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BMJ Case Rep. 2010; 2010: bcr0320102809.
Published online Sep 7, 2010. doi:  10.1136/bcr.03.2010.2809
PMCID: PMC3029454
Reminder of important clinical lesson
Gastric ulcers and swollen kidneys: a rare diagnosis complicating Crohn's disease
C Ormerod,1 S Sarkar,2 B Woodcock,3 D White,4 and S Lal5
1Department of Gastroenterology, University Hospital Aintree, Liverpool, UK
2Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK
3Department of Haematology, University Hospital Aintree, Liverpool, UK
4Department of Radiology, University Hospital Aintree, Liverpool UK
5Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK
Correspondence to C Ormerod, clareormerod/at/hotmail.com
Abstract
We present a case of a 48-year-old woman with Crohn's colitis admitted with abdominal pain and fever. She had been started on azathioprine 6 months before presentation and had received three doses of infliximab.
Abdominal CT scan revealed a liver abscess. Azathioprine was stopped and antibiotics started. She was subsequently discharged with follow-up imaging planned.
She presented 3 weeks later with haematemesis. Gastroscopy revealed multiple gastric ulcers. A repeat CT scan showed bilateral renal masses and a renal biopsy was arranged. Gastric and renal biopsies were consistent with B cell lymphoma. Chemotherapy was started and resulted in improvement in CT scan findings as well as ulcer healing.
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