scholarly journals Is Crohn’s Disease a Rightly Used Eponym?

2019 ◽  
Vol 14 (6) ◽  
pp. 867-871 ◽  
Author(s):  
Philippe Van Hootegem ◽  
Simon Travis

Abstract In 1932 Burrill B. Crohn, a gastroenterologist at Mount Sinai Hospital in New York City, described, together with two surgical colleagues, a series of 14 patients with an inflammatory condition of the terminal ileum. All patients were operated on by Dr Albert Berg, the Chief Surgeon of the hospital, whose name did not appear on the initial publication. The ‘new’ disease was called ‘regional ileitis’, but was rapidly referred to as ‘Crohn’s disease’. From earlier accounts and publications it has become clear that the condition had already existed for many centuries and was ‘discovered’ several times before 1932, most notably by Giovanni Morgagni in 1769, Antoni Lesniowski in 1903 and Thomas K. Dalziel in 1913. ‘Crohn’s disease’ might reasonably be known by another eponym. Nevertheless, the 1932 publication of Crohn was pivotal, as were his later contributions to the knowledge of ‘his’ disease. Therefore the worldwide use of the eponym is rightly to be continued. Present researchers and clinicians with an interest in inflammatory bowel disease [IBD] might learn from the complicated story summarised in this contribution. Apart from an interesting historical overview, there are some lessons for today: the importance of thorough clinical observation and pattern recognition, the need for communication between colleagues and multidisciplinary approaches, and the need for broad access to valuable data, past or present, regardless of the journal or language of publication. It should ultimately bring us some humility, despite great achievements in treating this chronic disease, which defies all our efforts yet to find a cure.

PEDIATRICS ◽  
1975 ◽  
Vol 55 (6) ◽  
pp. 866-871 ◽  
Author(s):  
Eugene J. Burbige ◽  
Shi-Shung Huang ◽  
Theodore M. Bayless

Crohn's disease (regional enteritis) is a chronic disorder which usually appears in adolescence or early adulthood.1-8 The average age of onset reported in the adult literature is 27 years.9 Although it has not been reported frequently in children, Van Patter et al., found that 14% of 600 patients observed at the Mayo Clinic had an onset of symptoms occurring before the age of 15.10 Rogers et al.,11 utilizing a computerized analysis of their files, found that 21% of 489 patients with the diagnosis of Crohn's disease had the onset before age 15. In fact, the first patient that attracted Dr. Crohn's attention to this entity was a 16-year-old boy.12 Among the patients in the 7 to 15-year-age range at the Mount Sinai Hospital in New York, the maximum incidence was at 10 to 14 years of age.5 The current communication summarizes the clinical features of 58 patients with Crohn's disease of the small intestine and/or of the colon whose disease appeared before they were 15 years of age and emphasizes the prominence of the extra-intestinal manifestations. The mode of presentation of these younger patients was often such that the clinician's attention was diverted from the gastrointestinal tract. PATIENTS STUDIED During a 20-year period (1952 to 1972) at the Johns Hopkins Hospital, 376 patients were discharged with the diagnosis of regional enteritis or Crohn's disease. Forty-eight of them, or 12.7%, were under the age of 15. The diagnosis was based on pathological and/or roentgenographic cnteria. The study group included these 48 patients plus 10 others seen in the outpatient department or at other Baltimore hospitals (Sinai Hospital and the Greater Baltimore Medical Center).


2019 ◽  
Vol 114 (1) ◽  
pp. S382-S383
Author(s):  
Alexandra Feathers ◽  
Gina Lovasi ◽  
Kade Beem ◽  
Zoya Grigoryan ◽  
Samit K. Datta ◽  
...  

1988 ◽  
Vol 27 (03) ◽  
pp. 83-86 ◽  
Author(s):  
B. Briele ◽  
F. Wolf ◽  
H. J. Biersack ◽  
F. F. Knapp ◽  
A. Hotze

A prospective study was initiated to compare the clinically proven results concerning localization/extent and activity of inflammatory bowel diseases with those of 111ln-oxine leukocyte imaging. All patients studied were completely examined with barium enema x-ray, clinical and laboratory investigations, and endoscopy with histopathology. A total of 31 leukocyte scans were performed in 15 patients (12 with Crohn’s disease, 3 with ulcerative colitis). The scans were graded by comparing the cell uptake of a lesion (when present) and a bone marrow area providing a count ratio (CR). The inflammatory lesions were correctly localized on 26 leukocyte scans, and in 21 scans the scintigraphically estimated extent of disease was identical to endoscopy. In 5 cases the disease extent was underestimated, 4 scans in patients with relapse of Crohn’s disease were falsely negative, and in one patient with remission truly negative. The scintigraphically assessed disease activity was also in a good agreement with clinical disease activity based on histopathology in all cases. We conclude that leukocyte imaging provides valuable information about localization and activity of inflammatory bowel disease.


2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Raisa Epistola ◽  
Tiffanie Do ◽  
Ritika Vankina ◽  
Daniel Wu ◽  
James Yeh ◽  
...  

While the association of immune thrombocytopenic purpura (ITP) and inflammatory bowel disease (IBD) has been described in a few case reports, management of ITP as an extraintestinal manifestation of Crohn’s disease (CD) is less studied. There are approximately a dozen cases describing the management of patients dually diagnosed with CD/ITP. Previous reports postulated that the mechanism of ITP in CD was through the presence of circulating immune complexes in the serum and antigenic mimicry due to increased mucosal permeability in active colitis, versus increased mucosal production of TH1-type proinflammatory cytokines during CD flares, which may account for remission of ITP with surgery for CD. We present a case of a 27-year-old man who presented with medically refractory CD and ITP who responded to surgical management with colectomy and splenectomy, along with a systematic review of the literature. These cases suggest that colectomy should be considered in the treatment of medically refractory ITP among patients with concomitant CD.


2021 ◽  
Author(s):  
Burton I Korelitz ◽  
Judy Schneider

Abstract We present a bird’s eye view of the prognosis for both ulcerative colitis and Crohn’s disease as contained in the database of an Inflammatory Bowel Disease gastroenterologist covering the period from 1950 until the present utilizing the variables of medical therapy, surgical intervention, complications and deaths by decades.


Author(s):  
Shinichiro Shinzaki ◽  
Katsuyoshi Matsuoka ◽  
Hiroki Tanaka ◽  
Fuminao Takeshima ◽  
Shingo Kato ◽  
...  

Abstract Background This multicenter prospective study (UMIN000019958) aimed to evaluate the usefulness of serum leucin-rich alpha-2 glycoprotein (LRG) levels in monitoring disease activity in inflammatory bowel disease (IBD). Methods Patients with moderate-to-severe IBD initiated on adalimumab therapy were enrolled herein. Serum LRG, C-reactive protein (CRP), and fecal calprotectin (fCal) levels were measured at week 0, 12, 24, and 52. Colonoscopy was performed at week 0, 12, and 52 for ulcerative colitis (UC), and at week 0, 24, and 52 for Crohn’s disease (CD). Endoscopic activity was assessed using the Simple Endoscopic Score for Crohn’s Disease (SES-CD) for CD and the Mayo endoscopic subscore (MES) for UC. Results A total of 81 patients was enrolled. Serum LRG levels decreased along with improvements in clinical and endoscopic outcomes upon adalimumab treatment (27.4 ± 12.6 μg/ml at week 0, 15.5 ± 7.7 μg/ml at week 12, 15.7 ± 9.6 μg/ml at week 24, and 14.5 ± 6.8 μg/ml at week 52), being correlated with endoscopic activity at each time point (SES-CD: r = 0.391 at week 0, r = 0.563 at week 24, r = 0.697 at week 52; MES: r = 0.534 at week 0, r = 0.429 at week 12, r = 0.335 at week 52). Endoscopic activity better correlated with LRG compared to CRP and fCal on pooled analysis at all time points (SES-CD: LRG: r = 0.636, CRP: r = 0.402, fCal: r = 0.435; MES: LRG: r = 0.568, CRP: 0.389, fCal: r = 0.426). Conclusions Serum LRG is a useful biomarker of endoscopic activity both in CD and UC during the adalimumab treatment.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
M. Hornschuh ◽  
E. Wirthgen ◽  
M. Wolfien ◽  
K. P. Singh ◽  
O. Wolkenhauer ◽  
...  

AbstractEpigenetics has become a promising field for finding new biomarkers and improving diagnosis, prognosis, and drug response in inflammatory bowel disease. The number of people suffering from inflammatory bowel diseases, especially Crohn's disease, has increased remarkably. Crohn's disease is assumed to be the result of a complex interplay between genetic susceptibility, environmental factors, and altered intestinal microbiota, leading to dysregulation of the innate and adaptive immune response. While many genetic variants have been identified to be associated with Crohn's disease, less is known about the influence of epigenetics in the pathogenesis of this disease. In this review, we provide an overview of current epigenetic studies in Crohn's disease. In particular, we enable a deeper insight into applied bioanalytical and computational tools, as well as a comprehensive update toward the cell-specific evaluation of DNA methylation and histone modifications.


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