Clinical characteristics of ulcerative colitis in four patients with severe motor and intellectual disabilities

: We retrospectively reviewed four patients with severe motor and intellectual disabilities (SMID), aged 8-56 years, who presented with ulcerative colitis (UC), and discussed causal interrelationships between UC and SMID. UC started at 3-50 years of age with early childhood-onset in two patients. Two patients had an intractable clinical course in which leukocytapheresis and surgery were ineffective, and resulted in steroid-dependency. We failed to find any causal relationships between infectious events, nutrition and anticonvulsants with the development of UC. However, when occult blood in feces is frequently positive in SMID patients, it is important to consider the possibility of UC and to perform an intestinal endoscopic examination.