Fulminant onset of Crohn's disease of the colon (CDC). An observation of six cases.

Six female patients are described with a fulminant onset of Crohn's's disease involving the whole of the colon. The initial picture resembled that of an acute infectious diarrhea, but rapid clinical deterioration with pronounced weight loss, major anal complications, toxic megacolon, and erythema nodosum necessitated reappraisal of the diagnosis. Extensive endoscopy and multiple biopsies confirmed the diagnosis of pancolitis in all patients. Only one patient needed resection. Recognition of such fulminant onset as a distinct clinical modality in Crohn disease of the colon and starting treatment immediately upon diagnosis is probably important in preventing the development of a critical clinical situation.