Crohn's disease initiated with extraintestinal features
Crohn's disease initiated with extraintestinal features
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DOI：
10.1136/bcr-2019-229916
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发表时间：
2019-07-01
期刊：
影响因子：
0.9
通讯作者：
Stoufi, Eleana
中科院分区：
文献类型：
--
作者：
Chang, Jeffrey;Li, Chia-Cheng;Stoufi, Eleana
克罗恩病（CD）是一种多因素的慢性免疫介导疾病。0.5% - 20%的乳糜泻患者累及口腔。乳糜泻的口腔表现有时是非特异性的，可能被临床医生忽视。这些表现可能先于肠道症状，可作为早期诊断的指标。为了提高认识，并有助于标准的干预，在这里我们报告一个儿科病例持续特发性肿胀的下唇和肛周瘘。镜下检查显示多发性非坏死性肉芽肿伴慢性炎症、水肿及淋巴管扩张。患者给予甲硝唑500mg、环丙沙星500mg，每日2次，连用1个月。口腔周围病变局部使用0.03%他克莫司和口服强的松10mg，每天两次，持续一个月，然后逐渐减少10mg/天，持续一个月。在6个月的随访中，患者症状有所改善，但未完全缓解。
Crohn's disease (CD) is a multifactorial, chronic immune-mediated disorder. The oral cavity is involved in 0.5% to 20% of the patients with CD. Oral manifestations of CD are sometimes nonspecific and can be overlooked by the clinicians. These manifestations may precede intestinal symptoms and can serve as indicators for early diagnosis. To increase awareness and to contribute to the standard intervention, here we report a paediatric case with persistent idiopathic swelling of the lower lip and perianal fistula. Microscopic examinations revealed multiple non-necrotising granulomas with chronic inflammation, oedema and lymphangiectasia. The patient was treated with metronidazole 500mg and ciprofloxacin 500mg twice a day for onemonth. The perioral lesions were managed with topical 0.03% tacrolimus and oral prednisone 10mgtwice a day for onemonth, followed by a tapered regimen of 10mg/day for another month. The patient's symptoms improved without full remission at the 6-month follow-up.