[Extra-intestinal manifestations associated with Crohn's disease]. / Extra-intestinale uitingen van inflammatoire darmziekte.

Extra-intestinal manifestations (EIM) associated with Crohn's disease (CD) are frequently observed and can manifest as either the initial symptom or develop later in the disease course following gastrointestinal symptoms. The most common EIM affect the joints, skin, or eyes, with some correlating with active CD activity while others may occur during periods of inactivity. EIM can affect both pediatric and adult CD patients, potentially reducing their quality of life if not promptly identified and treated. Thus, emphasizing the prevalence and clinical presentation is essential to initiate appropriate diagnostic assessments and effectively treat both EIM and the underlying CD. In this case series, we present two pediatric and one adult case where EIM preceded CD diagnosis, resulting in delayed CD diagnosis. Additionally, we outline the most prevalent EIM, their epidemiology, and associated symptoms.

[An infant with prolonged jaundice]. / Een zuigeling met persisterende icterus.

BACKGROUND: In every neonate presenting with prolonged jaundice persisting beyond day 21 of life, neonatal cholestasis should always be excluded even if the infant is breast fed. Pale stools are an alarm symptom and additional tests for neonatal cholestasis should be carried out directly. CASE DESCRIPTION: We describe the case of a five-week-old girl of Chilean origin who was referred with conjugated hyperbilirubinaemia. The jaundice had possibly arisen directly after birth, but due to the dark skin colour of the neonate the jaundice was not recognized as such, although her scleras were yellow. According to the stool colour card, her stools were pale. The findings of a histological examination of a liver biopsy confirmed the diagnosis of biliary atresia, for which a Kasai hepatoportoenterostomy was performed. CONCLUSION: Neonatal cholestasis is always pathological and requires further investigation. In infants with dark skin, jaundice is sometimes difficult to see and inspection of the scleras should give the definitive answer.