Abstract
Background An adolescent boy aged 17 years presented with sudden onset of visual impairment, which was rapidly diagnosed as bilateral anterior uveitis by an ophthalmologist. A systemic review noted episodes of nonbloody diarrhea, weight loss of 3 kg and a diminished appetite during the previous 10 months. The patient's family history revealed an older brother with Crohn's disease.
Investigations Visual acuity test, slit-lamp examination, ophthalmologic fundoscopy and endoscopic evaluation of the upper and lower gastrointestinal tract with biopsy.
Diagnosis Multifocal Crohn's disease, involving the terminal ileum and cecum, in addition to the stomach and duodenum.
Management Treatment with topical corticosteroids, in the form of ophthalmic drops and oral budesonide ileal-release capsules. Once remission was achieved, it was maintained with mercaptopurine.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Veloso FT et al. (1996) Immune-related systemic manifestations of inflammatory bowel disease. A prospective study of 792 patients. J Clin Gastroenterol 23: 29–34
Taylor SR et al. (2006) The ocular manifestations of inflammatory bowel disease. Curr Opin Ophthalmol 17: 538–544
Schorr-Lesnick B and Brandt LJ (1988) Selected rheumatologic and dermatologic manifestations of inflammatory bowel disease. Am J Gastroenterol 83: 216–223
Fernández-Melón J et al. (2004) Uveitis as the initial clinical manifestation in patients with spondyloarthropathies. J Rheumatol 31: 524–527
Brophy S et al. (2001) Inflammatory eye, skin, and bowel disease in spondyloarthritis: genetic, phenotypic, and environmental factors. J Rheumatol 28: 2667–2673
Korelitz BL and Coles RS (1967) Uveitis (iritis) with ulcerative and granulomas colitis. Gastroenterology 52: 78–82
Orchard TR et al. (2002) Uveitis and erythema nodosum in inflammatory bowel disease: clinical features and the role of HLA genes. Gastroenterology 123: 714–718
Bernstein CN et al. (2001) The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol 96: 1116–1122
Lyons JL and Rosenbaum JT (1997) Uveitis associated with inflammatory bowel disease compared with uveitis associated with spondyloarthropathy. Arch Ophthalmol 115: 61–64
Das KM (1999) Relationship of extraintestinal involvements in inflammatory bowel disease: new insights into autoimmune pathogenesis. Dig Dis Sci 44: 1–13
Labunski S et al. (2001) Tumour necrosis factor-alpha promoter polymorphism in erythema nodosum. Acta Derm Venereol 81: 18–21
Mielants H et al. (1993) A prospective study of patients with spondyloarthropathy with special reference to HLA-B27 and to gut histology. J Rheumatol 20: 1353–1358
Williams JG et al. (1998) Ocular manifestations of Whipple disease: an atypical presentation. Arch Ophthalmol. 116: 1232–1234
Danese S et al. (2005) Extraintestinal manifestations in inflammatory bowel disease. World J Gastroenterol 11: 7227–7236
Sandborn WJ (2003) Evidence-based treatment algorithm for mild to moderate Crohn's disease. Am J Gastroenterol 98 (12 Suppl): S1–S5
Acknowledgements
This report was supported by a Research Fellowship Award to M Girardin from the Eugenio Litta Foundation and a Canada Research Chair in Immune Mediated Gastrointestinal Disorders, in addition to the B Kaufman Chair in IBD at McGill University, Montréal, QC, Canada, for EG Seidman. We thank M Diamond for her expert secretarial assistance.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Supplementary information
Rights and permissions
About this article
Cite this article
Girardin, M., Waschke, K. & Seidman, E. A case of acute loss of vision as the presenting symptom of Crohn's disease. Nat Rev Gastroenterol Hepatol 4, 695–698 (2007). https://doi.org/10.1038/ncpgasthep0982
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/ncpgasthep0982
This article is cited by
-
Extraintestinal manifestations of inflammatory bowel disease
Current Gastroenterology Reports (2008)