Volume 88 - 2025 - Fasc.3 - Clinical images
Cat Scratch Colon
A 59-year old woman was referred for colonoscopy
with symptoms of diarrhea for two months and
unintentional weight loss of seven kilograms. The patient
had a history of Graves disease treated with radioactive
iodine therapy. She used a proton pump inhibitor (PPI) for
gastroesophageal reflux disease (GERD). Colonoscopy
revealed multiple longitudinal mucosal tears in the
ascending colon resembling cat scratch lesions. Biopsies
were taken in the ascending colon.
A rare cause of B-symptoms and polyarthritis
A 39-year-old male patient without any relevant
medical history presented with 15 kg involuntary weight
loss and night sweats for 2 months. He mentioned one
episode of evening fever, altered consistency of stools and
a dry cough that appeared since one year. Clinically there
was a cachectic man without palpable adenopathies, nor
organomegaly. The patient developed a synovitis of the
left shoulder and right knee. Furthermore, tenosynovitis
of all finger flexor tendons was seen. Blood tests revealed
a progressive hypochromic microcytic anemia with
thrombocytosis and elevated CRP 75 μg/l (normal range
<5 μg/l). The ferritin was inflammatory elevated, yet the
transferrin saturation also indicated iron deficiency. The
family doctor referred the patient to a hematologist.
A positron emission tomography and computed
tomography scan showed adenopathy retroperitoneally,
diffuse mesenteric and axillary bilateral.
Because of ongoing weight loss and cachexia despite
normal intake, the patient was admitted to the hospital
for total parenteral nutrition and endoscopic evaluation