A 77-year-old man with chronic iron-deficiency anemia and prior small bowel resection presented with terminal ileal ulcerations suggestive of Crohn’s disease, along with elevated C-reactive protein and markedly increased fecal calprotectin. Medication review revealed chronic meloxicam use. Following discontinuation, his inflammatory markers and anemia normalized, and repeat colonoscopy demonstrated complete resolution of ileal ulcers. This case highlights nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy as an important mimic of Crohn’s disease and emphasizes the importance of thorough medication review and clinical correlation to prevent misdiagnosis and unnecessary immunosuppressive therapy.
Baik et al. (Tue,) studied this question.