scholarly journals Extra-Intestinal Features of Crohn’s Disease

2021 ◽  
Author(s):  
Monjur Ahmed
Keyword(s):  
Crohn’S Disease ◽  
Clinical Practice ◽  
Immune System ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Bile Salts ◽  
Chronic Inflammatory Disease ◽  
Multiple Organs ◽  
Immune Mediated ◽  
Pulmonary Manifestations

Although Crohn’s disease is a chronic inflammatory disease of the gastrointestinal tract, it can affect multiple organs behaving like a multisystem immune mediated disease. The dysregulated immune system in patients with Crohn’s disease leads to uncontrolled inflammation which primarily affects the gastrointestinal tract but may also affect various extra-intestinal organs. With the increased incidence and prevalence of Crohn’s disease, its extra-intestinal manifestations are increasingly being seen in our clinical practice. The musculoskeletal, mucocutaneous, ophthalmic, hepatobiliary, renal, cardiovascular and pulmonary manifestations of Crohn’s disease have been reviewed in this chapter. Some of these extra-intestinal manifestations are due to systemic inflammation, some of them are due to malabsorption of nutrients and bile salts, and some due to medications given for the treatment of Crohn’s disease. These extra-intestinal manifestations of Crohn’s disease are seen in at least 25% of patients with Crohn’s disease. Some of them correlate well with Crohn’s disease activity but the rest of them have no relation to the activity of Crohn’s disease. Although most of the time the extra-intestinal features are seen after the diagnosis of Crohn’s disease, they can precede or follow the diagnosis of Crohn’s disease. Management of these extra-intestinal manifestations varies as the ones associated with activity of Crohn’s disease respond to remission of Crohn’s disease whereas the ones not related to the activity of Crohn’s disease require specific treatments for those conditions.

scholarly journals Aphthous stomatitis as the debut of Crohn’s disease

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.

Inflammatory Bowel Disease

2014 ◽  
pp. 734-747 ◽  
Author(s):  
Sonia Friedman
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Inflammatory Disease ◽  
Bowel Disease ◽  
Chronic Inflammatory Disease ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract that can affect any site from the mouth to the anus. The two major types of IBD are Crohn's disease (CD) and ulcerative colitis (UC).

scholarly journals Targeted 1H NMR metabolomics and immunological phenotyping of human fresh blood and serum samples discriminate between healthy individuals and inflammatory bowel disease patients treated with anti-TNF

2021 ◽  
Author(s):  
Sara Notararigo ◽  
Manuel Martín-Pastor ◽  
Juan E. Viñuela Roldán ◽  
Adriano Quiroga ◽  
J. Enrique Dominguez-Munoz ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
T Lymphocyte ◽  
Fresh Blood ◽  
Serum Samples ◽  
Nmr Metabolomics ◽  
Inflammatory Bowel

Abstract Inflammatory bowel disease is a multifactorial etiology, associated with environmental factors that can trigger both debut and relapses. A high level of tumor necrosis factor-α in the gut is the main consequence of immune system imbalance. The aim of treatment is to restore gut homeostasis. In this study, fresh blood and serum samples were used to identify biomarkers and to discriminate between Crohn’s disease and ulcerative colitis patients under remission treated with anti-TNF. Metabolomics based on Nuclear Magnetic Resonance spectroscopy (NMR) was used to detect unique biomarkers for each class of patients. Blood T lymphocyte repertories were characterized, as well as cytokine and transcription factor profiling, to complement the metabolomics data. Higher levels of homoserine-methionine and isobutyrate were identified as biomarkers of Crohn’s disease with ileocolic localization. For ulcerative colitis, lower levels of creatine-creatinine, proline, and tryptophan were found that reflect a deficit in the absorption of essential amino acids in the gut. T lymphocyte phenotyping and its functional profiling revealed that the overall inflammation was lower in Crohn’s disease patients than in those with ulcerative colitis. These results demonstrated that NMR metabolomics could be introduced as a high-throughput evaluation method in routine clinical practice to stratify both types of patients related to their pathology. Key messages NMR metabolomics is a non-invasive tool that could be implemented in the normal clinical practice for IBD to assess beneficial effect of the treatment. NMR metabolomics is a useful tool for precision medicine, in order to sew a specific treatment to a specific group of patients. Finding predictors of response to IFX would be desirable to select patients affected by IBD. Immunological status of inflammations correlates with NMR metabolomics biomarkers.

scholarly journals P578 Evolution of Crohn's disease treatment in clinical practice: a 25 year single centre cohort study

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S375-S375
Author(s):  
K. Hartery ◽  
C. Moran ◽  
J. Sheridan ◽  
D. Keegan ◽  
K. Byrne ◽  
...  
Keyword(s):  
Cohort Study ◽  
Crohn’S Disease ◽  
Clinical Practice ◽  
Crohn's Disease ◽  
Single Centre ◽  
Disease Treatment

scholarly journals Isolated Duodenal Crohn's Disease: A Case Report and a Review of the Surgical Management

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Faruk Karateke ◽  
Ebru Menekşe ◽  
Koray Das ◽  
Sefa Ozyazici ◽  
Pelin Demirtürk
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Crohn's Disease ◽  
Medical Treatment ◽  
Immunosuppressive Therapy ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Surgical Options ◽  
Crohn’S Diseases

Crohn's disease may affect any segment of the gastrointestinal tract; however, isolated duodenal involvement is rather rare. It still remains a complex clinical entity with a controversial management of the disease. Initially, patients with duodenal Crohn' s disease (DCD) are managed with a combination of antiacid and immunosuppressive therapy. However, medical treatment fails in the majority of DCD patients, and surgical intervention is required in case of complicated disease. Options for surgical management of complicated DCD include bypass, resection, or stricturoplasty procedures. In this paper, we reported a 33-year-old male patient, who was diagnosed with isolated duodenal Crohn’s diseases, and reviewed the surgical options in the literature.

scholarly journals The Role of Inflammation in Crohn’s Disease Recurrence after Surgical Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
B. Sensi ◽  
L. Siragusa ◽  
C. Efrati ◽  
L. Petagna ◽  
M. Franceschilli ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Immune System ◽  
Crohn's Disease ◽  
Disease Recurrence ◽  
Postoperative Recurrence ◽  
Preventive Strategies ◽  
Mesenteric Lymph Nodes ◽  
Surgical Strategies ◽  
Driving Mechanisms

Introduction. Postoperative recurrence after surgery for Crohn’s disease (CD) is virtually inevitable, and its mechanism is poorly known. Aim. To review the numerous factors involved in CD postoperative recurrence (POR) pathogenesis, focusing on single immune system components as well as the immune system as a whole and highlighting the clinical significance in terms of preventive strategies and future perspectives. Methods. A systematic literature search on CD POR, followed by a review of the main findings. Results. The immune system plays a pivotal role in CD POR, with many different factors involved. Memory T-lymphocytes retained in mesenteric lymph nodes seem to represent the main driving force. New pathophysiology-based preventive strategies in the medical and surgical fields may help reduce POR rates. In particular, surgical strategies have already been developed and are currently under investigation. Conclusions. POR is a complex phenomenon, whose driving mechanisms are gradually being unraveled. New preventive strategies addressing these mechanisms seem promising.

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