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A case of acute loss of vision as the presenting symptom of Crohn's disease

Nature Clinical Practice Gastroenterology & Hepatology volume 4, pages 695–698 (2007)Cite this article

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.

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Figure 1: Ocular manifestations of IBD.

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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.

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Authors and Affiliations

  1. M Girardin is a Gastroenterology Research Fellow at the McGill University Health Center, KA Waschke is Assistant Professor of Medicine and EG Seidman is Professor of Medicine and Pediatrics at McGill University, Montréal, QC, Canada.,

    Marc Girardin, Kevin A Waschke & Ernest G Seidman

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  1. Marc Girardin
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  2. Kevin A Waschke
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  3. Ernest G Seidman
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Correspondence to Ernest G Seidman.

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The authors declare no competing financial interests.

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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

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