Terlato M, Gao W, Pillay L, Williams D, Segal JP, Macrae F, Christensen B. Renal granuloma as an extraintestinal manifestation in Crohn’s disease: A case report. World J Clin Cases 2026; 14(10): 118527 [DOI: 10.12998/wjcc.v14.i10.118527]
Corresponding Author of This Article
Leshni Pillay, MD, Consultant, Doctorate Student, FRACP, Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, 300 Grattan Street, Melbourne 3050, Victoria, Australia. leshni.pillay@mh.org.au
Research Domain of This Article
Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Apr 6, 2026 (publication date) through Apr 5, 2026
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Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Terlato M, Gao W, Pillay L, Williams D, Segal JP, Macrae F, Christensen B. Renal granuloma as an extraintestinal manifestation in Crohn’s disease: A case report. World J Clin Cases 2026; 14(10): 118527 [DOI: 10.12998/wjcc.v14.i10.118527]
Renal granuloma as an extraintestinal manifestation in Crohn’s disease: A case report
Maddison Terlato, Weilun Gao, Leshni Pillay, David Williams, Jonathan P Segal, Finlay Macrae, Britt Christensen
Maddison Terlato, Weilun Gao, Leshni Pillay, Jonathan P Segal, Finlay Macrae, Britt Christensen, Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Melbourne 3050, Victoria, Australia
David Williams, Department of Anatomical Pathology, Austin Health, Melbourne 3084, Victoria, Australia
Jonathan P Segal, Finlay Macrae, Britt Christensen, Department of Medicine, University of Melbourne, Melbourne 3052, Victoria, Australia
Co-first authors: Maddison Terlato and Weilun Gao.
Author contributions: Terlato M, Gao W, Pillay L, Williams D, Segal JP, Macrae F, and Christensen B contributed to conceptualization, writing - review and editing; Terlato M, Gao W, and Pillay L contributed to investigation; data curation; formal analysis; writing - original draft; Williams D contributed to resources (histopathology expertise); Williams D, Segal JP, Macrae F, and Christensen B contributed to supervision; Terlato M and Gao W contributed equally to this manuscript and are co-first authors.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Leshni Pillay, MD, Consultant, Doctorate Student, FRACP, Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, 300 Grattan Street, Melbourne 3050, Victoria, Australia. leshni.pillay@mh.org.au
Received: January 13, 2026 Revised: February 3, 2026 Accepted: March 9, 2026 Published online: April 6, 2026 Processing time: 87 Days and 22.1 Hours
Abstract
BACKGROUND
Crohn’s disease (CD) is a chronic inflammatory bowel disorder characterized by transmural inflammation and granuloma formation. Extraintestinal manifestations are well-recognized but renal granulomatous involvement remains exceedingly rare, with limited reports in the literature.
CASE SUMMARY
We describe an 18-year-old male with Crohn’s colitis who concurrently presented with renal impairment. Renal biopsy revealed acute interstitial nephritis with a single non-necrotizing granuloma. Initial steroid therapy led to partial improvement in gastrointestinal and renal parameters; however, relapse occurred upon tapering. Subsequent induction and maintenance therapy with infliximab resulted in sustained clinical, endoscopic, and biochemical remission, including resolution of pyuria and normalization of renal function.
CONCLUSION
This case highlights a rare presentation of Crohn’s-related renal granuloma successfully managed with infliximab monotherapy following corticosteroid induction. It underscores the importance of recognizing renal granuloma as a potential extraintestinal manifestation of CD and demonstrates that targeted Crohn’s therapy can result in both intestinal and renal recovery. Our findings add to the sparse literature supporting anti-tumor necrosis factor agents as an effective, steroid-sparing treatment in this context.
Core Tip: Renal granulomatous inflammation is an exceedingly rare extraintestinal manifestation of Crohn’s disease (CD) and lacks established management guidelines. We report a biopsy-confirmed case of CD-associated renal granuloma with interstitial nephritis demonstrating sustained renal and intestinal response to infliximab therapy. This case underscores the importance of considering immune-mediated renal involvement in CD and suggests that disease-targeted biologic therapy may represent an effective treatment approach for this rare manifestation.
