Crohn's Disease Defined in Three Elderly Disters

Three elderly sisters presented with symptomatic Crohn's disease. All had ileocolic involvement, and granulomatous inflammation was documented in endoscopic biopsies or surgically resected intestinal specimens. The present report documents the unusual occurrence of very late phenotypical expression of familial ileocolic Crohn's disease. The observations presented here reflect a possible gene-based predisposition to Crohn's disease or, alternatively, disease clustering related to a commonly shared environmental factor.

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Significance of Granulomatous Inflammation Found on Endoscopic Biopsies or Surgical Resections on the Severity of Crohn’s Disease

Journal of Clinical Gastroenterology ◽

10.1097/mcg.0b013e31829007d4 ◽

2013 ◽

Vol 47 (10) ◽

pp. 894 ◽

Cited By ~ 2

Author(s):

Manasa Kanneganti ◽

Bijan Dehghani ◽

James Steinberg ◽

Sandra Cerda ◽

Denis Rybin ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Granulomatous Inflammation ◽

Endoscopic Biopsies

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CROHN’S DISEASE IN CHILDREN: THE CURRENT STATE OF THE PROBLEM

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-6-78-85 ◽

2021 ◽

Vol 100 (6) ◽

pp. 78-85

Author(s):

A.S. Bekin ◽

◽

E.Yu. Dyakonova ◽

A.N. Surkov ◽

A.P. Fisenko ◽

...

Keyword(s):

Crohn’S Disease ◽

Surgical Treatment ◽

Crohn's Disease ◽

Granulomatous Inflammation ◽

Unknown Etiology ◽

Systemic Complications ◽

Current State ◽

Conservative And Surgical Treatment ◽

Scientific Ideas ◽

Local And Systemic Complications

Crohn's disease (CD) is chronic recurrent bowel disease of unknown etiology, characterized by segmental transmural granulomatous inflammation, mainly with the development of local and systemic complications. Despite the active development of conservative therapy methods, the number of drug-resistant forms of CD and complications of the disease requiring surgical treatment continues to increase. The article reflects modern scientific ideas about the methods of diagnosis, conservative and surgical treatment of CD in children.

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Unsuccessful Treatment of Cheilitis Granulomatosa with Oral Methotrexate

Case Reports in Dermatology ◽

10.1159/000503138 ◽

2019 ◽

Vol 11 (3) ◽

pp. 249-255 ◽

Cited By ~ 1

Author(s):

Thanapon Sutharaphan ◽

Kumutnart Chanprapaph ◽

Vasanop Vachiramon

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Case Reports ◽

Corticosteroid Injection ◽

Granulomatous Inflammation ◽

Spontaneous Remission ◽

Expert Opinions ◽

Cheilitis Granulomatosa ◽

Unsuccessful Treatment ◽

Intralesional Corticosteroid

Cheilitis granulomatosa (CG) is a rare idiopathic condition with painless lip swelling, characterized by non-necrotizing granulomatous inﬂammation in the absence of other identifiable causes such as Crohn’s disease, sarcoidosis, foreign body reaction, or infection. CG may precede the presentation of Crohn’s disease after long-term follow-up. Spontaneous remission of CG rarely occurs. To date, given the rarity of CG, there is no gold standard treatment. Recommended treatments are supported by small studies, case reports/series, and expert opinions. Glucocorticoids are the first-line therapy in the acute stages of the disease; however, recurrence commonly occurs. Previously, methotrexate (MTX) showed a beneﬁcial effect on orofacial swelling in a case of CG accompanied by Crohn’s disease. We present a patient with CG without Crohn’s disease. He was treated with oral MTX in combination with intralesional corticosteroid injection on one side of the lip. The injected side showed improvement, while lip swelling on the noninjected area remained unchanged after 3 months of treatment. Therefore, CG is refractory to treatment with MTX from our experience. Further studies regarding the optimum dosage of MTX is needed.

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Anticipation in an Indo-Canadian Family with Crohn's Disease

Canadian Journal of Gastroenterology ◽

10.1155/2001/518043 ◽

2001 ◽

Vol 15 (10) ◽

pp. 695-698 ◽

Cited By ~ 7

Author(s):

Hugh J Freeman ◽

Noel B Hershfield

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Neurological Disorders ◽

Molecular Basis ◽

Present Report ◽

Phenotypic Expression ◽

Apparent Increase ◽

The Family ◽

Perianal Sepsis ◽

Common Environmental Factor

Genetic anticipation, associated elsewhere with monogenic neurological disorders, has been hypothesized to be present in familial forms of Crohn's disease. Usually, with studies of parent-child pairs, the parent who is initially diagnosed is older at the onset of disease than the child. With each successive generation, an apparent increase in disease severity or behaviour occurs. This phenomenon is believed to have a molecular basis. In the present report, an Indo-Canadian family with Crohn's disease is described. In all members of the family, disease was diagnosed only after prolonged residence in Canada, supporting the view that Crohn's disease arises in individuals with a genetic predisposition following exposure to some, as yet unknown, common environmental factor. Three siblings with Crohn's disease, first diagnosed between ages 15 and 27 years, or six to 11 years after arrival in Canada, had phenotypically concordant disease localized in the ileum and colon, with fistulizing complications, including perianal sepsis. Crohn's disease was only diagnosed in the father at the age of 76 years, almost three decades after his arrival in Canada. His disease was localized to the ileum and had a fibrostenosing behaviour. This is the first reported instance of familial Crohn's disease in an immigrant population, illustrating potential biases in genetically based studies of Crohn's disease that rely solely on phenotypic expression.

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A case report of a patient with isolated Crohn’s disease of the stomach

Voprosy detskoj dietologii ◽

10.20953/1727-5784-2021-3-95-101 ◽

2021 ◽

Vol 19 (3) ◽

pp. 95-101

Author(s):

E.A. Trush ◽

◽

A.I. Ulyanin ◽

A.V. Korolev ◽

L.N. Androsova ◽

...

Keyword(s):

Differential Diagnosis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Clinical Symptoms ◽

Granulomatous Inflammation ◽

Endoscopic Finding ◽

Disease Course ◽

Morphological Examination ◽

Gastric Biopsies ◽

Upper Gastrointestinal

Crohn’s disease of the esophagus, stomach or duodenum is extremely rare and characterized by an aggressive disease course with a poor prognosis. Clinical symptoms of the upper gastrointestinal tract lesion are nonspecific, therefore esophagogastroduodenoscopy with biopsy is necessary for the differential diagnosis. Crohn’s disease of the stomach is characterized by a specific endoscopic finding – bamboo-joint-like appearance of gastric folds. Granulomatous inflammation in morphological examination of gastric biopsies in patients with Crohn’s disease is rare, therefore endoscopic finding is more pathognomonic. This article presents a clinical case of a patient with isolated Crohn’s disease of stomach, differential diagnosis and treatment approaches of the disease. Key words: Crohn’s disease, Crohn’s disease with lesions of the stomach, gastroprotective agents, proton pump inhibitors, endoscopic sonography

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Aphthous stomatitis as the debut of Crohn’s disease

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-169-9-97-100 ◽

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.

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SUBSTANTIATION OF DIAGNOSIS AND TREATMENT OF CHRONIC RECURRENT APHTHOUS STOMATITIS IN CROHN’S DISEASE

Wiadomości Lekarskie ◽

10.36740/wlek202003120 ◽

2020 ◽

Vol 73 (3) ◽

pp. 512-516

Author(s):

Oksana Y. Feleshtynska ◽

Olena O. Dyadyk

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Oral Mucosa ◽

Morphological Study ◽

Comparison Group ◽

Granulomatous Inflammation ◽

Main Group ◽

Recurrent Aphthous Stomatitis ◽

Aphthous Stomatitis ◽

Diagnosis And Treatment

The aim: To substantiate the diagnosis and treatment of chronic recurrent aphthous stomatitis in Crohn’s disease. Materials and methods: The analysis of diagnostic and treatment of 52 patients with chronic recurrent aphthous stomatitis in Crohn’s disease (main group), mean age 31.8 + 2.3 was performed. The comparison group consisted of 50 patients with chronic recurrent aphthous stomatitis not associated with Crohn’s disease (mean age 34.7 + 1.8). Patients in both groups were studied for clinical manifestations, morphological and immunohistochemical studies the aphthae on the oral mucosa were performed. Results: An objective evaluation of the oral mucosa showed that the aphthae on the oral mucosa in patients of both groups did not differ visually. In the morphological study, the patients in the main group had granulomatous inflammation of the oral mucosa, characteristic of Crohn’s disease, while the patients in the comparison group had fibrinous inflammation. Immunohistochemical study of the cell infiltrate phenotype in the area of the lesion revealed that the patients in the main group there prevailed CD68+macrophages, the appearance of both intraepithelial and cell infiltrates of T-lymphocyte suppressors, which is characteristic of Crohn’s disease. Conclusions: Diagnosis of chronic recurrent aphthous stomatitis in Crohn’s disease is based on biopsy of the aphthae on the oral mucosa and their morphological examination, the results of which confirm the presence of granulomatous inflammation, with a large number of macrophages, the presence of T-lymphocytes, characteristic of Crohn’s disease, while recurrent aphthous stomatitis of another genesis morphologically detect fibrinous inflammation. The choice of therapeutic tactics for chronic recurrent aphthous stomatitis depends on the results of the morphological study. When granulomatous inflammation is detected in patients with chronic recurrent aphthous stomatitis, which is characteristic of Crohn’s disease, in addition to topical treatment of the oral mucosa, specific therapy with mesalazine drugs is prescribed.

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Osteonecrosis in a Patient with Crohn's Disease Unrelated to Corticosteroid Use

Canadian Journal of Gastroenterology ◽

10.1155/2001/293059 ◽

2001 ◽

Vol 15 (11) ◽

pp. 765-768 ◽

Cited By ~ 8

Author(s):

Ali Khan ◽

Gerald Illiffe ◽

Donald S Houston ◽

Charles N Bernstein

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Present Report ◽

Vascular Thrombosis ◽

Inflammatory Disorders ◽

Direct Association

Osteonecrosis is a feared complication of corticosteroid use. However, a direct association between corticosteroid use and osteonecrosis has never been proven. The present report examines the case of a patient with longstanding Crohn's disease who had never been treated with corticosteroids and who developed osteonecrosis of the talus. The association of systemic inflammatory disorders with osteonecrosis and the possible association with vascular thrombosis are discussed.

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