Leukocytoclastic Vasculitis and Myositis as Initial Manifestations of Crohn's Disease

Crohn's disease is a chronic inflammatory condition that mainly affects the digestive tract; however, it possesses extra-intestinal manifestations. We present a case of a 19-year-old male with a history of non-specific gastrointestinal (GI) symptoms of nausea, vomiting, and diarrhea who underwent a colonoscopy with a biopsy due to worsening GI symptoms. The colonoscopy was inconclusive for GI pathology. Three months later, he developed several symptoms, which were later indicative of leukocytoclastic vasculitis and myositis as extra-intestinal manifestations of Crohn's disease. The patient was started on high-dose prednisolone, which improved his symptoms remarkably, and the steroid dose was tapered gradually. He was subsequently followed up by the Rheumatology and Gastroenterology outpatient departments. The case reinforces the need for physicians to have a high index of suspicion in patients with non-specific GI symptoms presenting with new-onset cutaneous manifestations and myositis.