title: Fibromuscular dysplasia mimicking Crohn's disease over a period of 23 years.
abstract: Rare diseases with similar clinical presentation as more frequent gastrointestinal disorders might be challenging in the diagnostic and therapeutic management. In this case we report on a 47-year-old woman who was thought to suffer from Crohn's disease. Symptoms, macroscopic and histological aspects of the gastrointestinal tract, treatment response and clinical course had encouraged the wrong diagnosis over a period of 23 years. After the patient died in the context of a sudden clinical deterioration, fibromuscular dysplasia of the aorta was finally unmasked by post-mortem examination as underlying cause of all symptoms attributed to Crohn's disease. Re-evaluation of former diagnostic procedures revealed subtle aspects of fibromuscular dysplasia, even in biopsy samples from 23 years ago. This first case report of fibromuscular dysplasia of the aorta documents a rare pitfall in the diagnostic workup of a frequent clinical presentation in gastroenterology.
authors.affiliation: Medical University of Vienna, Internal Medicine III, Gastroenterology and Hepatology, Austria. werner.dolak@meduniwien.ac.at
authors.forename: W
authors.initials: W
authors.lastname: Dolak
authors.forename: J
authors.initials: J
authors.lastname: Maresch
authors.forename: F
authors.initials: F
authors.lastname: Kainberger
authors.forename: F
authors.initials: F
authors.lastname: Wrba
authors.forename: Ch
authors.initials: Ch
authors.lastname: Müller
mesh_terms: D001011:Aorta / Q000473:pathology*; D001344:Autopsy; D003424:Crohn Disease / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D017809:Fatal Outcome; D005260:Female; D005352:Fibromuscular Dysplasia / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D013997:Time Factors