Histology in CD

CE / CME

Interactive Case Challenge 3: Evolving Role of Histology in Crohn’s Disease Management 

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Nurse Practitioners/Nurses: 0.50 Nursing contact hour

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

ABIM MOC: maximum of 0.50 Medical Knowledge MOC point

Released: March 18, 2025

Expiration: March 17, 2026

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

A 38-year-old man with a history of moderate to severe Crohn’s disease (CD) presents for follow-up after 6 months of treatment following a loss of response to his previous therapy. He reports mild, intermittent abdominal pain but no diarrhea, weight loss, or fever. His C-reactive protein (CRP) is 4 mg/L and fecal calprotectin is 120 µg/g. A recent colonoscopy shows near-complete mucosal healing (Simple Endoscopic Score for Crohn’s Disease [SES-CD] improved from 10 to 2), but histologic evaluation reveals persistent crypt architectural distortion and mild neutrophilic infiltration in the lamina propria.  

How should histologic findings influence the next step in this patient’s management?