title: Familial adenomatous polyposis and Crohn's disease in one patient: dilemmas and concerns.
abstract: Familial adenomatous polyposis (FAP) and Crohn's disease (CD) are two entities with no known etiologic or physiopathogenic relation. The rarity of the former makes the coincidence of both diagnoses in one patient very unlikely. Nevertheless, management in such cases can be puzzling as surgical options must be considered, and immunosuppression/immunomodulation is set in a territory of accelerated carcinogenesis. We report the case of a 29-year-old male with a diagnosis of FAP since adolescence, already submitted to prophylactic proctocolectomy, presenting with anemia and bloody diarrhea, revealing small bowel CD. This case allows for a rich discussion of the clinical dilemmas presenting when FAP and CD are diagnosed in the same patient and for a deep analysis of the concerns inherent to the available therapeutic options.
authors.affiliation: Gastroenterology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E., Lisbon, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Fidalgo
authors.forename: Sara
authors.initials: S
authors.lastname: Ferreira
authors.forename: Isadora
authors.initials: I
authors.lastname: Rosa
authors.forename: Susana Mão
authors.initials: SM
authors.lastname: de Ferro
authors.forename: António Dias
authors.initials: AD
authors.lastname: Pereira
keywords: Capsule endoscopy; Crohn's disease; Familial adenomatous polyposis
references.citation: Int J Colorectal Dis. 2006 Oct;21(7):730-1
references.pmid: 16775703
references.citation: Dig Dis Sci. 1995 Feb;40(2):402-5
references.pmid: 7851206
references.citation: CA Cancer J Clin. 2012 Jan-Feb;62(1):10-29
references.pmid: 22237781
references.citation: Gut. 2005 Aug;54(8):1121-5
references.pmid: 16009685
references.citation: Gut. 2008 May;57(5):704-13
references.pmid: 18194984
references.citation: Inflamm Bowel Dis. 2012 Jul;18(7):E1398
references.pmid: 22081510
references.citation: Hum Mutat. 1994;3(2):121-5
references.pmid: 8199592
references.citation: Gut. 2012 Feb;61(2):235-40
references.pmid: 21602529
references.citation: Gastroenterology. 2011 Nov;141(5):1621-28.e1-5
references.pmid: 21708105
references.citation: Cochrane Database Syst Rev. 2010 Jun 16;(6):CD000545
references.pmid: 20556747
references.citation: Am J Gastroenterol. 2010 Jan;105(1):51-64
references.pmid: 19755972