Silent or subclinical inflammatory bowel diseases (IBD) is a relatively new term that has been used to describe individuals with asymptomatic active mucosal bowel inflammation, often unaware of their disease due to either the lack of or mild inflammatory symptoms. These patients are at risk for gastrointestinal and extra-gastrointestinal manifestations, with more advanced complications. In this article we intend to describe a case report of a patient with chronic history of many organ involvements including ocular, skin, and musculoskeletal, which was later placed under the umbrella of silent ulcerative colitis.

Background: Crohn's disease (CD) is a common disease of the gastrointestinal tract. It is cause heavy inflammation of the digestive system, and it can hit any area of the digestive tract. Cytokines are very important in the progression and reduction of disease severity so it is important to know about them. Objective: The aim of this study is to measure levels of IL-23, IL-17, and calprotectin in serum of Iraqi patients with Crohn's disease, and also measure the levels of inflammation markers CRP, ESR, and WBCs and the reasons for their elevation in blood or serum of patients. Materials and Methods: In the current study, 30 Iraqi patients with Crohn's disease and 30 Iraqi control were included. From November 2021 to April 2022 blood samples were collected, samples were collected in the Gastro-Enterology and Hepatology Hospital in Baghdad, Iraq. The biomarkers used to assess disease activity were C-reactive protein (CRP), complete blood count (CBC), and erythrocyte sedimentation rate (ESR). Calprotectin, IL-23, and IL-17 were measured by the sandwich enzyme-linked immune-sorbent assay technology. Results: Higher incidence of Crohn's disease was noticed in males compared to females, and a higher incidence was found in patients with medium economic situation. The mean age for Crohn's disease diagnosis was 22.96 ±1.89. Abnormal levels of CRP, ESR, WBCs were noticed and also high levels of IL-23, IL-17, and calprotectin were found in serum of Crohn's disease patients. Conclusion: Elevation of cytokines and inflammatory markers in the blood depends on the severity of the inflammation.