Crohn's disease presenting as protein-losing enteropathy

Abstract

Background: Crohn's disease is one of the major inflammatory bowel diseases, which is described as a transmural inflammation and may involve any portion of the luminal gastrointestinal tract. the patient with protein- losing enteropathy (PLE) will mainly present with peripheral edema and gastrointestinal symptoms of diarrhea, steatorrhea, abdominal pain, bloating, or flatulence. Case Presentation: A 19-year-old Kuwaiti female, medically and surgically free, presenting with 14 days history of bilateral painless leg swelling progressively worsening, reached to the sacral area, associated with facial puffiness and lower limb numbness. The symptoms started 5 months ago when she started having diarrhea once per day, watery with mucous. She reported epigastric pain radiating to the left upper quadrant. She had a history of multiple vomiting since then, unintentional weight loss was noticed, around 10 kg, and amenorrhea for 4 months with regular cycles prior. She was managed and stabilized and admitted to the medical ward. During the admission, she was investigated and diagnosed. The patient was discharged after 12 days of overall hospital stay as a case of inflammatory bowel disease. Conclusion: Although PLE is rare, it is, therefore, important to recognize that these complications can cause initial atypical symptoms of Crohn's disease before finalizing the diagnosis.