A 30-year-old woman presents to the clinic due to abdominal pain and bloody diarrhea for the past 2 weeks. Past medical history is significant for previous episodes similar to this one. The patient denies any fever, nausea, or vomiting. She had been prescribed budesonide in the past for her previous episodes. She does not drink alcohol, use drugs, or smoke cigarettes. Her vital signs are within normal limits. On physical examination, the patient has lower left quadrant tenderness to palpation without guarding or rebound. The patient is prescribed budesonide and mesalamine.
Which of the following explains the pathophysiology behind the patient’s most likely condition?
E) T helper cell type 2 mediated condition
The patient presents with abdominal pain and bloody diarrhea with previous similar episodes of the same. This is characteristic of inflammatory bowel disease. This is further supported by the patient not having any fever, nausea, or vomiting. She has lower left quadrant tenderness which suggests ulcerative colitis. This is due to the fact that ulcerative colitis affects the colon which is present in the lower left abdominal quadrant. The patient’s demographics are also high risk for ulcerative colitis. The typical patient with ulcerative colitis is 15-40 years old, white, and female. This condition’s pathophysiology is mediated by T-helper cells type 2. Budesonide is a corticosteroid medication, while mesalamine is a 5-aminosalicyic acid and both are prescribed for ulcerative colitis.
Answer choice A: Bacterial exotoxin-mediated condition, is incorrect. These conditions are infectious in nature and cause a wide variety of conditions. Some examples include tetanus, botulism, diptheria, and cholera.
Answer choice B: IgE-mediated conditions, is incocrrect. IgE-mediated conditions are type 1 hypersensitivity reactions. These include anaphylaxis to food, drugs, and bee stings.
Answer choice C: Immune complex-mediated condition, is incorrect. These are type 3 hypersensitivity reactions. Examples include systemic lupus erythematosus, rheumatoid arthritis, and IgA vasculitis.
Answer choice D: T helper cell type 1-mediated condition, is incorrect. Crohn disease is an example of a T-herlpe cell type 1-mediated condition. Crohn disease is also an inflammatory bowel disease, however, there are differences between it and ulcerative colitis. Crohn disease affects any portion of the GI tract, usually the ileum and the colon while sparing the rectum. It presents with transmural inflammation sometimes resulting in fistulas, cobblestone mucosa, creeping fat, bowel wall thickening, linear ulcers and fissures. A biopsy would show noncaseating granulomas and lymphoid aggregates.
Key Learning Point
Ulcerative colitis affects the colon and is a T helper cell type 2 mediated condition.
