Keep an eye out for crohn’s disease: Orbital myositis as the initial sign before gastrointestinal manifestations

Abstract

Extraintestinal manifestations of Crohn's disease sometimes occur and can present prior to intestinal symptoms. Ocular manifestations of Crohn's disease are considered rare, with orbital myositis an even rarer manifestation with only a handful of cases reported in the literature. We present the case of a young woman who was diagnosed with orbital myositis, which was initially attributed to pseudotumor cerebri after an extensive negative work-up. Months later, the patient presented with haematochezia, and was subsequently diagnosed with Crohn's disease. LEARNING POINTS • Orbital myositis is a rare manifestation of inflammatory bowel disease (IBD), and even more rarely is the initial presentation before the development of intestinal luminal disease. • Orbital myositis is a rare extraintestinal manifestation of Crohn’s disease and mimics thyroid ophthalmopathy. When a thyroid function test is negative, it is important to keep IBD in mind.