A cause of recurrent iron deficiency anemia: An atypical presentation of crohn's disease: Case report

Copyright © 2014 by Türkiye Klinikleri.A 17-year-old male patient with recurrent iron deficiency anemia for 3-4 years presented to our hospital for advanced medical evaluation. The physical examination of the patient was normal other than skin and mucosal paleness with no clinical findings suggestive of Crohn's disease, such as diarrhea, abdominal pain, and growth retardation. The cause of the iron deficiency anemia could not be explained with hematological, serological, and conventional endoscopic (upper and lower gastrointestinal endoscopy) studies. Oral and parenteral treatments with iron resulted in transient improvement. A capsule endoscopy was performed to detect a possible small bowel lesion. Endoscopic and pathologic findings were in accordance with Crohn's disease. The ulcerated area of the small bowel was resected due to a recurrent iron deficiency anemia after a year of medical treatment with Mesalamine/Pentasa and Budesonide. The patient had no complaints afterwards without a recurrent iron deficiency anemia. This case indicates that, whenever the cause of an iron deficiency anemia is not clear with hematological and serological studies and with conventional endoscopy (upper and lower gastrointestinal endoscopy), lesions of the small bowel should also be investigated.