[A potpourri of diagnoses-Unusual manifestations of a chronic inflammatory bowel disease : Case report].

Abstract

Background: Inflammatory bowel diseases (IBD) are frequently associated with extraintestinal manifestations, which usually occur concomitantly with or following onset of an intestinal disease. The presence of multiple autoimmune manifestations preceding the diagnosis of IBD is rare and unusual.

Case report: We report the case of a 22-year-old woman referred for rheumatological evaluation due to bilateral anterior uveitis. Her medical history included type 2 autoimmune pancreatitis and persistently elevated liver enzyme parameters. Further diagnostic work-up revealed primary sclerosing cholangitis. A few weeks later she developed bloody diarrhea and Crohn's disease was confirmed histologically. A retrospective review of previous imaging studies showed findings consistent with small bowel inflammation prior to clinical manifestation.

Conclusion: This case highlights the importance of interdisciplinary diagnostics in young patients presenting with multiple autoimmune manifestations. An underlying chronic inflammatory bowel disease should be considered even in the absence of gastrointestinal symptoms.