i'm a nurse working in oncology department of a hospital
i'm talking about 27 years old female patient.
* in 2005 she started suffering from headache, vertigo, palpation and shortness of breath, MCV:61, Hbg 8, WBC and platelets are normal, blood transfusion was given and she was diagnosed as iron deficiency anemia, treated by oral iron supplement.
* then she suffering from massive hematurea and renal colic, admission to urological department, blood transfusion was given due to severe anemia, investigation revealed PUJ stenosis with mild hydronephrosis (systoscopy, IVP, Lt retrograde pyclography C.T.) then Lt Pyoloplasty was done with DJ stent insertion.
* 5 months later she presented with severe anemia and hematurea, new investigation revealed nothing about source of intermittent gross hematurea and chronic microscopic hematurea coagulation profile was normal.
* in egypt, IVP, C.T. were done, no evidence of urological diseases.
* later in 2006 she started suffering from hematemesis, and giagnosed as Upper GIT Bleeding, Gastroscopy was tried to done 4 times but failed due to severe esophageal spasm.
* pt admitted to Hametology department, B12 and folate level were normal, PNH, HBsAg, HCV, ANA, Anti DNA, EMA AB were Negative.
* she treated with iron supplement without improvement.
* high grade fever of unknown origin presented and repeated attacks of Upper GIT bleeding and hematurea.
* new CBC shows hgb: 3.8, hct: 12.6%, MCV: 59, MCH 17.9, MCHC: 30.2, RDW: 29.2, PLT 536, intermettent high temprature reaching 39.5.
Recognize the risks associated with Crohn’s disease.
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