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Elemental diet in the treatment of orofacial Crohn's disease
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  1. E A B Cameron,
  2. S J Middleton
  1. Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK
  1. Correspondence to:
    Dr S J Middleton, Department of Gastroenterology, Unit E7, Box 201a, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK;
    stephen.middleton{at}addenbrookes.nhs.uk
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http://dx.doi.org/10.1136/gut.52.1.143

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    HISTORY

    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.

    DIAGNOSTIC PROCEDURES

    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 …

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