DOI: 10.12890/2024_004814
Isolated gastric Crohn's disease: a growing tendency
Authors
elias.fiani@hotmail.com
Keywords
Isolated gastric Crohn's disease, non-caseating granulomas, ASCA test, p-ANCA test, infliximabAbstract
Isolated gastric Crohn's disease (IGCD) is a rare manifestation of Crohn's disease confined to the stomach, unlike its more common forms that primarily affect the ileum and colon. We report the case of a 25-year-old female presenting with a one-month history of epigastric discomfort and nausea, with no other significant gastrointestinal or systemic symptoms. Upper endoscopy revealed an aphthous ulceration on the greater curvature of the stomach, with biopsies showing non-caseating granulomas consistent with Crohn's disease. The diagnosis of IGCD was confirmed through a positive ASCA test and negative p-ANCA test, alongside the absence of ileal and colonic involvement. The patient was treated with prednisone for acute symptom management, followed by infliximab for long-term maintenance. Follow-up evaluations showed no significant relapse episodes. This case highlights the diagnostic challenges and management strategies for IGCD, emphasising the need for further research to optimise treatment protocols and improve long-term outcomes.
References
- Ranasinghe IR, Tian C, Hsu R. Crohn Disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
- Ingle SB, Hinge CR, Dakhure S, Bhosale SS. Isolated gastric Crohn's disease. World J Clin Cases 2013;1:71–73.
- Kumarasinghe MP, Quek TP, Chau CY, Mustapha NR, Luman W, Ooi CJ. Endoscopic biopsy features and diagnostic challenges of adult Crohn's disease at initial presentation. Pathology 2010;42:131–137.
- Ardizzone S, Cassinotti A, Manes G, Porro GB. Immunomodulators for all patients with inflammatory bowel disease? Therap Adv Gastroenterol 2010;3:31–42.
- Balendran K, Udumalagala S, Nawaraththne NMM. Pyloric stenosis as a manifestation of isolated gastric Crohn's disease responding to intralesional steroid injection and balloon dilation: a case report. J Med Case Rep 2019;13:331.
- Kim ES, Kim MJ. Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents. Clin Exp Pediatr 2022;65:21–28.