2003 Volume 64 Issue 4 Pages 932-935
This paper deals with a case of Crohn's disease with macrocytic anemia due to vitamin B12 deficiency after an ileocecal resection. A 35-year-old woman undergone an ileocecal resection in 1982 and a partial resection of the ileum in 1993 with the diagnosis of Crohn's disease, was seen at the hospital because of general fatigue and edema of her legs in August, 2001. A hemogram revealed macrocytic anemia. While the serum folate level was within normal range, serum vitamin B12 level was abnormally low. Neither intestinal fistula nor blind loop were detected on radiological enteroclysis and colonoscopy. It was judged that this macrocytic anemia was induced by vitamin B12 deficiency caused by malabsorption following the ileocecal resection for Crohn's disease. Intravenous administration of vitamin B12 rapidly improved macrocytic anemia. Crohn's disease commonly involves from the terminal ileum to the cecum so that an ileocecal resection in often performed. Macrocytic anemia due to vitamin B12 deficiency should be kept in mind in patients with Crohn's disease after an ileocecal resection.