Home|Journals|Articles by Year|Audio Abstracts


A rare cause of lip swelling

Marta Caldas, Mariana Pedro, Helena Loreto, Catarina Gomes.


A 14-year-old, previously healthy, boy presented with a one-month history of persistent swelling of the lower lip. There were no associated symptoms or identifiable inciting events. Physical examination showed soft and painless swelling of the lower lip, particularly on the left side. Two months later, he presented to consultation with permanent lip swelling, weight loss, abdominal pain and vomiting. Initial bloodwork revealed increased inflammatory markers and calprotectin. Gastro-intestinal endoscopies displayed superficial erosions of the colon and esophagus. Mucosal biopsies showed noncaseating transmural granulomas and lip biopsies revealed giant cell granulomas without necrosis. The diagnosis of orofacial granulomatosis associated with Crohn’s disease was confirmed. The patient was treated with azathioprine and mesalamine, with good response.
Orofacial granulomatosis is a rare disorder characterized by facial or lip swelling and can be related to systemic disease. Crohn’s disease presenting as orofacial granulomatosis is very rare in the pediatric population and it can precede the intestinal symptoms of Crohn Disease by months or years. Therefore, it is important to have a low threshold of suspicion and carry out persistent clinical surveillance for the development of additional signs and symptoms.

Key words: Crohn Disease, Orofacial granulomatosis, Pediatrics

Full-text options

Share this Article

Online Article Submission
• ejmanager.com

ejPort - eJManager.com
Refer & Earn
About BiblioMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Bibliomed are open access articles licensed under Creative Commons Attribution 4.0 International License (CC BY), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.