{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:14:25Z","timestamp":1762474465760,"version":"build-2065373602"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":276,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>\n                    <jats:italic>Introduction<\/jats:italic>\n                    . Differentiating Crohn\u2019s disease (CD) and Beh\u00e7et\u2019s disease (BD) with gastrointestinal (GI) manifestations can be clinically challenging, as current diagnostic criteria are not clear between both conditions and multiple symptoms could overlap.\n                    <jats:italic>Case Presentation<\/jats:italic>\n                    . The patient is an 8\u2010year\u2010old boy of Brazilian descent, who initially presented with a 1\u2010year history of painful oral ulcers. Before presenting to the hospital, he had been treated for periodic fever, aphthous stomatitis, pharyngitis, and adenitis and placed on steroids, with relapsing symptoms on attempts to wean the doses. The initial workup was largely unremarkable. Buccal biopsies showed no granulomas, and the ophthalmologic exam was normal. Infectious and rheumatological tests were negative. Prometheus IBD sgi testing showed a pattern consistent with CD; however, the patient had multiple negative endoscopies, colonoscopies, and capsule endoscopies. He developed intermittent bloody stools and severe malnutrition and did not respond to infliximab, colchicine, or methotrexate. After a large GI bleed, a 4th colonoscopy was performed, which showed large round ulcers in the terminal ileum, and no granulomas. He was started on ustekinumab with clinical improvement. One month later, he developed bilateral hip effusion and meningismus, being diagnosed with aseptic meningitis secondary to COVID\u201019. He improved, but in one month developed worsening symptoms, and MRV showed extensive venous sinus thrombosis. The patient was started on enoxaparin, methylprednisolone, and colchicine, with resolution of the thrombus on a 3\u2010month follow\u2010up. The patient\u2019s overall symptoms remained controlled with clinical and biochemical remission on monthly ustekinumab.\n                    <jats:italic>Discussion and Conclusion<\/jats:italic>\n                    . Our patient had a challenging clinical course, with nonspecific systemic and intestinal manifestations which proved difficult to differentiate between BD and CD. Given endoscopic findings and the worsening of an auto\u2010inflammatory reaction in the central nervous system after COVID\u201019 in a patient with controlled GI symptoms, the most likely diagnosis is BD.\n                  <\/jats:p>","DOI":"10.1155\/2023\/4705638","type":"journal-article","created":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T15:50:09Z","timestamp":1696434609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Challenging Case of Oral Ulcers and Gastrointestinal Bleeding: Crohn\u2019s or Beh\u00e7et\u2019s Disease"],"prefix":"10.1155","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8316-882X","authenticated-orcid":false,"given":"Marina A. S.","family":"Dantas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Luiza","family":"Graneiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Cavalcante","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina Maria","family":"Felipez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,4]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_9_1_2","DOI":"10.4291\/wjgp.v5.i3.228"},{"doi-asserted-by":"publisher","key":"e_1_2_9_2_2","DOI":"10.1186\/s12969-017-0162-4"},{"doi-asserted-by":"publisher","key":"e_1_2_9_3_2","DOI":"10.1055\/s-0028-1103481"},{"key":"e_1_2_9_4_2","first-page":"904","article-title":"Inflammatory bowel disease and cerebral venous sinus thrombosis","volume":"2","author":"Kupfer S. 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L.","year":"2012","journal-title":"Gastroenterology and Hepatology"}],"container-title":["Case Reports in Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2023\/4705638.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2023\/4705638.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2023\/4705638","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:10:09Z","timestamp":1762474209000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2023\/4705638"}},"subtitle":[],"editor":[{"given":"Nur","family":"Arslan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1155\/2023\/4705638"],"URL":"https:\/\/doi.org\/10.1155\/2023\/4705638","archive":["Portico"],"relation":{},"ISSN":["2090-6803","2090-6811"],"issn-type":[{"type":"print","value":"2090-6803"},{"type":"electronic","value":"2090-6811"}],"subject":[],"published":{"date-parts":[[2023,1]]},"assertion":[{"value":"2022-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"4705638"}}