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Isolated Vulvar Crohn's Disease with Co-existing Rheumatoid Arthritis: A Diagnostic Pitfall in Adolescent and Young
Shweta T Kanyal1, Pauras Mhatre1, Soham Nadkarni2
1Department of Obstetrics and Gynecology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India.
None:
Crohn's disease (CD) is an inflammatory bowel disease affecting the gastrointestinal tract, with extra-intestinal manifestations involving joints, skin or eyes. Isolated vulvar involvement is uncommon and poses a diagnostic challenge in young adults. Here, we describe a nulligravid young woman with a twelve-year history of joint pain and five-year history of painful vulvar swelling who was ultimately diagnosed with isolated vulvar Crohn's disease and coexisting rheumatoid arthritis (RA). Multidisciplinary evaluation and surgical vulvar debulking resulted in clinical remission at follow-up. This case highlights the importance of considering CD in the differential diagnosis of chronic vulvar symptoms in adolescents and young adults to prevent diagnostic delay and preserve sexual and reproductive health. It also underscores the importance of long-term surveillance for subsequent gastrointestinal manifestations and the potential for autoimmune disease clustering, including coexisting RA.
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