Gut Liver.  2012 Oct;6(4):512-515.

A Case of Acute Myocarditis as the Initial Presentation of Crohn's Disease

Affiliations
  • 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. gicch@cau.ac.kr
  • 2Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea.

Abstract

We experienced a case of acute myocarditis as the initial presentation of Crohn's disease. A 19-year-old woman was admitted with impaired consciousness, shock, and respiratory failure. She had suffered from frequent diarrhea and abdominal pain for several years. Cardiac troponin I and creatine kinase-MB fraction levels were elevated to 5.32 and 16.66 ng/mL, respectively. A 12-lead electrocardiogram showed sinus tachycardia, and a chest radiograph revealed interstitial pulmonary edema. An echocardiogram showed dilated ventricles with akinesia of the basal to apical inferoseptal, anteroseptal, anterior, and inferior left ventricular walls and severely impaired systolic function. Intensive care with inotropic support was effective, and her clinical condition gradually improved. Two weeks later, a colonoscopy revealed ulceration with stenosis in the terminal ileum and multiple aphthous ulcers in the rectum. A biopsy of the rectum revealed non-caseating granulomatous inflammation. She was diagnosed with Crohn's disease presenting with acute myocarditis.

Keyword

Crohn disease; Myocarditis

MeSH Terms

Abdominal Pain
Biopsy
Colonoscopy
Consciousness
Constriction, Pathologic
Creatine
Crohn Disease
Diarrhea
Electrocardiography
Female
Humans
Ileum
Inflammation
Myocarditis
Pulmonary Edema
Rectum
Respiratory Insufficiency
Shock
Stomatitis, Aphthous
Tachycardia, Sinus
Thorax
Troponin I
Ulcer
Young Adult
Critical Care
Creatine
Troponin I
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