Ulcerative colitis in a Nigerian child: case report

Abstract

Ulcerative colitis (UC) is a chronic re-occuring inflammatory disease affecting mainly the colon. It is more prevalent in the United Kingdom, North America Scandinavia and less common in southern Europe, Asia and Africa. Commonly, UC is suspected in patients presenting with bloody diarrhoea, tenesmus, abdominal pain, and, when severe, weight loss, fatigue, and vomiting. Perhaps one child so far with UC has been reported southwest geo-political zone of Nigeria. We here report the first case of ulcerative colitis in a child in south-south Nigeria.

The objective of this report was to highlight the occurence of ulcerative colitis in a Nigerian child in the setting of poor sociopsychological/economic background coupled with difficulty in investigating patient to arrive at a diagnosis. An 11 year old Nigerian male child who was referred to the University of Calabar Teaching Hospital with bleeding per rectum, abdominal pain and swelling, bilateral leg swelling and weight loss for seven months prior to presentation. Examination and investigations done including colonoscopy, histology of biopsy, faecal calprotectin and pANCA confirmed ulcerative colitis. Ulcerative colitis though rare in Africa may have been missed in some children due to mis-conception and lack of diagnostic facilities/expertise. We may begin to see more of this with increasing interest in the subspecialty of paediatric gastroenterology and presence of diagnostic facilities.

Keyword: Ulcerative Colitis, Diagnostic difficulties, Nigerian child