Multiple Aseptic Liver Abscesses as the Initial Manifestation of Crohn's Disease: Report of a Case

• Published in: Diseases of the colon & rectum Vol. 52; no. 2; pp. 343 - 345
• Main Authors: Zakout, Raed, Fonseca, Marina, Santos, João Meneses, Marques, António, Távora, Isabel, Oliveira, Emília, Ferreira, Carlos, Victorino, Rui M. M
• Format: Journal Article
• Language: English
• Published: Hagerstown, MDc The ASCRS 01.02.2009; Lippincott Williams & Wilkins
• Subjects: Adult; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Crohn Disease - complications; Crohn Disease - diagnosis; Female; Gastroenterology. Liver. Pancreas. Abdomen; Human bacterial diseases; Humans; Infectious diseases; Liver Abscess - complications; Medical sciences; Other diseases. Semiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Human; Multiple; Hepatic disease; Crohn's disease; Inflammatory disease; Lymphocyte homing receptors; Case study; Crohn disease; Gastroenterology; Digestive diseases; Intestinal disease; Liver abscess; Extraintestinal manifestation; Lymphocyte; Aseptic liver abscess; Neutrophilic disease
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/DCR.0b013e318199db60

Aseptic liver abscesses preceding the diagnosis of Crohn's disease are extremely rare. We report a patient with multiple liver abscesses that yielded negative microbiologic investigation and failed to develop full remission under antibiotic therapy. Diagnosis of Crohn's disease of small and large bowel was later established and she was started on sulfasalazine and azathioprine with total regression of the hepatic abscesses. This case illustrates the rare possibility of aseptic liver abscesses as an initial manifestation of Crohn's disease, which could be interpreted in the light of recent data on aberrant homing of gut T memory/effector lymphocytes in the liver.