Nasal Septal Perforation in an Adolescent Girl with Crohn’s Disease: A Rare Extraintestinal Manifestation

Sarı, Sinan; Dalgıç, Buket; Yılmaz, Metin; Poyraz, Aylar

doi:10.1007/s10620-006-9584-4

Cited by 16 publications

(12 citation statements)

References 11 publications

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“…Histopathologic examination of nasal biopsies may demonstrate non--specific chronic inflammation [15]. It also showed non--caseating granulomas in the majority of patients, as in our case [10][11][12][13]. Pharyngeal or laryngeal involvement, pansinusitis, peritonsillitis and oral ulcerations were also described in some of these patients [12].…”

Section: Discussionmentioning

confidence: 75%

“…Very few reports of laryngeal CD exist in the literature [7][8][9]. Nasal manifestations are extremely rare [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…In our patient, nasal obstruction and recurrent epistaxis were the main symptoms. Chronic atrophic or scabby rhinitis, oedema, ulcerations and polyposis of nasal mucosa, perforation of nasal septum, lysis and necrosis of the turbinates, saddle nose deformity, stenosis of the nasal fossae and empty nose syndrome were the most common endoscopic findings in these patients [10][11][12][13]. Nasal involvement with septum perforation, excoriation of the left nasal septum and abundant mucus revealed CD in only one patient [14].…”

Section: Discussionmentioning

confidence: 99%

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A Rare Manifestation of Crohn's Disease: Sinonasal Granulomatosis. Report of a Case and Review of Literature

Baïli

Rachdi

Daoud

et al. 2014

European Journal of Case Reports in Internal Medicine

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Abstract:Crohn's disease is a granulomatous inflammatory bowel disease. Its pathologic findings include non--contiguous chronic inflammation and non--caseating granulomas, sometimes with extra--intestinal localizations. Sinonasal manifestations of Crohn's disease are quite rare and only a few cases have been reported up to date in the worldwide literature. They are characterized by chronic mucosal inflammation, obstruction, bleeding and occasionally septal perforation. We report a case of sinonasal granulomatosis revealing Crohn's disease in a 22--year--old woman and go over the available literature on sinonasal involvement in Crohn's disease.

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Section: Discussionmentioning

confidence: 75%

“…Very few reports of laryngeal CD exist in the literature [7][8][9]. Nasal manifestations are extremely rare [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Manifestation of Crohn's Disease: Sinonasal Granulomatosis. Report of a Case and Review of Literature

Baïli

Rachdi

Daoud

et al. 2014

European Journal of Case Reports in Internal Medicine

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“…The clinical spectrum of orofacial CD includes hyperplasia, cobblestoning, ulceration of the buccal and gingival mucosa, and swelling of the lips and face [3]. Involvement of the nasal cavity has also been described; findings include intermittent epistaxis, obstruction, and septal perforation [4].…”

Section: Introductionmentioning

confidence: 99%

Severe Refractory Orofacial Crohn’s Disease: Report of a Case

Quezada

Turner

Alexiev³

et al. 2008

Dig Dis Sci

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Oral involvement is common in patients with Crohn's disease (CD) and can precede intestinal symptoms, making diagnosis difficult. We report a case of severe orofacial CD. A 41-year-old woman presented with palate and tongue ulcers. Biopsies showed acute inflammation with ulcer. Colonoscopy demonstrated ascending colon ulceration. Biopsies revealed acute colitis and mild architectural distortion. Prednisone was started but the symptoms recurred with taper; steroids were resumed and infliximab (IFX) 5 mg/kg was infused. After improvement, oral pain and weight loss returned. A G tube was placed. Mercaptopurine was started at 1.5 mg/kg per day. IFX was increased to 10 mg/kg. Debridement of the oral ulcers and a skin graft to the lips was performed. Pathology from oral and facial lesions was consistent with granulation tissue and fibrosis with chronic inflammation. She was readmitted several months later for weight loss and dehydration. Abdominal pain, distension, and feculent drainage developed around the G tube. Repeat computed tomography (CT) scan demonstrated pneumatosis. Laparotomy revealed purulent drainage from a perforated segment of sigmoid colon. Histology was consistent with perforated CD. Despite ventilatory and hemodynamic support and broad-spectrum antibiotics, the patient died 1 week later. Our case highlights the difficulty in diagnosing and managing orofacial CD. In this case, medical treatment was initiated based on a high index of suspicion. CD was only confirmed after intestinal resection very late in the disease course. Treatment of orofacial CD includes topical or systemic steroids, immunomodulators, and anti-tumor necrosis factor (TNF) therapies. As our case demonstrated, patients can be refractory to therapy.

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“…Перфорация может возникать у па циентов, страдающих ревматоидным артритом [14], гранулематозом Вегенера [15]. Имеются данные о связи ППН с системным юношеским идиопатиче ским артритом, или болезнью Стилла [16], эритема тозной формой волчанки [17], болезнью Крона [18], болезнью Рейно и другими системными васкулита ми. Причина возникновения ППН при системных заболеваниях также связана с нарушением крово снабжения СО и хряща ПН [8].…”

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