P55 | Myocarditis and hidradenitis suppurativa as extraintestinal manifestations of chronic inflammatory bowel diseases: a single clinical case

A. Da Rin Bianco¹, E. Lella², A. Cavarape¹ | ¹Dipartimento di Medicina, Università degli Studi di Udine, ²Dipartimento di Medicina, Ospedale Santa Maria della Misericordia di Udine, Italy

Abstract

Premises: Extraintestinal manifestations of inflammatory bowel diseases (IBD) are known and described in the literature; However, among these, myocarditis is rare and often overlooked.
Case study: A 41-year-old man came to our attention following multiple visits to the Emergency Department for abdominal pain due to non-specific colitis, which was unresponsive to antibiotic therapy. Past history of suppurative hidradenitis and oral aphthous ulcers, no pharmacological therapy. Blood tests showed neutrophilic leukocytosis with elevated inflammatory markers. Due to persistent abdominal pain and diarrhea, a colonoscopy was performed, revealing aphthoid ulcers in the colon, histologically confirmed as Crohn's disease. Corticosteroid therapy (methylprednisolone 1mg/kg/day) was initiated, with benefit. Subsequently, the patient developed retrosternal chest pain, radiating to the jaw; During the normal ECG episode, the peak of high-sensitivity Troponin I was 8636 ng/L. Echocardiography showed good biventricular systolic function, and coronary angiography was negative for coronary stenosis. The diagnostic suspicion of myocarditis therefore arose, which was confirmed by magnetic resonance imaging. Excluding infectious and pharmacological causes, the episode was considered an extraintestinal manifestation of IBD.
Conclusions: The peculiarity of this case suggests maintaining a high diagnostic suspicion for the rare extraintestinal manifestations of IBD; Indeed, the timeliness of diagnosis is crucial to avoid potentially fatal cardiovascular complications.