TITLE:
Atypical Presentation of Crohn’s Disease: Diagnostic Challenges in a Clinical Case
AUTHORS:
Catarina Pinto Silva, Rita Sevivas, Flávia Ramos, Dany Cruz, Cristina Marques, Beatriz Rosa, Márcia Ribeiro, Carlos S. Oliveira
KEYWORDS:
Crohn’s Disease, Atypical Presentation, Diagnostic Challenges, Inflammatory Markers, Infliximab, Imaging
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.14 No.1,
January
7,
2025
ABSTRACT: Introduction: Crohn’s Disease (CD) is a chronic inflammatory disorder with a heterogeneous presentation. While diarrhea, abdominal pain, and weight loss are hallmarks, atypical manifestations can obscure the diagnosis. This report highlights an unusual presentation of CD to emphasize the need for comprehensive diagnostic strategies. Case Report: A 25-year-old male presented with peripheral edema, anorexia, and abdominal distension but lacked classic gastrointestinal (GI) symptoms. Laboratory findings included microcytic anemia and hypoalbuminemia, while imaging revealed ascites and bowel wall thickening. Elevated fecal calprotectin and positive Anti-Saccharomyces cerevisiae antibodies (ASCA) supported the diagnosis. Endoscopy confirmed ileocolic Crohn’s Disease (L3 + L4). Infliximab therapy resulted in marked clinical improvement. Discussion: This case underscores the complexity of atypical CD presentations. Early use of serological markers, imaging, and endoscopy guided the diagnosis. Recognition of CD’s diverse manifestations is critical for timely intervention. Conclusion: Atypical CD presentations require heightened clinical suspicion and a multidisciplinary approach to reduce diagnostic delays and improve patient outcomes.