case_images: PMC3662170_01
case_images: Acute colitis in the ascending and transverse colon.
case_images: CRIM.HEMATOLOGY2013-592930.001.jpg
case_images: PMC3662170_01_CRIM.HEMATOLOGY2013-592930.001.jpg
case_images: fig1
case_images: CT scan demonstrated acute colitis in the ascending and partial transverse colon (Figure 1).
case_images: Mucosal edema with friability and ulceration on colonoscopy.
case_images: CRIM.HEMATOLOGY2013-592930.002.jpg
case_images: PMC3662170_01_CRIM.HEMATOLOGY2013-592930.002.jpg
case_images: fig2
case_images: The patient underwent a colonoscopy on hospital day 2 which revealed multiple diverticuli, evidence of mucosal edema with friability and ulceration from the transverse colon to sigmoid colon (Figure 2).
case_images: Colonic biopsy at medium magnification (100x, H&E stain) showing features characteristic of ischemic injury, including crypt atrophy, loss of cytoplasmic mucin, nuclear hyperchromasia, and absence or shedding of the luminal surface epithelium.
case_images: CRIM.HEMATOLOGY2013-592930.003.jpg
case_images: PMC3662170_01_CRIM.HEMATOLOGY2013-592930.003.jpg
case_images: fig3
case_images: Her colonic biopsies came back and were consistent with ischemic colitis (Figure 3).
case_images: Peripheral blood (Wright Stain, 1000x) showing schistocytes, characteristic of microangiopathic hemolytic anemia.
case_images: CRIM.HEMATOLOGY2013-592930.004.jpg
case_images: PMC3662170_01_CRIM.HEMATOLOGY2013-592930.004.jpg
case_images: fig4
case_images: Schistocytes were observed on the peripheral smear and bone marrow biopsy. (Figure 4) Her omeprazole was discontinued, steroids were started, and the patient underwent therapeutic plasmapheresis with plasma exchange.