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Published on: October 14, 2025
Metastatic Crohn's disease in pediatrics
Javier Blasco Alonso1, Francisco Girón Fernández-Crehuet2, Miguel A Lendínez Ramírez3
1Gastroenterología, Hepatología y Nutrición Infanti, Hospital Regional Universitario de Málaga, España.
Metastatic Crohn's disease (MCD) is rare in children, often presenting with genital lesions. Biopsy confirms diagnosis, and while exclusive enteral nutrition can be effective, combination therapies may be needed for recurrent cases.
Area of Science:
- Pediatric Gastroenterology
- Dermatology
- Inflammatory Bowel Disease
Background:
- Metastatic Crohn's disease (MCD) is an uncommon extraintestinal manifestation of Crohn's disease.
- Limited data exists on pediatric MCD, with an estimated adult incidence of 0.5-1%.
- Therapeutic strategies for MCD lack consensus.
Observation:
- This study reports on four pediatric cases of MCD diagnosed between ages 7 and 13.
- Lesions presented primarily in the genital region (3/4 cases) and pretibial area.
- Biopsies consistently revealed non-caseificant granulomas.
Findings:
- Exclusive enteral nutrition led to complete resolution in two patients.
- Two patients required combination therapies (corticosteroids, immunosuppressants, biologics) due to recurrence.
- One patient needed surgical intervention for refractory disease.
Implications:
- MCD should be considered in the differential diagnosis of cutaneous lesions in pediatric Crohn's disease patients.
- Genital involvement appears common in pediatric MCD.
- Treatment approaches for MCD align with those for intestinal Crohn's disease management.
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