Abstract
A 52-year-old woman presented at our hospital with cramping abdominal pain associated with bloody diarrhea. Laboratory data revealed leukocytosis, elevated serum CRP level, microcytic anemia and hypoproteinemia. Upper GI endoscopy revealed esophageal superficial aphthous ulcers while lower GI endoscopy revealed active colitis with longitudinal apthous ulcers extending from rectum through to sigmoid colon. Histological examination of biopsy specimens taken from both esophagus and sigmoid colon showed non-caseating epithelioid cell granuloma. A diagnosis of Crohn’s disease with esophageal lesions was determined, and treatment was initiated with mesalazine (3,000 mg/day) and nutritional support for 4 weeks. Despite treatment compliance, endoscopic examinations at this time showed slight worsening of mucosal lesions, hence infliximab was started at a dose of 5mg/kg/8 weeks. Endoscopy performed a year after infliximab therapy commenced demonstrated ulcer scars and the patient had no symptoms for more than a year.
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