A primary patient with a late diagnosis of Crohn's disease. Clinical observation

Background. Crohn's disease (CD) in childhood and adolescence most often proceeds in severe forms and is often accompanied by complications that significantly impair social adaptation and quality of life not only because of the disease but also as a consequence of surgical interventions. Objective. The report describes a clinical case of a patient 13 years old with Crohn's disease of the small and large intestine diagnosed for the first time at the Department of Gastroenterology, Moscow State Medical and Preventive Dispensary Hospital. Results. Initiation of genetically engineered biological therapy (GЕBT) with the first-line drug Infliximab was indicated. On day 16 of the infusions, echo signs of occlusive thrombosis of the left internal jugular vein were detected. Despite heparin therapy, occlusive thrombosis of the left internal jugular vein and pulmonary embolism (РЕ) developed and the child was transferred to the intensive care unit (ICU) for vital signs. After 7 days in the ICU, the patient was transferred to the gastroenterological department and subsequently discharged home with improvement. Three weeks later, he was hospitalized again for a third infusion of GЕBT and 8 weeks later for a fourth dose of Infliximab. The patient completed the course of treatment with positive dynamics and marked clinical and endoscopic improvements. He was discharged to the outpatient phase of treatment in satisfactory condition with the final diagnosis: "Crohn's disease of the small and large intestine, marked activity, (PCDAI 85) debut. Esophageal candidiasis. Nonspecific reactive hepatitis." The article is of interest for doctors of practical health care in terms of medical education on the problem of inflammatory bowel diseases.

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