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Rare disease
A difficult case of Crohn's disease?
  1. Neville Azzopardi1,
  2. Pierre Ellul1,
  3. Thomas Attard2,
  4. Jason Attard3,
  5. James DeGaetano4,
  6. Mario Vassallo5,
  7. Tonio Piscopo6
  1. 1Department of Medicine, Mater Dei Hospital, Tal Qroqq, Malta
  2. 2Department of Paediatrics, Mater Dei Hospital, Tal Qroqq, Malta
  3. 3Department of Pathology, Mater Dei Hospital, Tal Qroqq, Malta
  4. 4Department of Histopathology, Mater Dei Hospital, Tal Qroqq, Malta
  5. 5Department of Gastroenterology, Mater Dei Hospital, Tal Qroqq, Malta
  6. 6Department of Infectious Disease, Mater Dei Hospital, Tal Qroqq, Malta
  1. Correspondence to Dr Neville Azzopardi, oldcharm{at}onvol.net

Summary

A young lady with a long history of recurrent infections was referred to the gastroenterology department by an infectious disease consultant because of a long history of profuse diarrhoea. A nitroblue tetrazolium (NBT) test performed in her mid-teens had shown zero reduction of the dye. The clinical, biochemical, radiological and endoscopic findings were suggestive of possible underlying Crohn's disease. However, the NBT test was more suggestive of a granulomatous colitis which frequently mimics Crohn's disease in patients with Chronic granulomatous disease. Management with immunosuppressants is proving to be very difficult in this patient in view of recurrent sepsis on introducing these drugs.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.