Crohn's disease of the epiglottis, aryepiglottic folds, anus, and rectum

A 23-year-old white women complained of sore throat and difficulty in breathing. Examination of her larynx revealed chronic inflammatory changes of the epiglottis and aryepiglottic folds, and a biopsy demonstrated chronic granulomatous reaction. Six months later she developed chronic diarrhea, rectal pain, and typical anorectal findings of Crohn's disease. Biopsy of the anus revealed the same microscopic features as in the laryngeal structures. Treatment in keeping with the acceptable but limited measures for Crohn's disease brought improvement in both areas of inflammation. We feel this patient has Crohn's disease in the larynx, involvement which preceded that of the gastrointestinal tract.