Panuveitis in a patient with active Crohn's disease

Area of Science:

• Ophthalmology
• Gastroenterology
• Immunology

Background:

• Inflammatory bowel disease (IBD) can manifest with extraintestinal manifestations, including ocular complications.
• Ocular involvement in pediatric Crohn's disease is less common but can significantly impact vision.

Purpose of the Study:

• To report a case of a pediatric patient presenting with severe ocular inflammation secondary to undiagnosed Crohn's disease.
• To highlight the importance of a multidisciplinary approach in diagnosing and managing complex cases of pediatric inflammatory bowel disease with ophthalmic involvement.

Main Methods:

• A 14-year-old female presented with bilateral uveitis, vitritis, and retinal vasculitis, accompanied by gastrointestinal symptoms.
• Abdominal imaging and colonoscopy revealed characteristic features of Crohn's disease, confirmed by histopathology.
• Ocular and gastrointestinal symptoms were managed concurrently with topical steroids, oral budesonide, and mesalazine.

Main Results:

• The patient exhibited significant improvement in visual acuity and resolution of ocular inflammation within 3 weeks of treatment.
• Gastrointestinal symptoms achieved remission after 8 weeks of combined therapy.
• Histopathology confirmed granulomatous inflammation consistent with Crohn's disease.

Conclusions:

• This case underscores the critical need for ophthalmologists to consider IBD in the differential diagnosis of pediatric uveitis with systemic symptoms.
• Early recognition and integrated management of ocular and gastrointestinal manifestations are crucial for favorable outcomes in pediatric Crohn's disease.