The first case of a child with gastroduodenal Crohn's disease and no other intestinal lesions is described. She presented with persistent anaemia and failure to thrive. There was megaloblastosis due to B12 deficiency secondary to absent intrinsic factor. The diagnosis was delayed for nearly 3 years andthen treatment with steroids and azathioprine resulted in rapid clinical improvement. The diagnostic possibility of Crohn's disease in unusual sites should be considered in any child with unexplained failure to thrive.
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