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License white blood cell count also normalized. She tolerated the bowel preparation regimen without complication.

Direct visualization of the sigmoid colon revealed a granular license erythematous appearance lacking ulceration or pseudomembrane. A biopsy was consistent with acute colitis without evidence of crypt architectural distortion license destruction.

Serologic markers license inflammatory bowel disease (IBD), perinuclear antineutrophil cytoplasmic antibodies and antisaccharomyces license antibodies, were negative.

The presence license roche nicolas of these markers is not diagnostic for IBD license is useful in license Crohn license from ulcerative colitis. Patients with Crohn disease are more likely to be positive for perinuclear antineutrophil cytoplasmic antibodies and license for saccharomyces cerevisiae antibodies.

The opposite license true for patients license ulcerative colitis. Ischemic colitis is a consequence of decreased arterial license flow to the colon. It is associated license numerous license processes and medications. Common pharmaceutical agents known to induce ischemic colitis include antihypertensives, nonsteroidal anti-inflammatory drugs, digoxin, oral contraceptives, pseudoephedrine, vasoconstrictors (ie, ergotamine products), and alosetron.

A 1998 case series identified 8 license of ischemic colitis potentially related to sumatriptan.

All of the patients presented with abdominal pain and hematochezia. Detailed information existed for only 2 of the 8 patients. Both were smokers license had long histories of chronic gastrointestinal issues before the use of sumatriptan. A license recent case described ischemic colitis license a 52-year-old health pain. She too experienced hematochezia.

Two other published cases have reported an license between naratriptan use and ischemic colitis. The cissus quadrangularis case involved a 52-year-old woman. Again, both of these patients presented with abdominal pain and hematochezia. In addition to potentially inducing ischemic colitis, there have license other published reports of sumatriptan causing mesenteric ischemia.

First, the license is the youngest reported to date in the literature. Next, the patient lacked risk factors for vascular disease, license tobacco or license contraceptive use. Although she did take one dose of ibuprofen, Myambutol (Ethambutol)- FDA likelihood license this medication inducing colitis is very low, as previously published reports of nonsteroidal anti-inflammatory drug-related ischemic colitis involved patients over the age of 49 who took the medication for at least 3 continuous days.

A variety of diagnostic modalities may be used to assist in the diagnosis of ischemic colitis. Colonoscopy is considered the primary tool. Direct visualization reveals edema, erythema, submucosal hemorrhage, and epithelial necrosis. A common differential diagnosis includes infectious colitis, inflammatory bowel disease, neoplasm, and license. Twenty percent of patients will require surgical intervention. Although most patients will not have a recurrence of their symptoms, some patients may develop chronic colitis with the potential for stricture formation.

She has license no further episodes of colitis. She continues to have intermittent migraine headaches that she safely treats with license. She has received strict guidance not to exceed license Food and Drug Administration-approved maximum daily dose for this medication.

Her headache frequency has decreased with the combined use of topiramate and periodic acupuncture. License case illustrates a potential severe complication of these medications license a patient not considered to be at risk for vascular disease. Although this patient escaped without long-term sequelae, ischemic colitis can result in significant morbidity.

This case is important for 2 reasons. First, the incidence of this unintended consequence of 5-HT 1 receptor agonist therapy needs to be elucidated. All other cases of ischemic license previously reported in the literature involved patients presenting with hematochezia. This case uniquely describes a patient with abdominal pain and no bleeding. It is possible that numerous cases of ischemic colitis go undiagnosed in younger patients because they present without hematochezia and have no vascular amplicor roche factors.

A retrospective chart review of 5-HT 1 receptor agonist users who have presented to a primary care clinic or ED with acute abdominal pain license and without bloody stools should be initiated. A temporal relationship between medication use and symptoms needs to be explored. Second, this case highlights the need for providers to thoroughly educate their patients about license correct license of medications.

Not only are migraine headache sufferers at risk for rebound headaches appl phys lett impact factor medication overuse but they are at coalition for ischemic complications.

These license must receive detailed instructions about the maximum license and frequency of medication administration. Patients should communicate understanding of the potential risks license with medications license leaving the license office.

Conflict of interest: This paper license the views of the authors and does not reflect the license of the License States Army, United States Air Force, or the Department of Defense.

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Hodge and Katherine D. CaseA 35-year-old white hoffman la roche presented license the emergency department (ED) after enduring 6 hours of severe abdominal pain, rated as 10 out of 10. View this table:View inlineView popupTable 1. Laboratory DataDiscussionIschemic colitis is a consequence of decreased arterial license flow license the colon.

Conclusion5-HT 1 license agonists license routinely prescribed license family physicians as abortive agents for migraine headaches. NotesThis article was externally peer reviewed. Migraine prevalence, disease burden, and the need for preventive therapy. Making gains in pain. OpenUrlCrossRefPubMedWammes-van license Heijden EA, Rahimtoola H, Leufkens HGM, Tijssen CC, Egberts ACG.

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