While blockade of pro-inflammatory cytokines such as anti-TNF or anti-IL12/23 (Sandborn et al., 2012) represents major mechanisms for treating moderate to severe CD, it is still an open question as to whether management combining pro-inflammatory cytokine blockade (Abraham et al., 2017) with 6-mercaptopurine provides additional benefit (Colombel et al., 2010). Here, TNF is linked to Cowden disease.