Case of the Quarter: Coeliac disease and granulomatous ileocolitis: an association or chance occurrence?

Enteric granulomatous inflammation can be caused by a number of conditions including Crohn’s disease, sarcoidosis, enteric infections, chronic granulomatous disease and also by drug reactions. Granulomas have also been described in microscopic colitis associated with certain medications and autoimmune diseases. The association of granulomatous ileocolitis with coeliac disease is not common. We present a case of coeliac disease with granulomatous ileocolitis with follow-up and repeat histology on a gluten-free diet.

Adolescent inflammatory bowel disease: assessment, treatment and transition

Paediatric inflammatory bowel disease (IBD) most usually evolves during adolescence, a time of great challenge. For the adolescent, the disease should be thoroughly assessed by upper gastrointestinal endoscopy and ileo-colonoscopy, preferably performed under general anaesthetic or conscious sedation, with relevant radiological examination. This will enable the determination of diagnosis, IBD subtype and extent. Growth also needs to be assessed and the effect of disease on academic and social functioning must be explored.

Cytomegalovirus colitis: an unusual cause of diarrhoea in the immunocompetent

Cytomegalovirus (CMV) colitis is rarely reported in the immunocompetent adult and is often associated with inflammatory bowel disease (IBD), particularly ulcerative colitis (UC). An index of suspicion in the appropriate setting is vital to diagnosing the condition. Undiagnosed CMV colitis has a significant morbidity. A review of the natural history and diagnosis of CMV is followed by a discussion of the incidence, outcome and possible treatment of CMV in the immunocompetent patient.

Coeliac disease and granulomatous ileocolitis: an association or chance occurrence?

Enteric granulomatous inflammation can be caused by a number of conditions including Crohn’s disease, sarcoidosis, enteric infections, chronic granulomatous disease and also by drug reactions. Granulomas have also been described in microscopic colitis associated with certain medications and autoimmune diseases. The association of granulomatous ileocolitis with coeliac disease is not common. We present a case of coeliac disease with granulomatous ileocolitis with follow-up and repeat histology on a gluten-free diet.