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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/28328621/ocular-involvement-in-children-with-inflammatory-bowel-disease
#1
Samuele Naviglio, Fulvio Parentin, Silvia Nider, Nicolò Rassu, Stefano Martelossi, Alessandro Ventura
BACKGROUND: Data on ocular manifestations of inflammatory bowel disease (IBD) in children are limited. Some authors have reported a high prevalence of asymptomatic uveitis, yet the significance of these observations is unknown and there are no recommendations on which ophthalmologic follow-up should be offered. METHODS: Children with IBD seen at a single referral center for pediatric gastroenterology were offered ophthalmologic evaluation as part of routine care for their disease...
March 21, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28323747/supporting-a-youth-with-cerebellar-ataxia-into-adolescence
#2
Veronica Meneses, Zurisadai Gonzalez-Castillo, Veronica B Edgar, Marilyn Augustyn
Zoe, a 13-year-old white girl, presents as a new patient to your pediatric clinic with complaints of frequent emesis, anxiety, and learning problems, and previous diagnosis of cerebellar ataxia. Parents accompany Zoe and state, "it is really hard for her to go out, she gets sick and falls easily." She was born full term by vaginal delivery without complications. Given globally delayed milestones, she received early intervention services. Feeding problems began at infancy, including gastroesophageal reflux and aspiration pneumonia...
March 17, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28321155/pseudopolyps-in-inflammatory-bowel-diseases-have-we-learned-enough
#3
REVIEW
Dimitrios S Politis, Konstantinos H Katsanos, Epameinondas V Tsianos, Dimitrios K Christodoulou
Pseudopolyps are a well described entity in the literature and even though the exact pathogenesis of their formation is not completely understood, they are considered non-neoplastic lesions originating from the mucosa after repeated periods of inflammation and ulceration associated with excessive healing processes. Their occurrence is less common in Crohn's disease than in ulcerative colitis, and their overall prevalence ranges from 4% to 74%; moreover, they are found more often in colon but have been detected in other parts of the gastrointestinal tract as well...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28304125/subtotal-colectomy-for-ulcerative-colitis-lessons-learned-from-a-tertiary-centre
#4
Nicolas C Buchs, Alexander L A Bloemendaal, Christopher P J Wood, Simon Travis, Neil J Mortensen, Richard J Guy, Bruce D George
AIM: Subtotal colectomy (STC) is a well-established treatment for complicated and refractory ulcerative colitis (UC). A laparoscopic approach offers potentially improved outcomes. The aim of the study was to report our experience with STC for UC in a single large center. METHOD: From January 2007 to May 2015, all consecutive patients undergoing STC for UC were retrospectively analysed from a prospectively-managed database. Patients with known Crohn's disease or those undergoing one-stage procedures were excluded...
March 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28301429/results-at-up-to-30-years-after-ileal-pouch-anal-anastomosis-for-chronic-ulcerative-colitis
#5
Amy L Lightner, Kellie L Mathis, Eric J Dozois, Dieter Hahnsloser, Edward V Loftus, Laura E Raffals, John H Pemberton
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) has become the surgical procedure of choice for patients with chronic ulcerative colitis. No study to date has examined functional and quality-of-life outcomes 30 years after pouch construction. METHODS: Using data from a prospectively maintained database with annually distributed questionnaires, functional outcomes, pouch complications, and quality of life after IPAA were determined. RESULTS: Overall, 93...
March 15, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28298964/magnetic-resonance-enterography-in-crohn-s-disease-how-we-do-it-and-common-imaging-findings
#6
REVIEW
Annalisa Mantarro, Paola Scalise, Elisa Guidi, Emanuele Neri
Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract, with unpredictable clinical course by phases of relapses alternating with other of quiescence. The etiology is multifactorial and is still not completely known; globally the westernization of lifestyle is causing an increasing incidence of CD, with peak age of 20-30 years. The diagnostic workup begins with the evaluation of the clinical history, physical examination and laboratory tests. However, the clinical assessment is subjected interobserver variability and, occasionally, the symptoms of acute and chronic inflammation may be indistinguishable...
February 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28296781/efficacy-and-safety-of-medical-therapy-for-low-bone-mineral-density-in-patients-with-crohn-disease-a-systematic-review-with-network-meta-analysis
#7
Xiaojing Zhao, Changcheng Zhou, Han Chen, Jingjing Ma, Yunjuan Zhu, Peixue Wang, Yi Zhang, Haiqin Ma, Hongjie Zhang
BACKGROUND: Low bone mineral density (BMD) is a frequent complication of inflammatory bowel disease (IBD), particularly in patients with Crohn disease (CD). The aim of our study is to determine the efficacy and safety of different drugs used to treat low BMD in patients with CD. METHODS: PUBMED/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched for eligible studies. A random-effects model within a Bayesian framework was applied to compare treatment effects as standardized mean difference (SMD) with their corresponding 95% credible interval (CrI), while odds ratio (OR) was applied to compare adverse events with 95% CrI...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28293746/long-standing-crohn-s-disease-and-its-implication-on-anal-squamous-cell-cancer-management
#8
Amy L Lightner, Sara B Moncrief, Thomas C Smyrk, John H Pemberton, Michael G Haddock, David W Larson, Eric J Dozois, Kellie L Mathis
BACKGROUND: Anal squamous cell carcinoma (ASCC) is rare, accounting for only 1% of gastrointestinal malignancies. We sought to better understand management strategies for ASCC in the setting of Crohn's disease (CD). METHODS: A retrospective chart review from 2001 to 2016 was conducted using ICD-9/10 codes for CD (555.9/K50) and ASCC (154.3/C44.520). Adult patients with a diagnosis of CD at the time of ASCC diagnosis were included. RESULTS: Seven patients (five female) were included with a median age of 50 years...
March 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28288653/inflammatory-bowel-disease-following-anti-interleukin-1-treatment-in-systemic-juvenile-idiopathic-arthritis
#9
Boris Hügle, Fabian Speth, Johannes-Peter Haas
BACKGROUND: Inflammatory bowel disease can develop in the context of some rheumatic diseases in childhood, including juvenile idiopathic arthritis (JIA). Inflammatory bowel disease (IBD) is frequently associated with other immune-mediated diseases; however, systemic onset JIA (sJIA) has not previously been connected to IBD. Treatment of sJIA has significantly changed in recent years, possibly causing changes in inflammatory patterns. Therefore, data from the German Center for Pediatric and Adolescent Rheumtology from 2010 until 2015 were analyzed by retrospective chart review...
March 14, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28267043/a-fixed-stricture-on-routine-cross-sectional-imaging-predicts-disease-related-complications-and-adverse-outcomes-in-patients-with-crohn-s-disease
#10
Naueen A Chaudhry, Michael Riverso, Joseph R Grajo, Patricia P Moser, Fei Zou, Maher Homsi, Darashana R Punglia, Ellen M Zimmermann
BACKGROUND: Patients with Crohn's disease (CD) typically undergo multiple cross-sectional imaging exams including computed tomography and magnetic resonance enterography during the course of their disease. The aim was to identify imaging findings that predict future disease-related poor outcomes. METHODS: This was a retrospective, case control study at a single tertiary center. Cases were CD patients diagnosed with complications (bowel obstruction, perforation, internal fistula, or abscess); controls were CD patients without complications...
April 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28260712/a-case-of-turner-syndrome-46xxp-45x-complicated-with-crohn-s-disease-after-hormone-therapy
#11
Yutaro Ihara, Kazuoki Hizawa, Kouhei Fujita, Masahiro Iida, Ema Washio, Takahiro Kai, Tomoki Nitahata, Motohiro Esaki, Mitsuo Iida
A 19-year-old woman, who had been receiving hormone replacement therapy for 13 months before the diagnosis of mosaic Turner syndrome (46XXp-/45X), developed Crohn's colitis and erythema nodosum of the lower legs. Colonoscopy revealed an anal fistula and the presence of deep longitudinal ulcers with cobblestoning in the colorectum. Therapy with prednisolone and adalimumab was effective for the intestinal and skin lesions. To date, all seven case reports of Turner syndrome in Japan have also developed Crohn's disease after hormone therapy, suggesting a possible association of sex hormones in the pathogenesis...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28259484/prediction-of-complicated-disease-course-for-children-newly-diagnosed-with-crohn-s-disease-a-multicentre-inception-cohort-study
#12
Subra Kugathasan, Lee A Denson, Thomas D Walters, Mi-Ok Kim, Urko M Marigorta, Melanie Schirmer, Kajari Mondal, Chunyan Liu, Anne Griffiths, Joshua D Noe, Wallace V Crandall, Scott Snapper, Shervin Rabizadeh, Joel R Rosh, Jason M Shapiro, Stephen Guthery, David R Mack, Richard Kellermayer, Michael D Kappelman, Steven Steiner, Dedrick E Moulton, David Keljo, Stanley Cohen, Maria Oliva-Hemker, Melvin B Heyman, Anthony R Otley, Susan S Baker, Jonathan S Evans, Barbara S Kirschner, Ashish S Patel, David Ziring, Bruce C Trapnell, Francisco A Sylvester, Michael C Stephens, Robert N Baldassano, James F Markowitz, Judy Cho, Ramnik J Xavier, Curtis Huttenhower, Bruce J Aronow, Greg Gibson, Jeffrey S Hyams, Marla C Dubinsky
BACKGROUND: Stricturing and penetrating complications account for substantial morbidity and health-care costs in paediatric and adult onset Crohn's disease. Validated models to predict risk for complications are not available, and the effect of treatment on risk is unknown. METHODS: We did a prospective inception cohort study of paediatric patients with newly diagnosed Crohn's disease at 28 sites in the USA and Canada. Genotypes, antimicrobial serologies, ileal gene expression, and ileal, rectal, and faecal microbiota were assessed...
March 1, 2017: Lancet
https://www.readbyqxmd.com/read/28252200/exploration-of-inflammatory-bowel-disease-in-mice-chemically-induced-murine-models-of-inflammatory-bowel-disease-ibd
#13
Raffaella Maria Gadaleta, Oihane Garcia-Irigoyen, Antonio Moschetta
Inflammatory bowel disease (IBD) is a chronic multifactorial inflammatory disorder characterized by periods of activation and remission of intestinal inflammation, with potentially severe complications, that can lead to mortality. Experimental animal models of intestinal inflammation are crucial for understanding the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC), the two major human IBD phenotypes. Animal models have been instrumental in unveiling the molecular background of IBD, and although a single model is not able to capture the complexity of this disease, each of them provided valuable insight into its different aspects...
March 2, 2017: Current Protocols in Mouse Biology
https://www.readbyqxmd.com/read/28251684/influence-of-age-at-diagnosis-on-the-clinical-characteristics-of-crohn-s-disease-in-korea-results-from-the-connect-study
#14
Sung Wook Hwang, Jee Hyun Kim, Jong Pil Im, Byong Duk Ye, Hoon Sup Koo, Kyu Chan Huh, Jae Hee Cheon, You Sun Kim, Young Ho Kim, Dong Soo Han, Won Ho Kim, Joo Sung Kim
BACKGROUND AND AIM: The present study evaluated the clinical characteristics of Korean patients with Crohn's disease (CD) according to their age at diagnosis in a nationwide multicenter cohort study. METHODS: A total of 1,224 patients diagnosed with CD between 1982 and 2008 in 32 hospitals were included, and age at diagnosis was categorized as ≤ 16 (G1), 17-40 (G2), 41-59 (G3) and ≥ 60 (G4) years old. The baseline characteristics, medication, and intestinal resection were compared according to the age at diagnosis...
March 2, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28251502/avoiding-rash-conclusions-challenge-of-iga-vasculitis-in-adults
#15
S Hu, A Birg, M Hovaida, M W Gavin, D McCarthy
IgA vasculitis is primarily a pediatric disease that is rarely encountered in adults. With adults, gastrointestinal manifestations are quite common, yet are nonspecific and may overlap with other diseases, particularly Crohn's disease, which can make the diagnosis a challenging task. Treatment is controversial given the disease course is usually self-limited with few serious complications. We present a case of IgA vasculitis in an adult patient with limited extraintestinal findings illustrating the complexity of arriving at the correct diagnosis...
March 1, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28247769/symptomatic-retention-of-the-agile%C3%A2-patency-capsule
#16
Juan Egea Valenzuela, Esther Estrella Diez, Fernando Alberca de Las Parras
The Agile® capsule has shown to be useful when evaluating the patency of the small bowel in patients prior to capsule endoscopy studies. It is a safe tool and a low rate of complications have been reported, highlighting symptomatic retention, although references in literature are scarce and it is only observed in 1.2% of the procedures. We present the case of a symptomatic retention of this device in a patient with previously known colonic Crohn's disease in who a small bowel study was indicated and was sent for prior patency test...
March 1, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28239314/second-korean-guidelines-for-the-management-of-crohn-s-disease
#17
REVIEW
Jae Jun Park, Suk-Kyun Yang, Byong Duk Ye, Jong Wook Kim, Dong Il Park, Hyuk Yoon, Jong Pil Im, Kang Moon Lee, Sang Nam Yoon, Heeyoung Lee
Crohn's disease (CD) is a chronic, progressive, and disabling inflammatory bowel disease (IBD) with an uncertain etiopathogenesis. CD can involve any site of the gastrointestinal tract from the mouth to the anus, and is associated with serious complications, such as bowel strictures, perforations, and fistula formation. The incidence and prevalence rates of CD in Korea are still lower compared with those in Western countries, but they have been rapidly increasing during the recent decades. Although there are no definitive curative modalities for CD, various medical and surgical therapies have been applied for the treatment of this disease...
January 2017: Intestinal Research
https://www.readbyqxmd.com/read/28228435/crohn-s-disease-complicated-by-epstein-barr-virus-driven-haemophagocytic-lymphohistiocytosis-successfully-treated-with-rituximab
#18
Grace Thompson, Dominic Pepperell, Ian Lawrence, Benjamin David McGettigan
We report a case of Epstein-Barr virus (EBV)-driven haemophagocytic lymphohistiocytosis (HLH) in a man with Crohn's disease treated with 6-mercaptopurine and adalimumab therapy who was successfully treated with rituximab therapy alone. This is the first published case in an adult patient with EBV-driven HLH in the setting of thiopurine use and inflammatory bowel disease to be successfully treated with rituximab therapy alone. Here, we will discuss putative immunological mechanisms which may contribute to this potentially life-threatening complication...
February 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28218881/mr-imaging-of-perianal-crohn-disease
#19
Shannon P Sheedy, David H Bruining, Eric J Dozois, William A Faubion, Joel G Fletcher
Pelvic magnetic resonance (MR) imaging is currently the standard for imaging perianal Crohn disease. Perianal fistulas are a leading cause of patient morbidity because closure often requires multimodality treatments over a prolonged period of time. This review summarizes clinically relevant anal sphincter anatomy, imaging methods, classification systems, and treatment objectives. In addition, the MR appearance of healing perianal fistulas and fistula complications is described. Difficult imaging tasks including the assessment of rectovaginal fistulas and ileoanal anastomoses are highlighted, along with illustrative cases...
March 2017: Radiology
https://www.readbyqxmd.com/read/28216978/role-of-capsule-endoscopy-in-suspected-celiac-disease-a-european-multi-centre-study
#20
Marisol Luján-Sanchis, Enrique Pérez-Cuadrado-Robles, Javier García-Lledó, José-Francisco Juanmartiñena Fernández, Luca Elli, Victoria-Alejandra Jiménez-García, Juan Egea-Valenzuela, Julio Valle-Muñoz, Cristina Carretero-Ribón, Ignacio Fernández-Urién-Sainz, Antonio López-Higueras, Noelia Alonso-Lázaro, Mileidis Sanjuan-Acosta, Francisco Sánchez-Ceballos, Bruno Rosa, Santiago González-Vázquez, Federica Branchi, Lucía Ruano-Díaz, César Prieto-de-Frías, Vicente Pons-Beltrán, Pilar Borque-Barrera, Begoña González-Suárez, Sofía Xavier, Federico Argüelles-Arias, Juan-Manuel Herrerías-Gutiérrez, Enrique Pérez-Cuadrado-Martínez, Javier Sempere-García-Argüelles
AIM: To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE). METHODS: This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99)...
January 28, 2017: World Journal of Gastroenterology: WJG
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