Interstitial Nephritis Presenting as Bilateral Renal Masses in a Pediatric Patient with Crohn’s Disease

We present the case of a teenage boy with Crohn’s disease treated with adalimumab who presented with discrete renal masses, found while undergoing evaluation for elevated creatinine and hypocalcemia. The MRI result, as well as the potential increased risk of malignancy in patients treated with TNF-blockers, both contributed to primary concerns of malignancy in this case. Pathology was consistent, however, with IN and not malignancy. The radiographic presentation of the IN in this case was very unusual, as IN can present as a striated nephrogram on imaging, but has not been described as discrete masses. We are not aware of any other cases of IN reported appearing this way on imaging.

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Increased Risk of Malignancy With Adalimumab Combination Therapy, Compared With Monotherapy, for Crohn's Disease

Gastroenterology ◽

10.1053/j.gastro.2013.12.025 ◽

2014 ◽

Vol 146 (4) ◽

pp. 941-949.e2 ◽

Cited By ~ 120

Author(s):

Mark T. Osterman ◽

William J. Sandborn ◽

Jean-Frederic Colombel ◽

Anne M. Robinson ◽

Winnie Lau ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Combination Therapy ◽

Increased Risk ◽

Risk Of Malignancy

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P041 DEVELOPMENT OF PROMIS PEDIATRIC PATIENT-REPORTED OUTCOME SHORT FORMS FOR FATIGUE AND PAIN INTERFERENCE IN CHILDREN WITH CROHN’S DISEASE

Gastroenterology ◽

10.1053/j.gastro.2019.11.241 ◽

2020 ◽

Vol 158 (3) ◽

pp. S101-S102

Author(s):

Julia Schuchard ◽

Michael Kappelman ◽

Andrew Grossman ◽

Jennifer Clegg ◽

Christopher Forrest

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Pediatric Patient ◽

Patient Reported Outcome ◽

Pain Interference ◽

Short Forms ◽

Patient Reported

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Appendiceal Carcinoids In Crohn’s Disease

Canadian Journal of Gastroenterology ◽

10.1155/2003/625368 ◽

2003 ◽

Vol 17 (1) ◽

pp. 43-46 ◽

Cited By ~ 17

Author(s):

Hugh J Freeman

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Carcinoid Tumour ◽

Intestinal Resection ◽

Case Review ◽

Appendiceal Neoplasms ◽

Increased Risk ◽

Intestinal Neoplasms ◽

Resection Specimen ◽

Sporadic Cases

Earlier investigations demonstrate an increased risk for colon cancer in Crohn's disease. For other intestinal neoplasms, such as carcinoids, studies are limited. In Crohn's disease, repeated endoscopic and imaging studies along with intestinal resections may facilitate clinical recognition of neoplastic diseases, including appendiceal neoplasms. To date, however, only sporadic cases of appendiceal carcinoids have been described in Crohn's disease. In the present study, in a single clinician database of 1000 Crohn's disease patients, three of the 441 patients who had undergone intestinal resection had appendiceal carcinoids, all of which were pathologically confirmed. All were observed in female patients and were not suspected before surgical treatment. In one case, even though management was not altered, the tumour had already invaded serosal fat indicating a potential for more advanced disease. In this series, a carcinoid tumour was found in a resection specimen during a later clinical case review and another was a microcarcinoid, implying that these tumours may be overlooked in Crohn's disease. The percentage detected in the entire database (0.3%) exceeds the reported rates of detection of appendiceal carcinoids after removal of the appendix for appendicitis, as well as the rate of detection of appendiceal carcinoids in autopsy studies. This percentage would be higher if only those having an intestinal resection were considered (0.68%). Additional studies are needed to further define this risk of appendiceal carcinoids in Crohn's disease.

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391 OBESITY IS ASSOCIATED WITH INCREASED RISK OF OLDER ONSET CROHN'S DISEASE: RESULTS FROM THE DEFINE-IBD CONSORTIUM

Gastroenterology ◽

10.1016/s0016-5085(21)00938-0 ◽

2021 ◽

Vol 160 (6) ◽

pp. S-80

Author(s):

Simon Chan ◽

Ye Chen ◽

Kevin Casey ◽

Ola Olen ◽

Jonas F. Ludvigsson ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Increased Risk

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CMV pneumonitis in a patient with Crohn’s disease taking azathioprine

BMJ Case Reports ◽

10.1136/bcr-2020-241256 ◽

2021 ◽

Vol 14 (4) ◽

pp. e241256

Author(s):

Timothy Zef Hawthorne ◽

Rachel Shellien ◽

Lucy Chambers ◽

Graham Devereux

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Low Dose ◽

Antiviral Treatment ◽

Cmv Infection ◽

Rare Presentation ◽

Intravenous Ganciclovir ◽

Increased Risk ◽

Oral Valganciclovir

This case report discusses the rare presentation of cytomegalovirus (CMV) pneumonitis in a young patient with moderately severe Crohn’s disease managed with low dose azathioprine. CMV pneumonitis was initially suspected on CT chest images and confirmed by PCR for CMV. She was treated with intravenous ganciclovir and later stepped down to oral valganciclovir. Although this patient had a prolonged and complicated hospital admission, a good clinical outcome was achieved. CMV infection was raised as an early differential and antiviral treatment was started without delay. This case study, therefore, makes the case for increased awareness of the possibility of, and recognition of CMV pneumonitis among healthcare professionals as a way of preventing significant morbidity and mortality. It also raises awareness of checking for slow metabolisers of azathioprine before initiation to look for individuals who may be at increased risk of azathioprine’s adverse effects.

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Adalimumab treatment in infliximab resistant pediatric patient with Crohn’s disease

Orvosi Hetilap ◽

10.1556/oh.2009.28731 ◽

2009 ◽

Vol 150 (40) ◽

pp. 1858-1860 ◽

Cited By ~ 4

Author(s):

Gábor Veres ◽

Réka Putz ◽

Dolóresz Szabó ◽

Kriszta Molnár ◽

Hedvig Bodánszky ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Pediatric Patient ◽

Adalimumab Treatment

Hagyományos kezelésre refrakter, fistulás Crohn-betegek kezelésében a chimer antitumornekrózis-faktor-alfa- (infliximab-) terápia igen hatékony, bár a betegek egy részében infliximabrezisztencia alakulhat ki. A szerzők egy infliximabrezisztens, 12 éves Crohn-beteg fiú esetét ismertetik, akinek luminális gyulladása mellett 3 aktív perianalis fistulája is volt. Teljesen humanizált antitumornekrózis-faktor-alfa- (adalimumab-) kezelést követően a 10. héten a fistulák bezáródtak, a korábbi magas aktivitási index normalizálódott. Validált életminőségi mutatók szintén szignifikánsan javultak. Az eset alapján infliximabrezisztens Crohn-beteg gyermeknél az adalimumabterápia sikerrel alkalmazható.

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GENDER-RELATED DIFFERENCES IN CLINICAL COURSE OF CROHN’S DISEASE IN AN ASIAN POPULATION: a retrospective cohort review

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032014000200004 ◽

2014 ◽

Vol 51 (2) ◽

pp. 90-96 ◽

Cited By ~ 3

Author(s):

Siu-tong LAW ◽

Kin Kong LI

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Immunosuppressive Therapy ◽

Retrospective Cohort ◽

Clinical Characteristics ◽

Positive Family History ◽

Asian Population ◽

Smoking History ◽

Phenotypic Characteristics ◽

Increased Risk

ContextData from Asian populations about gender-related differences in Crohn’s disease are few.ObjectivesThis study was to analyze the clinical characteristics between women and men affected by Crohn’s disease.MethodsThis was a retrospective cohort study to analyze consecutive Crohn’s disease patients from Jan 2000 to Dec 2012. Clinical and phenotypic characteristics and treatment outcomes were evaluated.Results79 patients (55 male and two of them with positive family history) were diagnosed with Crohn’s disease. Ileocolonic disease and inflammatory lesion was the most dominant site of involvement and disease behavior respectively in both men and women. Apart from higher frequency of nausea (45.83 vs 23.64%, P 0.024) and lower body mass index (19.44 vs 22.03 kg/m2, P 0.003) reported in women, no significant gender-related differences in clinical characteristics were observed. Women were more associated with delay use of immunosuppressive therapy (12 vs 36 months, P = 0.028), particularly for those aged less than 40 years old (85 vs 62.6%,P = 0.023). Cox proportional hazard regression analysis revealed that active smoking (HR, 4.679; 95% CI, 1.03-21.18) and delayed use of immunosuppressive therapy (HR, 4.13; 95% CI, 1.01-16.88) were only independent risk factors associated with increased risk of complications.ConclusionsThere were no significant gender-specific differences in clinical and phenotypic characteristics between male and female Crohn’s disease patients. Smoking history and delay use of immunosuppressive therapy were associated with higher risk of complications.

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