and with only zinc for maintanence, her proteinuria resolved within a week’s time with full dose of steroids for nephrotic syndrome.Wilson disease itself may have tubular dysfunction but glomerulopathy is rare Isolated minimal change disease can occur in a 11 – year old patient yet it is statistically more likely to occur in a much younger age group.The most likely cause of nephrotic syndrome in this child is due to the late complication of D-penicillamine. It also re – emphasizes the importance of early monitoring for proteinuria and the need to shift to an alternative agent if side effects develop.