title: A case of acute myocarditis as the initial presentation of Crohn's disease.
abstract: We experienced a case of acute myocarditis as the initial presentation of Crohn's disease. A 19-year-old woman was admitted with impaired consciousness, shock, and respiratory failure. She had suffered from frequent diarrhea and abdominal pain for several years. Cardiac troponin I and creatine kinase-MB fraction levels were elevated to 5.32 and 16.66 ng/mL, respectively. A 12-lead electrocardiogram showed sinus tachycardia, and a chest radiograph revealed interstitial pulmonary edema. An echocardiogram showed dilated ventricles with akinesia of the basal to apical inferoseptal, anteroseptal, anterior, and inferior left ventricular walls and severely impaired systolic function. Intensive care with inotropic support was effective, and her clinical condition gradually improved. Two weeks later, a colonoscopy revealed ulceration with stenosis in the terminal ileum and multiple aphthous ulcers in the rectum. A biopsy of the rectum revealed non-caseating granulomatous inflammation. She was diagnosed with Crohn's disease presenting with acute myocarditis.
authors.affiliation: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: In Soo
authors.initials: IS
authors.lastname: Oh
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Choi
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Ju Wan
authors.initials: JW
authors.lastname: Kim
authors.forename: Bong Ki
authors.initials: BK
authors.lastname: Cha
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Do
authors.forename: Sae Kyung
authors.initials: SK
authors.lastname: Chang
authors.forename: Gui Young
authors.initials: GY
authors.lastname: Kwon