Severe Ileitis as the Sole Manifestation of Post-COVID-19 in an Adolescent: A Rare Case Report

Abstract

Inflammatory bowel disease is multifactorial, involving complex interactions between genetic predisposition, environmental factors, and dysregulated immune responses. However, in a rare subset of paediatric patients, a severe post-infectious hyperinflammatory syndrome may arise, termed multisystem inflammatory syndrome in children (MIS-C). Enteritis as the only manifestation of COVID-19 in adolescents without features of multisystem syndrome in children (MIS-C) or a prior history of IBD is presented. The case report of an adolescent patient (an 18-year-old male) presenting to tertiary-care centres in the ACDS United Arab Emirates in August 2022 with severe enteritis as the only manifestation of post COVID-19 (SARS-Cov-2) infection. He had a 6-week’ history of acute onset of severe epigastric and lower abdominal pain, nausea, and one episode of vomiting, loose bowel motion 1-2 times a day, back ache, sore throat, gases and distension, milk intolerance, chest pain. A previously healthy patient after COVID-19 infection was discovered to have severe ileitis associated with gastric helicobacter pylori infection and bilateral kidney stag horn calculi and thyroid nodules that showed Hurthle cell tumour. The patient was treated with budesonide and azathioprine. A positive ANCA and ASCA may point to susceptibility to develop Crohn’s disease triggered by COVID-19 virus. Moreover, awareness is needed to recognise the non-respiratory manifestations of COVID-19 infection.