CROHN'S DISEASE AND MULTIPLE MYELOMA: A CLINICAL CASE AND LITERATURE REVIEW

Crohn's disease and multiple myeloma are pathological entities, the development of which, at least in part, is associated with an immune disregulation. Crohn's disease is often combined with extra-intestinal manifestations from different organs and systems (joints, skin, eyes, etc.). Hematological extra-intestinal manifestations, such as myelodysplastic syndrome, aplastic autoimmune anemia, autoimmune thrombocytopenia, B12-deficiency anemia are less common. The list of extra-intestinal manifestations of Crohn's disease is constantly expanding, including more and more descriptions of the combination of Crohn's disease with diseases of the blood system. The paper presents a rare clinical case of a combination of Crohn's disease and multiple myeloma. The female patient is 53 years old. In 1993 ulcerative colitis was diagnosed and she received Sulfasalazine 4gr per day. In 2015, with the recurrent attack, the diagnosis was transformed towards Crohn's disease basing on colonoscopy. She received steroid therapy. In 2018 the control examination revealed an increase in the level of total protein to 117gr/l. Patient underwent a sternal biopsy. Multiple myeloma was diagnosed on the basis of a myelogram.

Download Full-text

Study of the role of soluble transferrin receptor/ferritin index in the assessment of anemia in inflammatory bowel disease patients

QJM ◽

10.1093/qjmed/hcaa052.019 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

E A Awad ◽

M L Soliman ◽

T M A George ◽

S G F Elshabasy

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Transferrin Receptor ◽

Inactive Disease ◽

Deficiency Anemia ◽

Soluble Transferrin Receptor ◽

Significant Difference ◽

Inflammatory Bowel

Abstract Background Idiopathic inflammatory bowel disease (IBD) includes those conditions characterized by a tendency for chronic or relapsing immune activation and inflammation within the gastrointestinal tract, Crohn’s disease (CD) and ulcerative colitis (UC) are the two major forms of idiopathic IBD. Aim of the Work The aim of this study is to evaluate the clinical usefulness of the soluble transferrin receptor-Ferritin index in the evaluation of anemia in patients with IBD and especially for differentiation between iron deficiency anemia and anemia of chronic disease. Patients and Methods This study included fifty patients with established diagnosis of IBD either Ulcerative Colitis or Crohn’s disease. They were collected at Internal Medicine and Gastroenterology outpatient clinics and inpatient wards at Ain Shams University hospitals as well at New Cairo hospital in the period from March 2017 to September 2017. They were classified into 2 groups: group I 25 patients with Crohn’s disease and anemia with active or inactive disease, group II 25 patients with ulcerative colitis and anemia with active or inactive disease, group III 25 healthy controls with no significant medical or family history of IBD. Results In the current study there was no significant difference between the different study groups regarding the demographic data except for the disease localization as there was significant difference between ulcerative and crohn’s disease. Conclusion The results of the current study stated that the sTfR and sTfR-F index seems to be very efficient in the detection and diagnosis of IDA, among patients with IBD. Its detection rate is higher using sTfR/F index than sTfR alone and of course higher than the other existing markers. It is essential to mention that the clinical use of this sTfR/F index rather adds to the value of other established markers, such as ferritin, transferrin and Tsat, than replaces them in the diagnosis of IDA. Therefore, sTfR-F index could be proposed as an additional parameter, which can improve the diagnosis of iron deficiency anemia in patients with IBD. This remains to be confirmed with other larger studies.

Download Full-text

Ulcerative Colitis in Hematological Malignancies: Paraneoplastic Manifestation or Coincidental Bystander?

Case Reports in Gastrointestinal Medicine ◽

10.1155/2020/6135425 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Gregorios Christodoulidis ◽

Konstantinos Perivoliotis ◽

Anastasios Manolakis ◽

Alexandros Diamantis ◽

Apostolos Koffas ◽

...

Keyword(s):

Ulcerative Colitis ◽

Multiple Myeloma ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Myelodysplastic Syndromes ◽

Hematological Malignancies

Evidence of coexistence of diverse hematological malignancies—lymphoma, leukemia, multiple myeloma, and myelodysplastic syndromes—and either ulcerative colitis or Crohn’s disease can be found in the literature. However, a more “systemic” effort to reach further and examine the potential of either one as paraneoplastic manifestation has not been performed. Based on these, three cases of ulcerative colitis manifesting before, simultaneously, and after the onset of different hematological malignancies are presented and critically evaluated.

Download Full-text

Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2014.1323568 ◽

2014 ◽

Vol 132 (3) ◽

pp. 140-146 ◽

Cited By ~ 13

Author(s):

Rodrigo Andrade Alves ◽

Sender Jankiel Miszputen ◽

Maria Stella Figueiredo

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Iron Deficiency ◽

Crohn's Disease ◽

Disease Activity ◽

Bowel Disease ◽

Activity Index ◽

Deficiency Anemia ◽

Inflammatory Bowel

CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.

Download Full-text

Modern approaches to the treatment of inflammatory bowel disease in children according to the latest recommendations of the European Organization for the Study of Crohn's disease and colitis, and the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists

Modern pediatrics. Ukraine ◽

10.15574/sp.2021.114.40 ◽

2021 ◽

pp. 40-57

Author(s):

O.M. Okhotnikova ◽

◽

T.M. Tkacheva ◽

A.A. Romanchuk ◽

O.M. Grishchenko ◽

...

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

European Society ◽

Bowel Disease ◽

Clinical Case ◽

Young Patients ◽

European Organization ◽

Inflammatory Bowel

Modern outpatient management of ulcerative colitis (UC) continues to be a difficult task, as 20% of children still need colectomy (there are no official statistics for Ukraine). Therefore, the European Organization for the Study of Crohn's Disease and Colitis (ECCO) and the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists (ESPGHAN), seeking to standardize the daily treatment of inflammatory bowel disease (IBD), have developed a protocol for the management and treatment of children with VC. Based on the analysis of medical research, followed by an evidentiary assessment of each provision, the 2012 recommendations were updated. The aim is to present the provisions of the updated protocol on therapeutic management of children with ulcerative colitis and to consolidate the material on a clinical case. Materials and methods. The article presents updated recommendations of ECCO and ESPGHAN (2018) on the treatment of COPD in children, the algorithm of induction and maintenance of remission of UC and COPD unclassified. A clinical case is given for an example of application of the algorithm of induction and support of remission of IBD at children, assessment of severity and the scheme of management of patients with this pathology is provided. Results and conclusions. The updated recommendations of ECCO and ESPGHAN facilitate the treatment of unclassified UC and IBD, provide a clear scheme for monitoring children with this pathology, which improves treatment outcomes and quality of life of young patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: ulcerative colitis, recommendations. children, anti-TNF, calprotectin, unclassified inflammatory bowel disease, monitoring, activity index, treatment.

Download Full-text