Fever as the Only First Sign of Crohn’s Disease—Difficulties in Diagnosis during the COVID-19 Pandemic

Kęsicka, Aleksandra; Burandt, Judyta; Główczewski, Adam; Krogulska, Aneta

doi:10.3390/children9121791

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…To verify the diagnosis, an abdominal CT scan and magnetic resonance imaging (MRI) with enterography were additionally performed; the results confirmed lesions typical of IBD, thus confirming the diagnosis of CD. The onset of the disease, which was manifested only by a fever that lasted for six weeks, was described in more detail in a previous article [19]. The present article presents a rare and dangerous complication of Crohn's disease, AIHA.…”

Section: Case Descriptionmentioning

confidence: 64%

Autoimmune Haemolytic Anaemia as a Rare and Potentially Serious Complication of Crohn’s Disease in a 11-Year-Old Child—Case Report and Minireview

Dybowska,

Krogulska

2023

Children

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Inflammatory bowel disease (IBD) is the term given to a heterogeneous group of chronic inflammatory diseases of the gastrointestinal tract (GI). These include ulcerative colitis (UC), where the inflammatory process involves only the intestinal mucosa, and Crohn’s disease (CD), where it can involve the entire wall of the GI in all of its sections. In addition to typical gastrointestinal complaints, IBD manifests with a range of extraintestinal symptoms involving inter alia the eyes, joints, skin, liver and biliary tract. These can cause a number of extraintestinal complications; of these, one of the most common is anaemia, usually resulting from nutritional deficiencies, especially iron, or chronic inflammation. When treating patients with IBD, it is important to consider the possibility of rare but serious complications, including autoimmune haemolytic anaemia (AIHA). This condition occurs in only 0.2 to 1.7% of UC cases and is even rarer in CD. AIHA is usually mild but can occur suddenly and cause very rapid anaemia. In the article presented here, we describe the case of a patient who developed AIHA two years after a diagnosis of CD, causing a life-threatening diagnostic and therapeutic challenge for the medical team.

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Section: Case Descriptionmentioning

confidence: 64%

Autoimmune Haemolytic Anaemia as a Rare and Potentially Serious Complication of Crohn’s Disease in a 11-Year-Old Child—Case Report and Minireview

Dybowska,

Krogulska

2023

Children

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“…Several cases of CD with atypical presentations have been reported: a case with poor systemic and gastrointestinal signs for CD other than fever [ 18 ], cases with lesions located in only the large intestine [ 19 , 20 ], and cases with atypical or rare extra-gastrointestinal signs of CD [ 21 – 25 ]. When lesions are located in only the large intestine, it can be difficult to distinguish CD from ulcerative colitis [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Polybacterial Iliopsoas Muscle Abscess as an Indication for Early Diagnosis of Crohn\'s Disease

Yamashita,

Nakamura,

Akutagawa

et al. 2023

Am J Case Rep

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Patient: Male, 22-year-old Final Diagnosis: Crohn’s disease Symptoms: Hip pain Clinical Procedure: — Specialty: Critical Care Medicine • Gastroenterology and Hepatology Objective: Unusual clinical course Background: Crohn disease (CD) is a chronic, relapsing inflammatory bowel disease characterized by penetrations or fistulae in the gastrointestinal tract and abscesses in the surrounding tissues. Diagnosis of CD is difficult with an iliopsoas muscle abscess (IMA) as an initial presentation. Case Report: A 22-year-old Japanese man had right hip pain 17 days prior to admission. Because of worsening pain, he was admitted to our hospital. Physical examination revealed limitation of his right hip motion and a positive right psoas sign. Abdominal contrast-enhanced computed tomography (CT) revealed a large right IMA. Continuous drainage, which revealed polymicrobial pus, with intravenous administration of antibiotics dramatically decreased the size of the IMA. The drainage tube was removed on hospitalization day 9 because barium enema and contrast radiography of the abscess through the drainage tube showed no fistula. However, on day 19 of hospitalization, the IMA was redetected by abdominal CT. Continuous abscess drainage was resumed, and the third contrast radiograph of the abscess revealed contrast medium flow into the small intestine. Colonoscopy detected stenoses and circumferential ulceration of the terminal ileum. Histopathological examination of the ileum biopsy showed histocyte aggregation with lymphocyte or plasmacyte infiltration of the lamina propria, compatible with a CD diagnosis. Laparoscopic ileocecal resection was performed on day 64 of hospitalization. Conclusions: Penetration of the intestinal tract caused by CD should be suspected in a patient with a polymicrobial IMA. It is essential to identify the fistula and subsequently perform surgical resection of the affected intestinal area.

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Fever as the Only First Sign of Crohn’s Disease—Difficulties in Diagnosis during the COVID-19 Pandemic

Cited by 2 publications

References 7 publications

Autoimmune Haemolytic Anaemia as a Rare and Potentially Serious Complication of Crohn’s Disease in a 11-Year-Old Child—Case Report and Minireview

Autoimmune Haemolytic Anaemia as a Rare and Potentially Serious Complication of Crohn’s Disease in a 11-Year-Old Child—Case Report and Minireview

Polybacterial Iliopsoas Muscle Abscess as an Indication for Early Diagnosis of Crohn\'s Disease

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