Crohn's disease — MRCPCH FOP MCQ

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HardGastroenterologyCrohn's diseaseMRCPCH FOP

A 13-year-old boy has three months of abdominal pain, loose stools and weight loss. He has mouth ulcers, perianal skin tags, raised CRP and low albumin. What is the most likely diagnosis?

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Correct answer: D — Crohn's disease

Chronic diarrhoea, weight loss, systemic inflammation, hypoalbuminaemia and perianal disease suggest Crohn's disease. Irritable bowel syndrome should not cause raised inflammatory markers or low albumin. Ulcerative colitis can cause bloody diarrhoea but perianal disease and mouth ulcers favour Crohn's. The pearl is that growth and nutrition are central disease markers in paediatric IBD.

Reference: NICE NG129 Crohn's disease; BSPGHAN IBD guidance