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BMJ Case Rep. 2010; 2010: bcr0320102809.
Published online 2010 September 7. 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

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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