Case 13

Submitted by Sabina Ali, MD

12-year-old male presents with a 1-year history of intermittent lower abdominal pain and loose stools. He has not yet started puberty; he is short compared to his peers. He has had weight loss over the past 2 years and has not grown in height. Family history is notable for an uncle with psoriasis. On physical exam, he is noted to have 2 large anal skin tags.

Which of the following are red flags for a diagnosis of IBD? (select all that apply)
Chronic Otitis Media
Oral apthous ulcers
Growth Failure
Large Perianal Skin Tags
Painful skin rash on lower extremities
Which of the following work up would you consider as part of further evaluation?
Complete blood count, Metabolic panel, CRP
Fecal Calprotectin
Upper Endoscopy and Colonoscopy
Cross sectional imaging
Lactose Breath Test
Food Allergy Panel