Splenic abscess as the first manifestation of Crohn's disease

Calzado, Sònia; Navarro, María Pleguezuelo; Puig, Ignasi; Font, Bernat

doi:10.1016/j.crohns.2010.09.002

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…Among the wide range of manifestations, musculoskeletal and dermatologic systems are the most commonly affected, although the involvement of the hepato-pancreato-biliary system (e.g., primary sclerosing cholangitis) and the ocular, renal, and pulmonary systems have also been described [11, 12]. Albeit Crohn’s extra-intestinal aseptic abscesses are well known and often described, in a literature search of the PUBMED database, only three papers reporting single cases of splenic abscesses as a first manifestation of disease, before the onset of clinically evident gastrointestinal manifestations were found [13–15]. In addition, a fourth paper from the “French Study Group on Aseptic Abscesses” describes 21 cases of aseptic splenic abscesses associated with IBDs, including 7 cases arisen before an IBD diagnosis was formulated [5].…”

Section: Discussionmentioning

confidence: 99%

Splenic abscesses as a first manifestation of Crohn’s disease: a case report

et al. 2019

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Background Splenic nodules are uncommon entities that occur rarely in the general population. Although an infectious etiology (primarily bacteria, followed by mycobacteria) is usually found, noninfectious diseases, including malignancies and autoimmune disorders, can also be involved. For instance, in course of inflammatory bowel diseases (IBDs), in particular Crohn’s Disease, aseptic splenic abscesses have been reported in patients with a long history of illness, or in those unresponsive to medical treatments, while are only anecdotally reported in the early phase of the disease. Hence, we presented the case of aseptic splenic nodules as a first manifestation of Crohn’s Disease. Case presentation A 21-year-old woman with a silent medical history was admitted to the Emergency Department of our hospital complaining of fever of 38–39 °C (mainly in the evening) for the past 10 days and left flank abdominal pain, accompanied by sweating and fatigue. An abdominal computed tomography showed multiple splenic nodules of unknown origin. Because of the absence of clinical improvement after several antibiotic therapiesand a positron emission tomography (PET) with hypercaptation strictly localized to spleen, she underwent splenectomy, in suspicion of lymphoma. For persistence of symptoms after splenectomy, she underwent many instrumental examination, including a colonoscopy with bowel and intestinal biopsies that poses diagnosis of Crohn’s disease. A second PET confirmed this diagnosis showing this time also the gastrointestinal involvement. Conclusion An unusual onset of Crohn’s disease with multiple splenic nodules is reported. This case suggests that in light of splenic nodules of unknown etiology attention should be paid to all possible diagnoses of aseptic abscesses, including IBDs (primarily Crohn’s Disease).

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Section: Discussionmentioning

confidence: 99%

Splenic abscesses as a first manifestation of Crohn’s disease: a case report

et al. 2019

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“…PubMed and OVID were searched for the current English literature using the following keywords: splenic abscess, IBD, Crohn's disease, and aseptic splenic abscess. The search revealed case reports and case series with a variable number of patients, ranging from 1 to 287 [ 1 , 6 , 13 – 20 ]. Splenic abscesses are uncommon and, based on autopsy reviews, the incidence between 0.14 and 0.7% has been reported [ 1 , 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…He experienced recurring splenic abscesses unresponsive to antibiotic therapy and had a negative workup for infections, malignancies, lymphoproliferative processes, and immunodeficiencies. Crohn's disease was eventually diagnosed after an enteroscopy with biopsy demonstrated cryptitis, inflammatory cellularity in the lamina propria, and epithelioid granuloma consistent with Crohn's disease [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Aseptic Splenic Abscess as Precursory Extraintestinal Manifestation of Inflammatory Bowel Disease

Brooks

Ghaffari

2014

Case Reports in Medicine

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Splenic abscesses are most often secondary to aerobic bacterial infections due to Streptococcus, Staphylococcus, and Enterococcus species of organisms. Sterile splenic abscesses rarely occur and diagnosis and treatment of those are challenging. We report a case of a previously healthy young female presenting with aseptic splenic abscesses as the initial manifestation of Crohn's disease along with a review of the literature on aseptic splenic abscess as an extraintestinal manifestation of Crohn's disease.

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“…MASA syndrome is a systemic disorder of unknown aetiology involving polymorphonuclear neutrophils 3. MASA syndrome is either associated with another disease, mainly Crohn's disease4 of which it may precede its diagnosis5 6 or polychondritis or is idiopathic. Antibiotics fail to achieve cure but there is a marked and fast improvement with corticosteroids.…”

Section: Answermentioning

confidence: 99%