scholarly journals P750 Prevalence and characteristics of incidentally diagnosed inflammatory bowel disease during screening colonoscopy

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S600-S600
Author(s):  
Y M Han ◽  
J Lee ◽  
J P Im ◽  
J S Kim
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
University Hospital ◽  
Screening Colonoscopy ◽  
Inflammatory Lesions ◽  
National University ◽  
Inflammatory Bowel ◽  
Seoul National University

Abstract Background Colonoscopy is the most powerful tool for colon cancer screening. As the performance rate of screening colonoscopy was rapidly increased, there was also a great increase in the incidental detection of inflammatory lesions during screening colonoscopy. The significance and clinical course of these lesions were never been investigated. The aim of this study is to evaluate the prevalence and clinical significance of incidentally detected inflammatory lesions during screening colonoscopy and investigate the characteristics of newly diagnosed inflammatory bowel disease among them. Methods Health check-up patients who underwent screening colonoscopy at Seoul National University Hospital Healthcare System Gangnam Center in 2018 were enrolled. Among them, patients who showed endoscopic inflammatory lesions such as ulcer, erosion, erythema, spontaneous bleeding, friability or exudate were selected. We reviewed the pathologic reports of those patients. We investigated if there were suggestive pathologic findings of inflammatory bowel disease, which were defined as presence of one of these findings: cryptitis, crypt abscess, crypt distortion, crypt atrophy or noncaseating granuloma. We classified them as possible inflammatory bowel disease patients and closely monitored clinical course of these patients. We investigated prevalence of incidentally diagnosed inflammatory bowel disease among health check-up patients. Results A total of 10366 patients underwent screening colonoscopy at Seoul National University Hospital Healthcare System Gangnam Center. Among them, 237 patients showed inflammatory lesions on colonoscopy. Nine patients were already diagnosed with inflammatory bowel disease; 1 with Bechet’s disease and 8 with ulcerative colitis. The others had no previous medical history of colonic disease. Biopsy specimens were obtained in 200 patients. Eighteen patients showed one of suggestive pathologic findings of inflammatory bowel disease. Among them, 12 patients did not undergo further diagnostic examination because they did have no associated symptom. Two patients immediately diagnosed as ulcerative colitis and other 4 patients underwent short-term follow-up colonoscopy. Three of them showed resolution of previously noted inflammatory lesions and the remaining one finally diagnosed with ulcerative colitis. Briefly, 3 patients were diagnosed with inflammatory bowel disease, 3 with eosinophilic colitis, 1 with tuberculosis, and 1 with amoebic colitis. Conclusion Incidental detection of inflammatory lesions during screening colonoscopy was relatively high; however, prevalence of inflammatory bowel disease is low. Careful examination of associated symptom and sustained close long-term follow-up are needed.

Systemic lupus erythematosus with inflammatory bowel disease-ulcerative colitis: case report

Lupus ◽  
2018 ◽  
Vol 27 (7) ◽  
pp. 1198-1201
Author(s):  
H Elsayed Mansour ◽  
S Gamal Arafa ◽  
W Abdelfatah Shehata
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Lupus Erythematosus ◽  
Bowel Disease ◽  
University Hospital ◽  
Small Vessel Vasculitis ◽  
Antibody Testing ◽  
Systemic Lupus ◽  
Inflammatory Bowel

A 30-year-old female presented to the rheumatology outpatient clinic of the Internal Medicine Department, Ain Shams University Hospital, Cairo, Egypt, complaining of a large right leg ulcer consistent with pyoderma gangrenosum. There was history of recurrent attacks of bleeding per rectum of one-year duration. During hospitalization she noticed blurring of vision in the left eye with diffuse blackish discoloration of the feet and toes, consistent with small-vessel vasculitis. Colonoscopy with biopsy and histopathology confirmed the diagnosis of inflammatory bowel disease-ulcerative colitis (IBD-UC). Meanwhile, the patient fulfilled the SLICC classification criteria for systemic lupus erythematosus (SLE): recurrent oral ulcers, positive antinuclear antibody testing, proteinuria >0.5 gm/24-hour urine, positive test for lupus anticoagulant and consumed C3 complement component. Herein we report a rare case of coexistence of SLE and IBD-UC.

scholarly journals Articular manifestations in patients with inflammatory bowel disease treated with vedolizumab

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3275-3283 ◽  
Author(s):  
Anastasia Dupré ◽  
Michael Collins ◽  
Gaétane Nocturne ◽  
Franck Carbonnel ◽  
Xavier Mariette ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Inflammatory Bowel Diseases ◽  
Bowel Disease ◽  
Bowel Diseases ◽  
History Of ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel

Abstract Objective Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors. Methods In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared. Results Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007]. Conclusion Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.

scholarly journals Chronic cough in a patient with stable ulcerative colitis: a rare but important extraintestinal manifestation of inflammatory bowel disease

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-227066 ◽  
Author(s):  
Thomas Chad ◽  
Jeremy Brown
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Lower Lobe ◽  
Gas Transfer ◽  
Extraintestinal Manifestation ◽  
Sputum Production ◽  
Inflammatory Bowel ◽  
The Right

A 74-year-old woman presented to her general practitioner with cough and occasional sputum production. Having failed to respond to courses of antibiotics in the community, she was referred to the thoracic medicine clinic. High-resolution CT chest revealed cylindrical bronchiectasis predominantly in the right lower lobe. Lung function revealed preserved FEV1 and FVC but reduced gas transfer values. Bronchiectasis secondary to ulcerative colitis was diagnosed. Inhaled corticosteroid therapy was initiated, with good clinical response noted at 6 monthly follow-up. Remission was sustained with tapering of the steroid dose. Recognition of respiratory complications in cases of inflammatory bowel disease is likely still poor among clinicians. Although rare, a working knowledge of principles of investigation and management will aid timely diagnosis and treatment, potentially preventing progression of respiratory disease.

scholarly journals Association of ulcerative colitis and IgA nephropathy: A case report

2021 ◽  
pp. 105-107
Author(s):  
Boulajaad S ◽  
Haida M ◽  
Errami Ait ◽  
Oubaha S ◽  
Samlani Z ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Iga Nephropathy ◽  
Bowel Disease ◽  
Renal Involvement ◽  
Chronic Inflammatory Bowel Disease ◽  
Secondary Amyloidosis ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

The extradigestive manifestations of chronic inflammatory bowel disease most often affect the articulations, skin, eyes, liver and bile ducts. Renal involvement is rare, and manifests as kidney stones, glomerulonephritis, tubulointerstitial nephritis, and secondary amyloidosis. In this context of chronic inflammatory bowel disease, in particular ulcerative colitis, renal involvement is very often secondary to nephrotoxicity of the basic treatment of digestive pathology, and very rarely an authentic extradigestive manifestation of intestinal disease. We report a case of IgA nephropathy as an extra-digestive manifestation of ulcerative colitis. The objective of this study is not to neglect the IgA nephtopathy as an extradigestive manifestation of IBD which, even though rare, remains a condition to be looked for by clinicians during the follow-up of IBD.

scholarly journals Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool

2021 ◽  
pp. 1-17
Author(s):  
Catarina Frias-Gomes ◽  
Joana Torres ◽  
Carolina Palmela
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Response To Therapy ◽  
Inflammatory Bowel

<b><i>Background:</i></b> Intestinal ultrasound is emerging as a non-invasive tool for monitoring disease activity in inflammatory bowel disease patients due to its low cost, excellent safety profile, and availability. Herein, we comprehensively review the role of intestinal ultrasound in the management of these patients. <b><i>Summary:</i></b> Intestinal ultrasound has a good accuracy in the diagnosis of Crohn’s disease, as well as in the assessment of disease activity, extent, and evaluating disease-related complications, namely strictures, fistulae, and abscesses. Even though not fully validated, several scores have been developed to assess disease activity using ultrasound. Importantly, intestinal ultrasound can also be used to assess response to treatment. Changes in ultrasonographic parameters are observed as early as 4 weeks after treatment initiation and persist during short- and long-term follow-up. Additionally, Crohn’s disease patients with no ultrasound improvement seem to be at a higher risk of therapy intensification, need for steroids, hospitalisation, or even surgery. Similarly to Crohn’s disease, intestinal ultrasound has a good performance in the diagnosis, activity, and disease extent assessment in ulcerative colitis patients. In fact, in patients with severe acute colitis, higher bowel wall thickness at admission is associated with the need for salvage therapy and the absence of a significant decrease in this parameter may predict the need for colectomy. Short-term data also evidence the role of intestinal ultrasound in evaluating therapy response, with ultrasound changes observed after 2 weeks of treatment and significant improvement after 12 weeks of follow-up in ulcerative colitis. <b><i>Key Messages:</i></b> Intestinal ultrasound is a valuable tool to assess disease activity and complications, and to monitor response to therapy. Even though longer prospective data are warranted, intestinal ultrasound may lead to a change in the paradigm of inflammatory bowel disease management as it can be used in a point-of-care setting, enabling earlier intervention if needed.

scholarly journals Real-world Effectiveness and Safety of Vedolizumab for the Treatment of Inflammatory Bowel Disease: The Scottish Vedolizumab Cohort

2019 ◽  
Vol 13 (9) ◽  
pp. 1111-1120 ◽  
Author(s):  
N Plevris ◽  
C S Chuah ◽  
R M Allen ◽  
I D Arnott ◽  
P N Brennan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Real World ◽  
Bowel Disease ◽  
Clinical Remission ◽  
Mucosal Healing ◽  
Inflammatory Bowel

Abstract Background & Aims Vedolizumab is an anti-a4b7 monoclonal antibody that is licensed for the treatment of moderate to severe Crohn’s disease and ulcerative colitis. The aims of this study were to establish the real-world effectiveness and safety of vedolizumab for the treatment of inflammatory bowel disease. Methods This was a retrospective study involving seven NHS health boards in Scotland between June 2015 and November 2017. Inclusion criteria included: a diagnosis of ulcerative colitis or Crohn’s disease with objective evidence of active inflammation at baseline (Harvey–Bradshaw Index[HBI] ≥5/Partial Mayo ≥2 plus C-reactive protein [CRP] >5 mg/L or faecal calprotectin ≥250 µg/g or inflammation on endoscopy/magnetic resonance imaging [MRI]); completion of induction; and at least one clinical follow-up by 12 months. Kaplan–Meier survival analysis was used to establish 12-month cumulative rates of clinical remission, mucosal healing, and deep remission [clinical remission plus mucosal healing]. Rates of serious adverse events were described quantitatively. Results Our cohort consisted of 180 patients with ulcerative colitis and 260 with Crohn’s disease. Combined median follow-up was 52 weeks (interquartile range [IQR] 26–52 weeks). In ulcerative colitis, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 57.4%, 47.3%, and 38.5%, respectively. In Crohn’s disease, 12-month cumulative rates of clinical remission, mucosal healing, and deep remission were 58.4%, 38.9%, and 28.3% respectively. The serious adverse event rate was 15.6 per 100 patient-years of follow-up. Conclusions Vedolizumab is a safe and effective treatment for achieving both clinical remission and mucosal healing in ulcerative colitis and Crohn’s disease.

scholarly journals Women’s earnings are more affected by inflammatory bowel disease than men’s: a register-based Swedish cohort study

2020 ◽  
Author(s):  
Åsa H Everhov ◽  
Gustaf Bruze ◽  
Jonas Söderling ◽  
Johan Askling ◽  
Jonas Halfvarson ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Disposable Income ◽  
Inflammatory Bowel ◽  
The Individual ◽  
Annual Earnings

Abstract Background/Aim Patients with inflammatory bowel disease (IBD) have more work disability than the general population. We aimed to estimate the monetary cost of IBD for the individual through assessment of earnings in relation to diagnosis. Methods Through linkage of national registers we identified patients aged 30-55 years at first IBD diagnosis in Sweden 2002-2011, and same-sex IBD-free siblings. We estimated taxable earnings and disposable income from 5 years before to 5 years after diagnosis. Results The 5,961 patients (27% Crohn’s disease, 68% ulcerative colitis, 4.3% IBD unclassified) had similar taxable earnings as their 7,810 siblings until the year of diagnosis, when earnings decreased and remained lower than in siblings during follow-up. The adjusted difference in earnings over the entire 5-year period after diagnosis was -5% (-8,212€; 95%CI: -11,458 to-4,967). The difference was larger in women than in men, and larger in Crohn’s disease than in ulcerative colitis. When stratifying for sex and IBD subtype and comparing earnings during each year of follow-up, the median annual earnings were lower in women with Crohn’s disease and ulcerative colitis than in their sisters during all years of follow-up, whereas the men had similar annual taxable earnings as their brothers. The disposable income was similar between patients and siblings during the investigated time period. Conclusion From the year of diagnosis and at least 5 years onwards, patients with IBD had 5% lower earnings than siblings, mainly explained by differences between women with IBD and their sisters. However, there were no differences in disposable income.

scholarly journals Accumulation of Mast Cells in the Lesions and Effects of Antiallergic Drugs on the Patients with Inflammatory Bowel Disease

Ulcers ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Motohiro Kurosawa ◽  
Hiroichi Nagai
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Gastrointestinal Tract ◽  
Mast Cells ◽  
Bowel Disease ◽  
Inflammatory Lesions ◽  
Eosinophilic Colitis ◽  
Number Of Patients ◽  
Antiallergic Drug ◽  
Inflammatory Bowel

The pathomechanism of inflammatory bowel disease (IBD) has not yet been fully demonstrated. However, it is well known that mast cells are present in the gastrointestinal tract, suggesting that mast cells may take part in it. So, we investigated the number of mast cells in IBD, such as ulcerative colitis (UC) and eosinophilic colitis, and showed that the number of mast cells was increased in the inflammatory lesions. We also presented a case of UC which was treated successfully with an antiallergic drug, tranilast. Furthermore, possible new approaches to treating the disease with immunomodulators including suplatast are introduced. However, our investigations were performed with a limited number of patients with IBD, and additional further studies are required to confirm the findings.

scholarly journals Fecal lactoferrin predicts primary non-response to biologic agents in inflammatory bowel disease

2021 ◽  
Author(s):  
Dario Sorrentino ◽  
Vu Q. Nguyen ◽  
Kim Love
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Clinical Remission ◽  
Biologic Agents ◽  
Fecal Lactoferrin ◽  
Inflammatory Bowel

Introduction: Fecal Lactoferrin (FL) is a timely and accurate marker of inflammation in ulcerative colitis (UC) and Crohn’s disease (CD). Aim of this study was to verify whether FL can predict primary non-response (PNR) to biologic agents during induction. Methods: Retrospective outcome review in 27 patients (13 with CD and 14 with UC) tested for baseline FL and re-tested within a week after the first and second induction doses. Clinical/biochemical outcomes were evaluated at end of induction and at follow up (3-24 months). Results: Compared to baseline, changes of the Harvey-Bradshaw (CD) and Partial Mayo Scoring (UC) indices at end of induction separated responders (18/27 or 67%) from non-responders (9/17 or 33%). In all patients the initial FL value at induction decreased compared to baseline, continuing to decrease after the following dose in clinical responders while bouncing back in the others. Models targeting the two consecutively decreased FL values or the second FL value compared to baseline or the second FL value compared to the first were able to accurately predict response at end of induction. Follow-up assessment confirmed clinical remission in initial responders (with FL values reduced on the average by 94±10% compared to baseline). Conclusions: In CD and UC patients during induction with biologic agents early FL measurements accurately separate clinical responders from those experiencing PNR. The method described here offers several potential advantages over other strategies to assess and manage these patients.

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