Oropharyngeal and proximal esophageal involvement during adalimumab treatment of Crohn disease.

摘要

Esophageal involvement is an uncommon but increasingly recognized complication of Crohn disease (CD). The reported prevalence of esophageal CD is variable in both the pediatric and adult populations. In adults, underestimation of its diagnosis may be partly related to reliance on visual endoscopic evidence as the sole criterion for identification of esophageal disease (1). Variability of reported pediatric prevalence data may be a consequence, at least in part, of differences in clinician-determined criteria for performing upper gastrointestinal tract endoscopic examinations in children without upper tract symptoms. In the case presented herein, we report an adolescent patient with known ileocolonic CD in clinical remission, who developed oropharyngeal and proximal esophageal disease during maintenance treatment with adalimumab. To our knowledge, this represents the first case report of esophageal CD occurring both during adalimumab treatment, as well as in the absence of lower gastrointestinal tract symptoms.