A 59-year-old female smoker diagnosed with ileocolic CD four years ago. The patient was stable under maintenance treatment with azathioprine. Clinically, she experienced only mild, self-limiting episodes of abdominal pain. The control laboratory tests showed sustained C-reactive protein elevation (20 mg/l). Colonoscopy was thus decided.
The histological findings of the samples obtained indicated Crohn's disease with acute and chronic inflammatory changes. MRE revealed a stricture of inflammatory appearance, with high degree of activity. In agreement with the patient, treatment was started with adalimumab, followed by disappearance of the symptoms and normalization of the laboratory test parameters. Endoscopic control was performed after 6 months of treatment.