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Kanwar R. S. Gill, Uma Mahadevan, Infliximab for the Treatment of Metastatic Hepatic and Pulmonary Crohn's Disease, Inflammatory Bowel Diseases, Volume 11, Issue 2, 1 February 2005, Pages 210–212, https://doi.org/10.1097/00054725-200502000-00020
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To the Editor:
Metastatic Crohn's disease (MCD) is defined as granulomatous inflammation in an area that is not contiguous with the gastrointestinal tract in a patient with Crohn's disease (CD). Although there have been rare case reports of isolated pulmonary and hepatic granulomas, there are no reports of simultaneous hepatic and pulmonary MCD. We report a case of a 20-year-old woman with CD who presented with concurrent hepatic and pulmonary lesions, which resolved with infliximab (INF) therapy.
The patient was a 20-year-old African American woman in whom CD had been diagnosed at the age of 11 years and whose condition had been maintained with INF for several years. She stopped therapy with INF secondary to the loss of medical care. Eight months later, she presented to our institution with a 2-month to 3-month history of loose stools, averaging 10 per day, a 10-lb weight loss, nausea, fatigue, and occasional bleeding from the rectum. She also noted occasional arthralgias but denied vomiting, abdominal pain, loss of appetite, fever or chills, tenesmus, rash, jaundice, or any eye symptoms. There was no family history of inflammatory bowel disease (IBD) or colon cancer. The patient smoked 3 cigarettes a day, drank occasional alcohol, and had smoked marijuana in the past. She denied any current recreational or intravenous drug use.
