Necrotizing Myositis as an Extraintestinal Manifestation of Crohn's Disease

Abstract

A 23-year-old woman presented with swelling and pain of the left popliteal area that had begun 1 week earlier. Twentytwo months before admission, she had presented with pyoderma gangrenosum on the left upper chest and was diagnosed with CD. She was treated with steroid and mesalazine for 3 months, which brought about improvement in her condition. Diarrhea continued intermittently, and she decided to discontinue the maintenance therapy 3 months before admission. The patient had never smoked and did not have a remarkable familial history. Blood pressure was 120/70 mmHg, body temperature was 36.2 o C, and heart rate was 84 beats/min. The left popliteal area was reddish, swollen, and tender (Fig. 1). Examination of the other systems was unremarkable. Laboratory findings were as follows at admission: white blood cell count, 9,000/μ L; hemoglobin, 12.4 g/dL; platelet count, 254,000/μ L; AST, 13 IU/L; ALT level, 8 IU/L; serum albumin, 4.0 g/dL; BUN, 12 mg/dL; and serum creatinine, 0.7 mg/dL. ESR and CRP level were slightly elevated (26 mm/h and 32.5 mg/L, respectively), but CK (35 IU/L), LDH