Renal amyloidosis as initial clinical manifestation of Crohn's disease

We present a 20-year-old man with oligosymptomatic Crohn's disease of the terminal ileum complicated by chronic renal insufficiency due to secondary amyloidosis. Definitive diagnosis of Crohn's disease was established 7 years after the onset of the renal disease as a result of symptoms of intestinal obstruction requiring surgery. The affected colonic segment was removed and histopathological examination of the surgical specimen confirmed the diagnosis of Crohn's disease without identifying intestinal amyloidosis. Despite the surgical intervention and the absence of recurrence of inflammatory bowel disease, renal insufficiency steadily progressed, and the patient required kidney transplantation. The patient's subsequent course was excellent and no recurrence of intestinal or renal disease was observed after 8 years of follow-up.