TNF and Cowden disease: Crohn’s disease (CD) is a chronic inflammatory bowel disease.1 Despite advances in the management of CD, a significant proportion of patients do not achieve acceptable disease control with conventional therapies, such as corticosteroids, immunomodulators, and anti-tumour necrosis factor (TNF) agents.2-4 Anti-TNF agents, such as infliximab and adalimumab, have become a cornerstone of CD treatment, and have demonstrated significant efficacy in both inducing the remission and its maintenance in patients with moderate to severe CD.5,6