Lymphogranuloma venereum masquerading as Inflammatory Bowel Disease in 12 homosexual men

Suneeta Soni (1) , Rajaventhan Srirajaskanthan (2) , Sebastian Lucas (3) , Sarah Alexander (4) , Terry Wong (5) , John A White (1)

1 Department of Genitourinary medicine
2 Centre of Gastroenterology
3 Department of Histopathology
4 HPA
5 Department of Gastroenterology

Background: Lymphogranuloma venereum(LGV) is a recognised cause of proctitis. Symptoms, endoscopy and histology findings are similar in IBD and LGV proctitis. Aims: To characterise the clinical, endoscopic and histological features seen in men diagnosed initially with IBD and subsequently with LGV proctitis. To attempt isolation of Chlamydia trachomatis DNA from the stored rectal biopsy specimens of these patients using real-time PCR. Methods: Clinical data were collated from confirmed or suspected cases of LGV proctitis where endoscopy and biopsy had been performed as part of the investigation of clinical symptoms. LGV was confirmed by the detection of LGV-specific DNA from rectal swab specimens, with supportive evidence from Chlamydial serology. Stored histological specimens from rectal biopsies were analysed retrospectively for LGV-specific DNA with molecular techniques. Results: Rectal biopsies had been obtained from twelve cases of LGV proctitis. Mucosal ulceration, cryptitis, crypt abscesses and granulomas were common histological findings. Extraction of LGV-specific DNA from rectal biopsy specimens enabled confirmation of three suspected cases. Conclusions: During the recent LGV proctitis epidemic among UK men who have sex with men, it has become apparent that this infection may closely resemble IBD. Gastroenterologists should remain alert to LGV as a cause of proctitis in this group.

Mots clés: Medicine

Suneeta Soni, Rajaventhan Srirajaskanthan, Sebastian Lucas, Sarah Alexander, Terry Wong, et al.. Lymphogranuloma venereum masquerading as Inflammatory Bowel Disease in 12 homosexual men. Alimentary Pharmacology and Therapeutics, 2010, ⟨10.1111/j.1365-2036.2010.04313.x⟩. ⟨hal-00552553⟩