CD40 and Cowden disease: The involvement of the CD40/CD40L platelet complex in the development of inflammatory bowel disease has been overwhelmingly demonstrated,[9] and the activation of platelet hyperactivity in active CD through the ROS-NLRP3 inflammasome-interleukin-1 β axis was reported recently.[10] However, no physician integrated his past medical history with laboratory tests, and associated with the possibility of CD; therefore, no further examination was conducted for 7 years.