An eight year old boy had abdominal pain, fever with bloody diarrhea for 18 months. His height is 100 ems and weight is 14.5kg. Stool culture was negative for known enteropathogens. The sigmoidoscopy was normal. During the same period, child had an episode of renal colic and passed urinary gravel. The mantoux test was 5 x 5 mm. The most probable diagnosis is -

Ans. is 'b' i.e., Crohn's disease See each option one by one. Option a o In this child sigmoidoscopy is normal. o Ulcerative colitis almost always sta from rectum. So, sigmoidoscopy is not normal in UC. Option b o All the given clinical features of this child can occur in CD. Renal colic is due to renal stone. Option c Montoux is negative. o In a child less than 2 years of age montoux is strongly positive if the child has tubercular infection. Option d Stool culture is negative for enteropathogens. So, strongyloidosis is excluded.