Mesenteric Inflammatory Venoocclusive Disease in a Patient with Sjögren's Syndrome

Challenging case of ischemic colitis, necrotic cutaneous vasculitis and thromboembolic disease in an elderly patient with Sjogren’s syndrome

Sjogren’s syndrome is a chronic autoimmune condition characterized by reduced lacrimal and salivary gland secretions. In a minority of the cases, patients can develop rarer complications, such as vasculitis and, even less commonly, ischemic colitis.

Herein, we present a challenging case of a 73-year-old woman with a background of Sjogren’s syndrome (SS) who initially presented with a purpuric rash on the right leg. She was initially managed with antibiotics and referred for an outpatient rheumatology review. A few days later, she was readmitted to the hospital generally unwell with a widespread rash. She developed deep vein thrombosis and per rectal bleeding secondary to ischemic colitis. She had excellent response to medical management including steroid therapy and azathioprine. This case highlights the very rare complications of SS. Whilecutaneous vasculitis is not uncommon in primary Sjogren’s, ischemic colitis is very rare and is a potentially serious complication, which requires prompt diagnosis and management.

Crystal structure of the human dual specificity phosphatase 1 catalytic domain

The dual specificity phosphatase DUSP1 was the first mitogen activated protein kinase phosphatase (MKP) to be identified. It dephosphorylates conserved tyrosine and threonine residues in the activation loops of mitogen activated protein kinases ERK2, JNK1 and p38-alpha. Here, we report the crystal structure of the human DUSP1 catalytic domain at 2.49 Å resolution. Uniquely, the protein was crystallized as an MBP fusion protein in complex with a monobody that binds to MBP. Sulfate ions occupy the phosphotyrosine and putative phosphothreonine binding sites in the DUSP1 catalytic domain.