Crohn's disease mimicking as bowel endometriosis. Are the symptoms reduced by nafarelin acetate?

Atsunori Nakao, Hiromi Iwagaki, Taiichiro Kanagawa, Atsushi Jikuhara, Nagahide Matsubara, Norihisa Takakura, Hiroshi Isozaki, Noriaki Tanaka

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Abstract

We report a 27-year-old female with Crohn's disease clinically misdiagnosed with intestinal endometriosis. Her complaints were abdominal pain and fullness, which occurred monthly during her menstual period. Although we had no histopathological evidence, we diagnosed her as bowel endometriosis on the basis of her clinical course. Since nafarelin acetate therapy started, the symptoms due to mechanical subileus have improved. The transverse colon, a 70 cm segment of the ileum, including the terminal ileum, were resected because of repeated symptoms of bowel obstruction despite prolonged nafarelin therapy. Histopathological findings of the resected specimen revealed Crohn's disease without endometrial tissue. In our patient, an increased cortisol and ACTH secretion, a side effect of nafarelin, was noted during the therapy. This case showed that nafarelin therapy could increase serum concentration of ACTH and cortisol, which was considered to suppress the pathology of Crohn's disease by its anti-inflammatory action. We emphasize that intestinal examination must be performed with Crohn's disease in mind, even if nafarelin acetate is effective.

Original languageEnglish
Pages (from-to)131-133
Number of pages3
JournalArchives of Gynecology and Obstetrics
Volume263
Issue number3
DOIs
Publication statusPublished - Feb 2000

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Keywords

  • Bowel endometriosis
  • Crohn's disease
  • Nafarelin acetate

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Nakao, A., Iwagaki, H., Kanagawa, T., Jikuhara, A., Matsubara, N., Takakura, N., Isozaki, H., & Tanaka, N. (2000). Crohn's disease mimicking as bowel endometriosis. Are the symptoms reduced by nafarelin acetate? Archives of Gynecology and Obstetrics, 263(3), 131-133. https://doi.org/10.1007/s004040050011