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Crohn's disease complicated by adult-onset Still's disease

Mizuki Kono1, Nobuhide Oshitani, Yoshinori Sawa

  • 1Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.

Journal of Gastroenterology
|October 18, 2003
PubMed

Insights

This case report details a patient with Crohn's disease who developed symptoms mimicking adult-onset Still's disease, including arthritis and fever. Early diagnosis and immunosuppressive treatment were crucial for managing this rare complication.

Area of Science:

  • Rheumatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Crohn's disease is a chronic inflammatory bowel disease.
  • Adult-onset Still's disease is a rare systemic inflammatory disorder.

Observation:

  • A 31-year-old male with a history of Crohn's disease presented with polyarthritis, spiking fever, and a macular skin rash.
  • Imaging revealed hepatosplenomegaly and bilateral pleural effusion, symptoms resembling adult-onset Still's disease.
  • The patient also had a periumbilical intestinal skin fistula, a complication of Crohn's disease.

Findings:

  • The clinical presentation was indistinguishable from adult-onset Still's disease.
  • This represents the first reported case of adult-onset Still's disease complicating Crohn's disease.
  • Misdiagnosis as enteropathic arthritis or erythema nodosum associated with Crohn's disease is a concern.

Implications:

  • Early diagnosis of adult-onset Still's disease in Crohn's patients is vital.
  • Prompt treatment with immunosuppressive agents can lead to successful outcomes.
  • Recognizing this rare association can prevent misdiagnosis and improve patient management.

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