MRCP2-1753

MRCP2-1753

A 35-year-old man with a history of Crohn’s disease presents to the clinic with worsening abdominal pain and bloody diarrhoea. He has undergone multiple surgical procedure in the past for a severe flare-up and now takes 10 mg of prednisolone daily for his condition.
On examination, he appears fatigued and uncomfortable. His abdomen is tender to palpation and there is evidence of inflammation on rectal exam.
Investigations reveal the following:

Haemoglobin (Hb) 90 g/l 130–180 g/l
White cell count (WCC) 12.5 × 109/l 4.0–11.0 × 109/l
Platelets (PLT) 200 × 109/l 150–400 × 109/l
Sodium (Na+) 137 mmol/l 135–145 mmol/l
Potassium (K+) 3.8 mmol/l 3.5–5.0 mmol/l
Creatinine (Cr) 80 µmol/l 50–120 µmol/l
Mean corpuscular volume (MCV) 92 fl 76–98 fl
Erythrocyte sedimentation rate (ESR) 54 mm/hour < 10mm/hour
Thiopurine methyl-transferase (TPMT) Activity normal
What is the most appropriate course of action for this patient?