Gastric ulcers and swollen kidneys: a rare diagnosis complicating Crohn's disease.
We present a case of a 48-year-old woman with Crohn's colitis admitted with abdominal pain and fever. She had been started on azathioprine 6 months before presentation and had received three doses of infliximab. Abdominal CT scan revealed a liver abscess. Azathioprine was stopped and antibiotics started. She was subsequently discharged with follow-up imaging planned. She presented 3 weeks later with haematemesis. Gastroscopy revealed multiple gastric ulcers. A repeat CT scan showed bilateral renal masses and a renal biopsy was arranged. Gastric and renal biopsies were consistent with B cell lymphoma. Chemotherapy was started and resulted in improvement in CT scan findings as well as ulcer healing.
Department of Gastroenterology, University Hospital Aintree, Liverpool, UK. clareormerod@hotmail.com
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Ormerod
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Sarkar
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Woodcock
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White
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Lal
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001707:Biopsy, Needle; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007674:Kidney Diseases / Q000175:diagnosis / Q000473:pathology*; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D012008:Recurrence; D013276:Stomach Ulcer / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed / Q000379:methods
D000900:Anti-Bacterial Agents; D001379:Azathioprine