Radiolucent foreign bodies presenting as inflammatory bowel disease: the case of an ingested plastic straw disguising as Crohn's.

More than 80% of ingested foreign bodies are thought to pass spontaneously in the faeces, with fewer than 1% requiring surgical intervention. 'Missed' gastrointestinal foreign bodies are rare and often due to the lack of an obtainable history in patients with communication difficulties or radiolucent foreign bodies. We present the rare case of a 27-year-old woman with severe learning difficulties and a complex surgical history who presented with a 2-year history of increasing abdominal discomfort due to a 'missed' foreign body. Initially diagnosed as Crohn's disease, this case highlights the value of oral contrast enhancement imaging in patients who do not fit a 'classical' inflammatory bowel disease presentation.

Vasculitis and glomerulonephritis: a subgroup with an antineutrophil cytoplasmic antibody.

Four subjects whose plasma produced positive staining of neutrophil cytoplasm, on testing for antinuclear factor, have been found over eight years (and over 10,000 antinuclear factor studies). All four had evidence of diffuse systemic disease with polyarthralgia and lung involvement. Three of four (at least) had evidence of renal involvement and two of four skin biopsy evidence of vasculitis. Defining such a subgroup may help in defining etiology(s) and treatment regimes in diffuse vasculitic disease.