Editor's quiz: GI snapshot
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From the question on page 10.1136/gut.2006.117200
Features compatible with Crohn’s disease were seen at colonoscopy, with "cobblestoning", aphthous ulceration and non-caseating granulomas in the terminal ileum and ascending colon (fig 1). Behçet’s disease was excluded given the absence of pathergy and genital ulceration in this case.
Figure 1 Ascending colonic biopsy showing active Crohn’s colitis with crypt abscesses, mucosal erosion, and non-necrotising granulomatous inflammation with a Langhans-type giant cell (arrow).
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The clinical presentation and features on skin biopsy suggest a diagnosis of Crohn’s disease-related, bowel-associated dermatosis–arthritis syndrome. Following intravenous hydrocortisone her dysphagia and arthritis rapidly resolved and she was commenced on azathioprine.
Bowel-associated dermatosis–arthritis syndrome (also known as bowel-bypass syndrome) is a rare manifestation of Crohn’s disease1 3 4 The disorder is characterised by arthralgia, polyarthritis and vesiculopustular eruptions on the upper limbs and trunk.1–4 The skin lesions develop over 24–48 h and usually resolve spontaneously within 8 days.1 They may be
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Gut 2008 57: 672.[Extract] [Full Text] [PDF]
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