A case study of a patient with Crohn’s disease complicated by paroxysmal nocturnal hemoglobinuria (PNH) mimicking recurrent intestinal ischemia has been published in Gastroenterology Nursing.
A 37-year-old man presented with a 6-month history of progressive, lower right quadrant abdominal pain. The patient revealed a 7-year history of PNH, of which recurrent abdominal pain and the passing of dark urine were common features.
A succession of imaging studies revealed a number of pertinent findings. A computed tomography scan revealed parietal thickening and fistula of the right colon as well as an abdominal abscess with psoas and iliacus muscle involvement. Invasive imaging studies, including colonoscopy, revealed multiple ulcers and pseudopolyps in the right colon. A laparoscopic right hemicolectomy was performed.
“Postoperative pathology found transmural and discrete ulcerations, neutrophil infiltration with features of crypt abscess, and the formation of pseudopolyps, which was compatible with Crohn’s disease,” the authors of the study reported.
Read more about PNH etiology
According to the authors of the study, this is the first known case of a diagnosis of PNH following complications arising from Crohn’s disease.
The conditions are easily misdiagnosed one condition for the other. For example, complications of intestinal ischemia are sometimes misdiagnosed as Crohn’s disease, which inevitably results in failure to respond to treatment. A thorough diagnosis of Crohn’s disease relies heavily on evidence retrieved from additional clinical, endoscopic, and histological findings.
The exact relationship between PNH and Crohn’s disease remains to be fully elucidated.
Huang Q, Jiang X, Jiang B. A rare case of Crohn disease complicated with paroxysmal nocturnal hemoglobinuria mimicking recurrent intestinal ischemia. Gastroenterol Nurs. 2023;10.1097/SGA.0000000000000701. doi:10.1097/SGA.0000000000000701