scholarly journals Pediatric Metastatic Crohn's Disease

2021 ◽  
Vol 41 (01) ◽  
pp. 079-082
Author(s):  
Amanda Trindade de Oliveira ◽  
Raissa Albuquerque Calais de Oliveira ◽  
Matheus Matta Machado Duque Estrada Meyer ◽  
Ilson Geraldo da Silva ◽  
Matheus Duarte Massahud
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Skin Lesions ◽  
Rapid Progression ◽  
Colorectal Surgeon ◽  
Transmural Inflammation ◽  
Gastrointestinal Complaints ◽  
Intravenous Steroids ◽  
Metastatic Crohn's Disease

AbstractCrohn's disease (CD) is a chronic, relapsing, idiopathic condition, characterized by granulomatous, transmural inflammation of the gastrointestinal tract, which can affect its entire length, from mouth to anus. Metastatic Crohn's disease (MCD) is a rare form of skin involvement and is defined by skin lesions without contiguity with the gastrointestinal tract. A 9-year-old patient presented with gastrointestinal complaints and gross skin lesions in the vulva and perianal region. The diagnosis of Crohn's disease was made when the patient was 11 years old, after being evaluated by the colorectal surgeon. Treatment was started with a “top-down” approach, with a sustained response for four years. Afterwards, there was a relapse of the skin disease in previously normal areas, without overt symptoms. Treatment consisted of steroids and local infiltration of infliximab, without improvement. A year later, there was a rapid progression of the skin lesions, and the drug changed to adalimumab, also without response and worsening of the skin lesions. The patient was admitted to the hospital and intravenous steroids were initiated, along with surgical debridement of the lesions. After some improvement, ustekinumab was initiated with satisfactory response. Pediatric MCD has an important impact on the patient's quality of life, with influences on growth and social development.

scholarly journals Metastatic Crohn’s Disease: An Approach to an Uncommon but Important Cutaneous Disorder

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Babak Aberumand ◽  
Jessica Howard ◽  
John Howard
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Early Recognition ◽  
Treatment Options ◽  
Age Groups ◽  
Skin Lesions ◽  
Cutaneous Manifestation ◽  
Clinical Approach ◽  
Inflammatory Disorder ◽  
Metastatic Crohn's Disease

Objective. To provide physicians with a clinical approach to metastatic Crohn’s disease (MCD).Main Message. Metastatic Crohn’s disease, defined as skin lesions present in areas noncontiguous with the gastrointestinal tract, is the rarest cutaneous manifestation of Crohn’s disease. MCD lesions vary in morphology and can arise anywhere on the skin. MCD presents equally in both sexes and across age groups. Cutaneous findings may precede, develop concurrently with, or follow gastrointestinal involvement. A detailed history and thorough physical examination including a full-skin exam may help to exclude other dermatoses, as MCD can mimic other common disorders. A biopsy is required for a definitive diagnosis. Treatment options for MCD remain underwhelming due to the lack of randomized control studies and varying responses of reported therapeutic methods. Topical, intralesional, and systemic corticosteroids, antibiotics, traditional immunosuppressants, and surgery have shown mixed results. Recently, biologics have shown promise, even with refractory cases of MCD.Conclusion. MCD is an important cutaneous manifestation of this inflammatory disorder. Although a rare entity, early recognition can provide opportunity for successful therapeutic intervention.

scholarly journals Aphthous stomatitis as the debut of Crohn’s disease

2020 ◽  
pp. 97-100
Author(s):  
O. V. Gaus ◽  
V. A. Akhmedov ◽  
A. S. Korshunov
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Granulomatous Inflammation ◽  
Aphthous Stomatitis ◽  
Systemic Complications ◽  
Immune Mediated ◽  
Transmural Inflammation ◽  
Retromolar Region

Crohn’s disease is an immune-mediated disease characterized by non-specific granulomatous transmural inflammation with segmental damage to any part of the gastrointestinal tract with the formation of extraintestinal and systemic complications. Clinical observation of patient I., 23 years old, a student who was sent for consultation to a gastroenterologist in the direction of a dentist, is presented. Active examination of the gastrointestinal tract during the inspection did not show any complaints. He considers himself ill for 6 months, when he first complained of pain in the neck, sore throat, and body temperature rise to 37.4–37.5 °C, mostly in the evening. Were treated by an otolaryngologist and a dentist without significant effect. In this connection, a biopsy of the ulcerative defect of the left retromolar region was performed, revealing noncaseating granulomatous inflammation. A follow-up examination by a gastroenterologist with colonoscopy and biopsy made it possible to establish Crohn’s disease as the true cause of aphthous stomatitis.

scholarly journals Metastatic Crohn's Disease of the Ear

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
J. H. Chuah ◽  
D. S. Kim ◽  
C. Allen ◽  
L. Hollis
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Rare Case ◽  
Antibody Therapy ◽  
Rare Condition ◽  
Skin Lesions ◽  
Cutaneous Lesions ◽  
Disease Treatment ◽  
Lower Trunk ◽  
Metastatic Crohn's Disease

Objective. We reported a very rare case of metastatic Crohn's disease involving the retro-auricular region.Method. A case report and a review of literature concerning metastatic Crohn's disease.Results. Metastatic Crohn's disease is an uncommon extraintestinal cutaneous manifestation of Crohn's disease and a very rare case involving the retro-auricular region is reported here. Given the limited existing literature little is known about this condition. The skin lesions appear to have a predilection for the lower trunk and genitalia regions. There is no clear association with the severity of Crohn's disease and in some cases, the cutaneous lesions predate the onset of gastrointestinal Crohn's disease. Treatment with immune-modulating medications together with the antitumour necrosis factor monoclonal antibody therapy appears to offer the best chance of remission.Conclusion. By reporting this interesting and rare condition we also hope to highlight the importance of considering underlying chronic systemic disorders, such as Crohn's disease, when presented with skin lesions resistant to simple local treatments.

scholarly journals Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

2021 ◽  
Vol 14 ◽  
pp. 175628482110066
Author(s):  
Rune Wilkens ◽  
Kerri L. Novak ◽  
Christian Maaser ◽  
Remo Panaccione ◽  
Torsten Kucharzik
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Symptom Control ◽  
Current Status ◽  
Clinical Relapse ◽  
Cross Sectional ◽  
Treatment Targets ◽  
Endoscopic Remission ◽  
Transmural Inflammation

Treatment targets of inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn’s disease (CD) have evolved over the last decade. Goals of therapy consisting of symptom control and steroid sparing have shifted to control of disease activity with endoscopic remission being an important endpoint. Unfortunately, this requires ileocolonoscopy, an invasive procedure. Biomarkers [C-reactive protein (CRP) and fecal calprotectin (FCP)] have emerged as surrogates for endoscopic remission and disease activity, but also have limitations. Despite this evolution, we must not lose sight that CD involves transmural inflammation, not fully appreciated with ileocolonoscopy. Therefore, transmural assessment of disease activity by cross-sectional imaging, in particular with magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS), is vital to fully understand disease control. Bowel-wall thickness (BWT) is the cornerstone in assessment of transmural inflammation and BWT normalization, with or without bloodflow normalization, the key element demonstrating resolution of transmural inflammation, namely transmural healing (TH) or transmural remission (TR). In small studies, achievement of TR has been associated with improved long-term clinical outcomes, including reduced hospitalization, surgery, escalation of treatment, and a decrease in clinical relapse over endoscopic remission alone. This review will focus on the existing literature investigating the concept of TR or residual transmural disease and its relation to other existing treatment targets. Current data suggest that TR may be the next logical step in the evolution of treatment targets.

scholarly journals Isolated Duodenal Crohn's Disease: A Case Report and a Review of the Surgical Management

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Faruk Karateke ◽  
Ebru Menekşe ◽  
Koray Das ◽  
Sefa Ozyazici ◽  
Pelin Demirtürk
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Medical Treatment ◽  
Immunosuppressive Therapy ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Surgical Options ◽  
Crohn’S Diseases

Crohn's disease may affect any segment of the gastrointestinal tract; however, isolated duodenal involvement is rather rare. It still remains a complex clinical entity with a controversial management of the disease. Initially, patients with duodenal Crohn' s disease (DCD) are managed with a combination of antiacid and immunosuppressive therapy. However, medical treatment fails in the majority of DCD patients, and surgical intervention is required in case of complicated disease. Options for surgical management of complicated DCD include bypass, resection, or stricturoplasty procedures. In this paper, we reported a 33-year-old male patient, who was diagnosed with isolated duodenal Crohn’s diseases, and reviewed the surgical options in the literature.

scholarly journals Metastatic Crohn's disease of the umbilicus.

BMJ ◽  
1981 ◽  
Vol 283 (6296) ◽  
pp. 887-887 ◽  
Author(s):  
R K Phillips ◽  
G Glazer
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Metastatic Crohn's Disease

scholarly journals Metastatic Crohn’s disease despite infliximab therapy

2017 ◽  
Vol 92 (5 suppl 1) ◽  
pp. 104-106 ◽  
Author(s):  
Sara Campos ◽  
Inês Coutinho ◽  
José Carlos Cardoso ◽  
Francisco Portela
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Infliximab Therapy ◽  
Metastatic Crohn's Disease

Capsule endoscopy in small bowel Crohn’s disease and Tuberculosis

2017 ◽  
Vol 47 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Surinder Singh Rana ◽  
Vishal Sharma ◽  
Ravi Sharma ◽  
Ritambhra Nada ◽  
Rajesh Gupta ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Ileocecal Valve ◽  
Final Diagnosis ◽  
Diagnostic Challenge ◽  
Large N ◽  
Aphthous Ulcers

Differentiation of small bowel tuberculosis (SBTB) from Crohn’s disease (CD) is a diagnostic challenge. We studied 52 patients with suspected SBTB or CD with terminal ileal involvement, who were prospectively enrolled. After confirming patency of the gastrointestinal tract, 26 patients underwent capsule endoscopy (CE). A final diagnosis of CD was found in 18 patients and SBTB in eight patients. All SBTB patients had involvment of the ileocecal valve (ICV) with large (n = 6) and aphthous (n = 2) ulcers in the ileal segment. In CD, ICV involvement was seen in five (33%) patients. Large and aphthous ulcers were observed in seven (47%) and 15 (100%) patients, respectively. On comparison with CD, patients with SBTB had increased frequency of ICV involvement ( P = 0.002) and lesser frequency of aphthous ulcers ( P = 0.007). CE can help in differentiating CD from SBTB by the position of its involvement and the type of ulcers present.

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