Late onset crohns ileitis-A diagnostic dilemma

Abstract

Crohn's disease may affect individuals across all age groups. Usually, it tends to start at a young age, hence late onset Crohn's disease may be difficult to diagnose. The incidence of late-onset inflammatory bowel disease in the United States is 4 to 8 per 100,000 per year. The incidence of Crohn's disease is more in the United States and Europe and less in Asia and Africa. This makes it more challenging to suspect Crohn's disease in an elderly individual of Indian origin. It may be confused with Irritable bowel syndrome or Intestinal tuberculosis.

Keywords: Crohn’s disease; inflammatory bowel disease; irritable bowel syndrome; late-onset Crohn’s disease.

Figure 1

Mucosal edema.

Figure 2

Ileal ulcers.

Figure 3

Ileal hyperemia.

Figure 4

Mycobacterium tuberculosis PCR report (biopsy specimen from colonoscopy).

Figure 5

Fecal calprotectin report.

Figure 6

Mucosal tissue with superficial erosions of epithelium.

Figure 7

Fissure-like ulceration.

Figure 8

Dense mixed inflammatory cells in lamina propria.