診断に苦慮した口腔病変を伴ったクローン病の１例

refractory oral ulcers

北海道歯学会

北海道歯学雑誌

Crohn’s disease (CD) is a granulomatous inflammatory disorder with no known cause that develops in the gastrointestinal tract. Oral lesions are associated with CD in 4 %- 20 % of cases. These oral lesions typically occur at the same time as intestinal lesions, but can precede intestinal lesions in 30 %- 60 % of cases. We describe a case of CD in a 15- year boy who presented with swollen lips and refractory oral ulceration. He attended our department for a thorough examination after visiting a dentist at a nearby hospital for m ultiple stomatitis. At the initial examination, he exhibited diffuse swelling of the upper lip and multiple intraoral ulcers , which did not improve with steroid ointment. At 1 year after his first visit, he complained of abdominal symptoms and was referred to the Department of Gastroenterology. Upper gastrointestinal endoscopy led to a suspected diagnosis o f CD. Treatment with immunosuppressive drugs was initiated, and the oral lesions improved. The patient is curren tly under medication control. When examining a patient with lip swelling and refractory oral ulcerative lesions, CD should be included as a differential diagnosis. Furthermore, it is important to conduct a thorough medical interview, provide f ollow-up observations, and collaborate with medical specialists for early diagnosis and treatment.