Renal involvement in Crohn’s disease

Abstract

Extraintestinal manifestations of Crohn's disease (CD) are varied and concentrated mainly to the skin and eye. Urinary tract or renal involvement is extremely rare. Herein we report on a case of renal lesion of a 50-year-old woman with a 15-year history of CD. Abdominal computed tomography scan of the patient identified heterogeneous multinodular mass lesions in the left kidney. Histology proved classic granulomatous inflammatory nodules with multinucleated giant cells, eosinophils, plasma cells, epithelioid cells, and spindle-shaped myofibroblasts in the areas, where the computed tomography scan indicated. After the extensive PubMed search in the literature, this is the first macroscopically documented and histologically proved, mass-like renal involvement in CD. From now on, differential diagnostics of renal mass lesions in CD should include the tumor-like, Crohn's-type granulomatous inflammation as direct kidney manifestation of the disease.

Mass-forming renal Crohn’s disease: a case report with multimodality imaging

“… 5 – 9 Renal granulomatous inflammation, characteristic of that associated with Crohn’s disease, has been described; however, to our knowledge, there is only one other case report of a discrete renal inflammatory pseudotumour attributed to Crohn’s disease. 4 In this case, histology of the lesion following left nephrectomy was that of nodular granulomatous inflammation, including multinucleated giant cells, eosinophils, epitheloid cells, plasma cells and lymphocyes, typical of the phenotype seen in Crohn’s disease. 4 …”

“… 4 In this case, histology of the lesion following left nephrectomy was that of nodular granulomatous inflammation, including multinucleated giant cells, eosinophils, epitheloid cells, plasma cells and lymphocyes, typical of the phenotype seen in Crohn’s disease. 4 …”

“…Mass-forming granulomatous inflammation in extraintestinal organs is extremely rare, with only a few recent reports of patients with Crohn’s disease presenting with inflammatory pseudotumours in the liver, pancreas and kidneys. 2 – 4 We present a case of mass-forming renal granulomatous inflammation in a patient with Crohn’s disease. A 31-year-old female was diagnosed with Crohn’s disease based on characteristic clinical features, and colonoscopy and histology of small and large bowel demonstrating non-caseating granulomas.…”