Isolated gastric Crohn's disease.

Area of Science:

• Gastroenterology
• Immunology
• Internal Medicine

Background:

• Crohn's disease (CD) typically affects the ileocolonic region, with isolated gastric involvement being exceptionally rare (less than 0.07% of cases).
• Diagnosis of isolated gastric CD is challenging due to nonspecific endoscopic and histological findings, particularly in atypical presentations.

Purpose of the Study:

• To highlight the diagnostic challenges and potential role of serological markers in isolated gastric Crohn's disease.
• To review current understanding of isolated gastric CD, including diagnostic tools and treatment efficacy.

Main Methods:

• Review of existing literature on isolated gastric Crohn's disease.
• Discussion of diagnostic modalities, including upper GI endoscopy, histology, and serological testing.
• Consideration of treatment options, specifically infliximab, based on limited case reports.

Main Results:

• Isolated gastric CD is an uncommon presentation, with very few documented adult cases and no reported pediatric cases.
• Serological markers, such as perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomyces cerevisiae antibody, show promise as supplementary diagnostic tools.
• The effectiveness and long-term outcomes of infliximab treatment for isolated gastric CD remain largely unknown, with limited supporting case reports.

Conclusions:

• Diagnosis of isolated gastric CD requires a high index of suspicion and consideration of atypical presentations.
• Serological testing can be crucial in diagnosing atypical CD when standard endoscopic and histological findings are non-specific.
• Further research is needed to establish optimal treatment strategies and long-term outcomes for isolated gastric CD.