© 2003 by Gut
Gut file
Elemental diet in the treatment of orofacial Crohn's disease
Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK
Correspondence to:
Correspondence to:
Dr S J Middleton, Department of Gastroenterology, Unit E7, Box 201a, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK;
stephen.middleton@addenbrookes.nhs.uk
| The first 150 words of the full text of this article appear below. |
A 12 year old boy presented via his orthodontist with a three month history of facial swelling and a one year history of intermittent diarrhoea. Examination revealed a pale boy with asymmetrical thickening of his cheeks, a buccal mucosal fold on the left, and friable mucosa on the right. Investigations revealed a mild hypochromic microcytic anaemia and raised inflammatory markers.
An oral biopsy showed occasional granulomata and a mixed inflammatory infiltrate with negative fungal stains consistent with a diagnosis of orofacial granulomatosis. 99Tcm-HMPAO leucocyte scintigraphy showed grade 3 white cell activity in the terminal ileum and caecum and grade 2 activity in the ascending colon and rectum. At colonoscopy, patchy aphthous ulceration was seen from the rectum to the caecum, more pronounced proximally, and biopsies revealed granulomatous inflammation consistent with a clinical diagnosis of Crohn's disease.
Elemental diet was commenced resulting in a dramatic improvement within two days. Two
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Gut 2003 52: 152.[Extract] [Full Text] [PDF]
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