2021 Volume 63 Issue 6 Pages 1255-1261
A 44-year-old woman presented to our hospital with fever, abdominal pain, and diarrhea. We administered treatment for acute colitis of the ascending colon, but she did not respond to the treatment. Total colonoscopy (TCS) showed multiple ulcers extending from the terminal ileum to the rectum, while esophagogastroduodenoscopy showed nonspecific findings. Histopathological examination of biopsy specimens from the lesions revealed noncaseating epithelioid cell granulomas, and Crohnʼs disease (CD) was suspected. Because laboratory data showed increased liver enzyme levels and amylase concentration, and eosinophilia, liver biopsy and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the pancreas were performed. Histopathological examination revealed granulomatous hepatitis and pancreatitis with eosinophilic infiltration caused by peripheral eosinophilia as extraintestinal manifestations of CD. After administering infliximab (5 mg/kg), TCS showed no ulcers, and the extraintestinal manifestations improved. We report a rare case of suspected CD in which the onset of multiple extraintestinal manifestations of CD was diagnosed in the early phase, and disease progression of CD could be assessed.
