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azathioprine crohn

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https://www.readbyqxmd.com/read/29760546/thiopurines-are-negatively-associated-with-anthropometric-parameters-in-pediatric-crohn-s-disease
#1
Neera Gupta, Robert H Lustig, Cewin Chao, Eric Vittinghoff, Howard Andrews, Cheng-Shiun Leu
AIM: To determine the distribution of anthropometric parameter (AP)- z -scores and characterize associations between medications/serum biomarkers and AP- z -scores in pediatric Crohn's disease (CD). METHODS: CD patients [< chronological age (CA) 21 years] were enrolled in a cross-sectional study. Descriptive statistics were generated for participants' demographic characteristics and key variables of interest. Paired t -tests were used to compare AP- z -scores calculated based on CA (CA z -scores) and bone age (BA) (BA z -scores) for interpretation of AP's...
May 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29756637/withdrawal-of-immunosuppressant-or-biologic-therapy-for-patients-with-quiescent-crohn-s-disease
#2
REVIEW
Ray K Boyapati, Joana Torres, Carolina Palmela, Claire E Parker, Orli M Silverberg, Sonam D Upadhyaya, Tran M Nguyen, Jean-Frédéric Colombel
BACKGROUND: Crohn's disease (CD) is a chronic, relapsing and remitting disease of the gastrointestinal tract that can cause significant morbidity and disability. Current treatment guidelines recommend early intervention with immunosuppressant or biological therapy in high-risk patients with a severe disease phenotype at presentation. The feasibility of therapeutic de-escalation once remission is achieved is a commonly encountered question in clinical practice, driven by patient and clinician concerns regarding safety, adverse events, cost and national regulations...
May 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29754190/allergic-and-immunologic-perspectives-of-inflammatory-bowel-disease
#3
REVIEW
Kofi Clarke, Jayakrishna Chintanaboina
Inflammatory bowel disease (IBD) is a chronic immune-mediated inflammatory condition primarily involving the gastrointestinal tract. It includes Crohn's disease (CD), ulcerative colitis (UC), and a less common phenotype-indeterminate colitis. It is thought to result from a complex interplay of environmental, microbial, and host factors including genetic factors, although the exact mechanism is not known. Dietary factors have been shown to play a role in the pathogenesis of IBD and can potentially alter the intestinal microbiota as well as disrupt the immune function in the gut...
May 12, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29743834/characteristics-and-management-of-patients-with-inflammatory-bowel-disease-between-a-secondary-and-tertiary-hospitals-a-propensity-score-analysis
#4
Ki Hwan Song, Eun Soo Kim, Yoo Jin Lee, Byung Ik Jang, Kyeong Ok Kim, Sang Gyu Kwak, Hyun Seok Lee
Background/Aims: This study aimed to compare the clinical characteristics and management patterns of inflammatory bowel disease (IBD) patients in a secondary hospital (SH) with those in tertiary referral centers (TRC). Methods: Data from IBD patients in SH and 2 TRCs were retrospectively reviewed. The cumulative thiopurine use rate was compared between hospitals after controlling for different baseline characteristics using propensity score matching. Results: Among the total of 447 patients with IBD, 178 Crohn's disease (CD) and 269 ulcerative colitis (UC) patients were included...
April 2018: Intestinal Research
https://www.readbyqxmd.com/read/29721514/epstein-barr-virus-positive-mucocutaneous-ulcer-in-an-immunosuppressed-patient
#5
Isabel A Hujoel, Alberto Rubio-Tapia, Linda N Dao, Luis F Porrata, Sunanda V Kane
Immunosuppressive medications, frequently used to treat inflammatory bowel disease, have been linked to the development of Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPD). We describe a case of an EBV-positive mucocutaneous ulcer involving the palate in an elderly woman with inactive Crohn's disease. This patient had been on high-dose azathioprine for a decade. Following diagnosis of her LPD and discontinuation of azathioprine, her oral ulcers resolved completely.
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29676289/natural-history-and-outcome-of-inflammatory-bowel-diseases-in-children-in-saudi-arabia-a-single-center-experience
#6
Khalid M Alreheili, Khalid A Alsaleem, Ali I Almehaidib
Background/Aim: Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder which includes ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis (IC). The natural history of pediatric IBDs is poorly understood and generally unpredictable. We aim to study the natural history of IBD in Saudi children including the extraintestinal manifestations, changes in diagnosis, disease behavior, medical management, and surgical outcome. Patients and Methods: A retrospective review of all the charts of children less than 14 years of age who were diagnosed as IBD and followed up in King Faisal Specialist Hospital and Research Center (KFSH and RC) from January 2001 to December 2011 was performed...
April 18, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29664147/predictors-and-clinical-outcomes-of-follow-up-loss-in-patients-with-inflammatory-bowel-disease
#7
Dae Hyung Woo, Kyeong Ok Kim, Min Kyu Kang, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
BACKGROUND AND AIM: Nonadherence is a risk factor of disease worsening in inflammatory bowel disease (IBD). We analyzed the frequency, predictors, and clinical outcomes of patients with IBD who are lost to follow-up in outpatient clinics. METHODS: Medical records of 784 IBD patients visiting our IBD clinic between January 2010 and December 2015 were reviewed retrospectively. Overall, 285 newly diagnosed IBD patients who were followed up for at least 12 months were included in the analysis...
April 17, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29658768/idiopathic-portal-hypertension-with-regard-to-thiopurine-treatment
#8
Salvador Machlab, Mireia Miquel, Mercedes Vergara
Idiopathic portal hypertension (IPH) is an infrequent adverse reaction to the use of thiopurines that tends to be overlooked. Herein, we present a patient with ileocolic Crohn's disease treated with azathioprine who presented ascites, esophageal varices and splenomegaly without any signs of liver cirrhosis. A portal hemodynamics study revealed a normal portosystemic gradient compatible with presinusoidal portal hypertension. Finally, IPH was diagnosed after a liver biopsy. IPH secondary to thiopurines is due to a 6-thioguanine nucleotide (6-TGN)-dependent reaction and occurs predominantly between three months and three years after the start of treatment...
April 16, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29657220/complete-remission-of-nephrotic-syndrome-secondary-to-amyloid-a-amyloidosis-in-patient-with-inactive-crohn-s-disease-after-treatment-by-infliximab
#9
Kawtar Hassani, Mohamed Amine Hamzi, Driss El Kabbaj
Secondary amyloidosis Amyloid A (AA) is an infrequent but a severe complication of Crohn's disease (CD). This complication results from the activity of the underlying inflammation disease to form amyloid fibril deposits in tissues. We present a case of a 34-year-old female patient with CD treated by azathioprine with inactive disease for three years and who developed a nephrotic syndrome secondary to AA amyloidosis. The treatment by infliximab for one year leads to a complete remission of the nephrotic syndrome...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29614587/-role-of-rac1-signaling-pathway-of-azathioprine-and-peptidoglycan-in-the-regulation-of-monocyte-macrophage-apoptosis-in-crohn-s-disease
#10
Z Zhou, Y Jing, Y Ran, J Zhao, L Zhou, B M Wang
Objective: To evaluate the changes of macrophages and expression of Rac1 in the inflammatory site of Crohn's disease, and to investigate the effects of 6-thioguanine (6-TG) and peptidoglycan on apoptosis of human peripheral blood monocyte-macrophage by regulating Rac1 signaling pathway. Methods: Ten patients with Crohn's disease and eight healthy controls diagnosed were enrolled at Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital from January 2013 to January 2014. The number of macrophages, apoptosis and expression of Rac1 in the inflammation sites and non-inflammation sites of intestinal mucosa were detected in both patients and controls...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29600982/variant-of-rare-hermansky-pudlak-syndrome-associated-with-granulomatous-colitis-diagnostics-clinical-course-and-treatment
#11
L Y Lozynska, A Plawski, M R Lozynska, I Vytvytskyi, R Y Lozynskyi, N Prokopchuk, B Tretiak
AIM: To study the relationship between the genotype and the phenotype in the patients with Hermansky - Pudlak syndrome (HPS) associated with granulomatous colitis; to monitor clinical course of the disease for adequate treatment, cancer surveillance and genetic counseling. MATERIALS AND METHODS: The diagnosis of HPS is established by physical examination, chest X-ray, computed tomography, endoscopic examination with biopsy, and laboratory tests, including histology, baseline laboratory blood, urine and feces tests, determination of ASCA-C and ANCA antibodies using an ELISA...
March 2018: Experimental Oncology
https://www.readbyqxmd.com/read/29576767/comparison-of-concomitant-mesalamine-and-immunomodulator-therapy-and-immunomodulator-monotherapy-for-crohn-s-disease
#12
Min Seob Kwak, Kyung-Jo Kim, Jae Hee Cheon, Wan Soo Kim, Jeong-Mi Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Background: Although immunomodulators are increasingly used in Crohn's disease (CD), a significant number of gastroenterologists still use 5-aminosalicylate (5-ASA) in combination with azathioprine (AZA) or 6-mercaptopurine (6-MP); there is limited evidence regarding the benefit of concomitant 5-ASA with AZA/6-MP compared with AZA/6-MP monotherapy for the treatment of CD. Study Design: A total of 106 patients who received AZA/6-MP for more than 3 months between January 1991 and May 2014 were identified retrospectively...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29560663/case-series-of-cryptogenic-multifocal-ulcerating-stenosing-enteritis-cmuse
#13
H Ooms, H U De Schepper, T G Moreels
BACKGROUND AND STUDY AIMS: Small bowel ulceration poses a limited, but difficult differential diagnosis. The most common causes are Crohn's disease (CD), NSAID-associated enteritis, lymphoma, cytomegaly virus infection and tuberculosis. A less known and relatively novel differential diagnosis is cryptogenic multifocal ulcerative stenosing enteritis (CMUSE). PATIENTS AND METHODS: ive patients referred for balloon-assisted enteroscopy for various reasons showed endoscopic features of CMUSE...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29529681/severe-complication-during-remission-of-crohn-s-disease-hemophagocytic-lymphohistiocytosis-due-to-acute-cytomegalovirus-infection
#14
Jan Miechowiecki, Waltraud Stainer, Gertraud Wallner, Herwig Tuppy, Walter Aichinger, Wolfgang Prammer, Andreas Kirchgatterer
INTRODUCTION: Immunosuppressive therapy is today's standard treatment of patients with moderate to severe inflammatory bowel disease (IBD). The risk for opportunistic infections is increased due to this therapy and is a concern in the management of patient with IBD undergoing such a treatment. CASE REPORT: In this paper, we describe a case of an acute cytomegalovirus (CMV) infection in a 35-year-old male patient with Crohn's disease being in remission while receiving azathioprine therapy...
March 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29513168/case-series-of-cryptogenic-multifocal-ulcerating-stenosing-enteritis-cmuse
#15
H Ooms, H U De Schepper, T G Moreels
BACKGROUND AND STUDY AIMS: Small bowel ulceration poses a limited, but difficult differential diagnosis. The most common causes are Crohn's disease (CD), NSAID-associated enteritis, lymphoma, cytomegaly virus infection and tuberculosis. A less known and relatively novel differential diagnosis is cryptogenic multifocal ulcerative stenosing enteritis (CMUSE). PATIENTS AND METHODS: ive patients referred for balloon-assisted enteroscopy for various reasons showed endoscopic features of CMUSE...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29503938/simultaneous-central-retinal-artery-occlusion-and-optic-nerve-vasculitis-in-crohn-disease
#16
Razek Georges Coussa, Andre Ali-Ridha, Natalia Vila, Rayan Alshareef, John Chen
Purpose: To describe a case of Crohn disease presenting as occlusive vasculitis resulting in a central retinal artery occlusion (CRAO) in one eye and transient ischemic optic neuropathy in the fellow eye. Observations: An 18-year-old patient recently diagnosed with biopsy-proven Crohn disease presented with CRAO OD after a previous episode of transient visual loss OS. Extensive workup was negative for other autoimmune or infectious etiologies. The patient was started on intravenous methylprednisolone for 72 h followed by maintenance dose of azathioprine and oral prednisone...
April 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29491687/comparison-of-tpmt-and-nudt15-polymorphisms-in-chinese-patients-with-inflammatory-bowel-disease
#17
Hong-Hui Wang, Ying He, Hong-Xian Wang, Cheng-Ling Liao, Yu Peng, Li-Jian Tao, Wei Zhang, Hui-Xiang Yang
AIM: To observe gene polymorphisms of TPMT and NUDT15 , and compare their predictive value for azathioprine (AZA)-induced leukopenia in inflammatory bowel disease (IBD). METHODS: This study enrolled 219 patients diagnosed with IBD in Xiangya Hospital, Central South University, Changsha, China from February 2016 to November 2017. Peripheral blood of all patients was collected to detect their genotypes of TPMT and NUDT15 by pyrosequencing at the Department of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics, Xiangya Hospital...
February 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29474531/subtherapeutic-infliximab-trough-levels-and-complete-mucosal-healing-are-associated-with-sustained-clinical-remission-after-infliximab-cessation-in-paediatric-onset-crohn-s-disease-patients-treated-with-combined-immunosuppressive-therapy
#18
Ben Kang, So Yoon Choi, Young Ok Choi, Min-Ji Kim, Kyunga Kim, Ji-Hyuk Lee, Yon Ho Choe
Background and aims: We aimed to investigate the outcome in paediatric-onset Crohn's disease patients who had discontinued infliximab after maintaining clinical remission with combined immunosuppression, and to determine factors associated with clinical relapse. Methods: We conducted a retrospective observational study of 63 paediatric-onset Crohn's disease patients who had stopped scheduled infliximab during sustained corticosteroid-free clinical remission for at least 1 year with infliximab and azathioprine, and were followed up for at least 1 year thereafter...
February 21, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29462391/combination-immunosuppression-in-ibd
#19
Steven Bots, Krisztina Gecse, Murray Barclay, Geert D'Haens
Whether to use biologic treatment for inflammatory bowel disease as monotherapy or in combination with immunosuppressives has been a matter of debate in the last 2 decades. Combination therapy was not superior in any of the registration trials for Crohn's disease and ulcerative colitis for TNF antagonists, vedolizumab, or ustekinumab. It needs to be mentioned, though, that none of these trials were powered to detect such differences, and that many patients entered the trial after having failed conventional immunosuppressives...
February 15, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29430323/declining-use-of-combination-infliximab-and-immunomodulator-for-inflammatory-bowel-disease-in-the-community-setting
#20
Joshua C Berkowitz, Joanna Stein-Fishbein, Sundas Khan, Richard Furie, Keith S Sultan
AIM: To describe trends of combination therapy (CT) of infliximab (IFX) and immunomodulator (IMM) for inflammatory bowel disease (IBD) in the community setting. METHODS: A retrospective study was conducted of all IBD patients referred for IFX infusion to our community infusion center between 04/01/01 and 12/31/14. CT was defined as use of IFX with either azathioprine, 6-mercaptopurine, or methotrexate. We analyzed trends of CT usage overall, for Crohn's disease (CD) and ulcerative colitis (UC), and for the subgroups of induction patients...
February 6, 2018: World Journal of Gastrointestinal Pharmacology and Therapeutics
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