A 21-year-old woman presented at our hospital with recurrent fever and abdominal pain. Due to this, the patient has been hospitalised over 100 times. Initially, she was diagnosed with tuberculous peritonitis, yet showed poor response to antituberculosis medication. Besides, exploratory laparotomy at age 5 years revealed no evidence of tuberculosis. Further treatment for Crohn’s disease with infliximab for 6 months also presented no significant improvement. The symptoms persistently recurred with glucocorticoid and immunosuppressive treatment despite momentary relief. One year prior current hospitalisation, the patient endured an acute intestinal perforation, and abdominal pain recurred 3 weeks before. In her family, her elder brother died as a neonate for unknown reasons. Large patches of brown pigmentation were examined on her back (figure 1A). Laboratory evaluation revealed notable increases in inflammatory indicators, and haemoglobin was 95 g/L. CT scan and colonoscopy showed extensive intestinal lesions (figure 1B-D). …

中文翻译：

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复发性肠道溃疡和穿孔并发色素沉着


一名 21 岁女性因反复发热和腹痛在我们医院就诊。因此，该患者已住院 100 多次。最初，她被诊断出患有结核性腹膜炎，但对抗结核药物反应不佳。此外，5 岁时的剖腹探查术未发现结核病的证据。用英夫利昔单抗进一步治疗克罗恩病 6 个月也没有显著改善。尽管暂时缓解，但糖皮质激素和免疫抑制治疗后症状持续复发。在当前住院前 1 年，患者患有急性肠穿孔，3 周前腹痛复发。在她的家人中，她的哥哥在新生儿时因不明原因去世。检查了她背部的大块棕色色素沉着（图 1A）。实验室评估显示炎症指标显着增加，血红蛋白为 95 g/L。CT 扫描和结肠镜检查显示广泛的肠道病变 （图 1B-D）。…