Granulomas as a Predictor of Disease Recurrence in Crohn's Disease

Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
G Cullen ◽  
A O'Toole ◽  
L Brennan ◽  
JM Hyland ◽  
K Sheahan ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Recurrence

scholarly journals Anastomotic Ulcers After Ileocolic Resection for Crohn’s Disease Are Common and Predict Recurrence

2019 ◽  
Vol 26 (7) ◽  
pp. 1050-1058 ◽  
Author(s):  
Robert P Hirten ◽  
Ryan C Ungaro ◽  
Daniel Castaneda ◽  
Sarah Lopatin ◽  
Bruce E Sands ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Multivariable Analysis ◽  
Disease Recurrence ◽  
Ileocolic Resection ◽  
Anastomotic Ulcer ◽  
Endoscopic Recurrence ◽  
Academic Center ◽  
Endoscopic Remission ◽  
The Impact

Abstract Background Crohn’s disease recurrence after ileocolic resection is common and graded with the Rutgeerts score. There is controversy whether anastomotic ulcers represent disease recurrence and should be included in the grading system. The aim of this study was to determine the impact of anastomotic ulcers on Crohn’s disease recurrence in patients with prior ileocolic resections. Secondary aims included defining the prevalence of anastomotic ulcers, risk factors for development, and their natural history. Methods We conducted a retrospective cohort study of patients undergoing an ileocolic resection between 2008 and 2017 at a large academic center, with a postoperative colonoscopy assessing the neoterminal ileum and ileocolic anastomosis. The primary outcome was disease recurrence defined as endoscopic recurrence (>5 ulcers in the neoterminal ileum) or need for another ileocolic resection among patients with or without an anastomotic ulcer in endoscopic remission. Results One hundred eighty-two subjects with Crohn’s disease and an ileocolic resection were included. Anastomotic ulcers were present in 95 (52.2%) subjects. No factors were associated with anastomotic ulcer development. One hundred eleven patients were in endoscopic remission on the first postoperative colonoscopy. On multivariable analysis, anastomotic ulcers were associated with disease recurrence (adjusted hazard ratio [aHR] 3.64; 95% CI, 1.21–10.95; P = 0.02). Sixty-six subjects with anastomotic ulcers underwent a second colonoscopy, with 31 patients (79.5%) having persistent ulcers independent of medication escalation. Conclusion Anastomotic ulcers occur in over half of Crohn’s disease patients after ileocolic resection. No factors are associated with their development. They are associated with Crohn’s disease recurrence and are persistent.

Post-Operative Crohn's Disease Recurrence is Associated with Specific Changes in the Faecal Microbiome and Potential Pathogenic and Protective Roles

2017 ◽  
Vol 152 (5) ◽  
pp. S991 ◽  
Author(s):  
Amy L. Hamilton ◽  
Michael A. Kamm ◽  
Shu-Mei Teo ◽  
Peter De Cruz ◽  
Emily K. Wright ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Recurrence ◽  
Faecal Microbiome

BactDNA as an Independent Risk Factor for Short-Term Crohn’s Disease Recurrence

2016 ◽  
Vol 111 (10) ◽  
pp. 1500-1501
Author(s):  
Alessandro Sartini ◽  
Maria Chiara Verga ◽  
Luca Marzi ◽  
Nicola De Maria ◽  
Erica Villa
Keyword(s):  
Risk Factor ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Independent Risk Factor ◽  
Disease Recurrence ◽  
Short Term

Small Bowel Crohn’s Disease Recurrence is Common After Total Proctocolectomy for Crohn’s Colitis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Robert H. Hollis ◽  
Nicholas Smith ◽  
Ipek Sapci ◽  
Benjamin Click ◽  
Miguel Regueiro ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Disease Recurrence ◽  
Total Proctocolectomy ◽  
Crohn’S Colitis ◽  
Crohn's Colitis

scholarly journals No Change in Determining Crohn’s Disease Recurrence or Need for Endoscopic or Surgical Intervention With Modification of the Rutgeerts’ Scoring System

2019 ◽  
Vol 17 (8) ◽  
pp. 1643-1645 ◽  
Author(s):  
Pauline Rivière ◽  
Séverine Vermeire ◽  
Marie Irles-Depe ◽  
Gert Van Assche ◽  
Paul Rutgeerts ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Scoring System ◽  
Surgical Intervention ◽  
Disease Recurrence

scholarly journals The Role of Inflammation in Crohn’s Disease Recurrence after Surgical Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
B. Sensi ◽  
L. Siragusa ◽  
C. Efrati ◽  
L. Petagna ◽  
M. Franceschilli ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Immune System ◽  
Crohn's Disease ◽  
Disease Recurrence ◽  
Postoperative Recurrence ◽  
Preventive Strategies ◽  
Mesenteric Lymph Nodes ◽  
Surgical Strategies ◽  
Driving Mechanisms

Introduction. Postoperative recurrence after surgery for Crohn’s disease (CD) is virtually inevitable, and its mechanism is poorly known. Aim. To review the numerous factors involved in CD postoperative recurrence (POR) pathogenesis, focusing on single immune system components as well as the immune system as a whole and highlighting the clinical significance in terms of preventive strategies and future perspectives. Methods. A systematic literature search on CD POR, followed by a review of the main findings. Results. The immune system plays a pivotal role in CD POR, with many different factors involved. Memory T-lymphocytes retained in mesenteric lymph nodes seem to represent the main driving force. New pathophysiology-based preventive strategies in the medical and surgical fields may help reduce POR rates. In particular, surgical strategies have already been developed and are currently under investigation. Conclusions. POR is a complex phenomenon, whose driving mechanisms are gradually being unraveled. New preventive strategies addressing these mechanisms seem promising.

scholarly journals P532 Delay of maintenance infliximab increases the risk of relapse in Crohn’s disease during the COVID-19 pandemic

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S507-S507
Author(s):  
H Guo ◽  
J Tang ◽  
Z Huang ◽  
B Li ◽  
Q Yang ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Delay Interval ◽  
Cumulative Effect ◽  
Disease Recurrence ◽  
Delay Group ◽  
Disease Relapse ◽  
Reactive Protein ◽  
Real World Evidence ◽  
Unusual Situation

Abstract Background Scheduled maintenance infliximab (IFX) therapies were frequently delayed during the COVID-19 pandemic. The unusual situation allowed us to study the influence of decreased treatment adherence on Crohn’s disease (CD). This retrospective study aimed to evaluate the effect of IFX delay on relapse in Crohn’s disease (CD) patients. Methods 166 CD patients with maintenance IFX between January 25, 2020, and April 25, 2020, were retrospectively enrolled. Demographic and clinical characteristics were recorded. Relapse was defined as clinical disease relapse or biochemical disease relapse (C-reactive protein (CRP) level ≥5 mg/L without other, non-IBD related explanation). Associations between relapse and IFX delay were analyzed. Results A retrospective cohort study was conducted, including 166 CD patients receiving maintenance IFX infusion during the COVID-19 pandemic. Of all, 135 (81.3%) had delayed their IFX infusion. Only 31 (18.7%) followed the schedule infusion during the COVID-19 pandemic. The median time of the IFX delay was 18.6±17.1 days. The relapse rate in the IFX-delay group was significantly higher than the group without delay (25.9% versus 5.5%, P＜0.02). During a median IFX delay interval of 46 days (95% CI 20.9–71.1), the ratio of relapse increased with the increase of IFX delay intervals. Delay interval had a cumulative effect on disease recurrence. We proposed interval prolongation resulted in a significant IFX trough concentration reduction. Conclusion Our study provided real-world evidence of influence on relapse of IFX delay in CD patients undergone maintenance therapy. It might help the IBD specialists arrange reasonable IFX treatment intervals for patients.

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