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Complications of Crohn's Disease

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https://www.readbyqxmd.com/read/28728316/use-of-novel-oral-anticoagulant-to-treat-pulmonary-thromboembolism-in-patient-with-ulcerative-colitis-superinfected-cytomegalovirus-colitis
#1
Seok Hwan Kim, Sunhee Jang, Yegyu Sung, Jun Kyu Park, Yunjung Park, Jintak Yun, Sang Bum Kang
Crohn's disease and ulcerative colitis are the two major types of inflammatory bowel disease, and affect mainly the gastrointestinal tract but also have extraintestinal sequelae, such as arterial and venous thromboembolism. Thromboembolic complications, particularly pulmonary thromboembolism, can be life threatening and require prompt management with anticoagulants. Conventional vitamin K antagonists have been used for the treatment of thromboembolic complications, but the development of novel oral anticoagulants has shifted the paradigm...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28719595/risk-of-postoperative-complications-among-inflammatory-bowel-disease-patients-treated-preoperatively-with-vedolizumab
#2
Akihiro Yamada, Yuga Komaki, Nayan Patel, Fukiko Komaki, Arthur S Aelvoet, Anthony L Tran, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
OBJECTIVES: Vedolizumab is increasingly used to treat patients with ulcerative colitis (UC) and Crohn's disease (CD), however, its safety during the perioperative period remains unclear. We compared the 30-day postoperative complications among patients treated preoperatively with vedolizumab, anti-tumor necrosis factor (TNF)-α agents or non-biological therapy. METHODS: The retrospective study cohort was comprised of patients receiving vedolizumab, anti-TNF-α agents or non-biological therapy within 4 weeks of surgery...
July 18, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28718336/coexistence-of-takayasu-s-arteritis-and-ankylosing-spondylitis-may-not-be-accidental-is-there-a-need-for-a-new-subgroup-in-the-spondyloarthritis-family
#3
Pawel Mielnik, Anja Myhre Hjelle, Jan Leidulv Nordeide
Aortitis of ascending aorta is a recognized complication of ankylosing spondylitis (AS). There are a few published cases of diffuse aortitis and aorta collaterals inflammation that fulfill Takayasu's arteritis (TA) criteria coexisting with AS. We have reviewed published cases from literature and present three new cases of such coexistence. We identified three patients who fulfilled definite AS New York criteria in our Takayasu's vasculitis cohort of eight patients. One of this patients had been diagnosed with Crohn's disease before AS and TA diagnosis...
July 18, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28711286/novel-therapeutic-targets-for-inflammatory-bowel-disease
#4
REVIEW
Marjorie Argollo, Gionata Fiorino, Pieter Hindryck, Laurent Peyrin-Biroulet, Silvio Danese
Inflammatory bowel disease (IBD), including Crohn's disease (CD) and Ulcerative Colitis (UC), are immune mediated conditions associated with progressive damage of the inflamed gut tissue, and have a considerable impact on the patient's quality of life. The pathogenesis remains uncertain, but it is clear that complex mechanisms associated with host and luminal factors are involved, generating an unbalance between pro- and anti-inflammatory signaling. It is well established that the purpose of an adequate and complete control of the intestinal inflammation measured not only by clinical symptoms, but also with more objective data such as fecal biomarkers (calprotectin) and endoscopy...
July 12, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28708806/understanding-the-cautions-and-contraindications-of-immunomodulator-and-biologic-therapies-for-use-in-inflammatory-bowel-disease
#5
H Matthew Cohn, Maneesh Dave, Edward V Loftus
Ulcerative colitis and Crohn's disease are chronic inflammatory bowel diseases for which there are no cures. These diseases are immunopathogenic, and medical treatment is centered on the temperance of a dysregulated immune response to allow mucosal healing and prevent the sequelae of fistulation and stenosis. Accordingly, the armamentarium of medications, which has expanded immensely in recent history, is not without significant infectious and neoplastic risks. Many of these untoward effects can be mitigated by screening and avoidance of contraindicated medications...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28708248/oral-and-upper-gastrointestinal-crohn-s-disease
#6
REVIEW
Robyn Laube, Ken Liu, Mark Schifter, Jessica L Yang, Michael K Suen, Rupert W Leong
Crohn's disease is a heterogeneous, inflammatory condition that can affect any location of the gastrointestinal tract. Proximal gastrointestinal involvement occurs in 0.5-16% of patients, and it is usually diagnosed after recognition of intestinal disease. Symptoms are often mild and non-specific, however upper gastrointestinal disease predicts a more severe Crohn's phenotype with a greater frequency of complications such as obstruction and perforation. Gastroscopy and biopsy is the most sensitive diagnostic investigation...
July 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28706415/role-of-new-endoscopic-techniques-in-inflammatory-bowel-disease-management-has-the-change-come
#7
EDITORIAL
Loredana Goran, Lucian Negreanu, Ana Maria Negreanu
Despite significant therapeutic progress in recent years, inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, remains a challenge regarding its pathogenesis and long-term complications. New concepts have emerged in the management of this disease, such as the "treat-to-target" concept, in which mucosal healing plays a key role in the evolution of IBD, the risk of recurrence and the need for surgery. Endoscopy is essential for the assessment of mucosal inflammation and plays a pivotal role in the analysis of mucosal healing in patients with IBD...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28704225/intravenous-iron-sucrose-for-treatment-of-iron-deficiency-anemia-in-pediatric-inflammatory-bowel-disease
#8
Ronen E Stein, Kristen Plantz, Elizabeth C Maxwell, Petar Mamula, Robert N Baldassano
OBJECTIVES: Iron deficiency anemia (IDA) is a common complication of pediatric inflammatory bowel disease (IBD), yet the effectiveness of oral iron supplementation is limited. Intravenous iron sucrose is an effective and safe alternative treatment for IDA in adults with IBD, but its role in the treatment of IDA in pediatric IBD is unclear. The primary aim of this study was to evaluate the use of iron sucrose in pediatric IBD subjects with IDA and determine the clinical response as measured by improvement in hemoglobin concentration...
July 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28703786/fistulizing-crohn-s-disease
#9
Michael Scharl, Gerhard Rogler, Luc Biedermann
Fistulas still represent one of the most important complications in patients with Crohn's disease (CD). At least one third of CD patients suffer from fistulas during their disease course and amongst them longstanding remission of complex fistulas occurs only in about one third. So far, fistula pathogenesis is only partially understood. From a histopathological view, a fistula is a tube covered by flat epithelial cells. Current research suggests that the driving force for fistula development is epithelial-to-mesenchymal transition (EMT)...
July 13, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28701261/five-year-survival-and-causes-of-death-in-patients-on-home-parenteral-nutrition-for-severe-chronic-and-benign-intestinal-failure
#10
Francisca Joly, Janet Baxter, Michael Staun, Darlene G Kelly, Yi Lisa Hwa, Olivier Corcos, Antonella De Francesco, Federica Agostini, Stanislaw Klek, Lidia Santarpia, Franco Contaldo, Cora Jonker, Geert Wanten, Luisa Chicharro, Rosa Burgos, Andre Van Gossum, Cristina Cuerda, Nuria Virgili, Loris Pironi
BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underlying disease are known predictors of HPN dependency and overall survival. Although the cause of death on HPN is mostly related to underlying disease in these patients, the relationship between mortality and duration of HPN use remains unclear...
June 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28696957/association-of-inflammatory-bowel-disease-and-urolithiasis-in-hospitalized-pediatric-patients
#11
Christopher M Stark, Gregory H Gorman, Cade M Nylund
BACKGROUND: Urolithiasis is rare in pediatric patients. All patients with inflammatory bowel disease (IBD) have an increased risk of urolithiasis, but this risk is poorly quantified in children. The objective of this study is to evaluate the association of IBD with urolithiasis, assess surgical outcomes, and analyze the financial burden for children hospitalized with urolithiasis and comorbid IBD. METHODS: The triennial Healthcare Cost and Utilization Project Kids' Inpatient Database for years 1997 to 2012 was used to evaluate the association between urolithiasis and IBD in hospitalized, nonpregnant children ages 5 to 20 years old...
July 10, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28694130/bowel-damage-in-patients-with-long-term-crohn-s-disease-assessed-by-magnetic-resonance-enterography-and-the-lemann-index
#12
Aida Kapic Lunder, Jørgen Jahnsen, Linda Tøften Bakstad, Arne Borthne, Johannes Roksund Hov, Morten Vatn, Anne Negård
BACKGROUND AND AIMS: Magnetic Resonance Enterography (MRE) is used to evaluate the extent and complications of Crohn's disease (CD) and has recently been included in a score for bowel damage, the Lemann Index (LI). The long-term outcomes of CD are still uncertain and we aimed to assess the structural bowel changes after 20 years of CD by means of MRE and LI score. METHODS: We performed a follow-up analysis of a population-based cohort of 237 patients in southeastern Norway diagnosed with CD from 1990 through 1993...
July 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28691939/autoantibodies-against-glycoprotein-2-isoforms-in-pediatric-patients-with-inflammatory-bowel-disease
#13
Nadja Röber, Lydia Noß, Alexander Goihl, Dirk Reinhold, Josefine Jahn, Jan de Laffolie, Wolf Johannes, Gunter M Flemming, Dirk Roggenbuck, Karsten Conrad, Martin W Laass
BACKGROUND: Anti-Glycoprotein 2 (GP2) antibodies are associated with a more complicated course of Crohn's disease (CD) in adults. Four different GP2 isoforms with different length and antibody-binding sites have been identified so far but not been explored in serological studies. We aimed to investigate the diagnostic utility of autoantibodies against all 4 isoforms of GP2 in an exclusively pediatric population for the first time. METHODS: We included 278 children and adolescents with inflammatory bowel disease: 164 with CD, 114 with ulcerative colitis, 83 disease controls (acute gastrointestinal infection, nonspecific gastrointestinal functional disorders), and 219 healthy controls...
July 6, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28690491/a-complicated-thread-abdominal-actinomycosis-in-a-young-woman-with-crohn-disease
#14
Ari Nahum, Gregory Filice, Ashish Malhotra
Crohn disease is a chronic inflammatory condition that primarily affects the gastrointestinal tract. Typical manifestations include fever, weight loss, fatigue, and abdominal pain, and abdominal abscesses and fistulae are frequent complications. Abdominal actinomycosis is a subacute or indolent disease associated with Actinomyces spp. Symptoms can be very similar to those of Crohn disease, and fistulae are also common. Since ulcerations in the intestinal tract are thought to be caused by Actinomyces escaping from the gut lumen and establishing intra-abdominal infection, it seems likely that abdominal actinomycosis may occur in patients with inflammatory bowel disease...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28684845/multiple-fresh-fecal-microbiota-transplants-induces-and-maintains-clinical-remission-in-crohn-s-disease-complicated-with-inflammatory-mass
#15
Zhi He, Pan Li, Jianguo Zhu, Bota Cui, Lijuan Xu, Jie Xiang, Ting Zhang, Chuyan Long, Guangming Huang, Guozhong Ji, Yongzhan Nie, Kaichun Wu, Daiming Fan, Faming Zhang
The ancient Chinese medical literature, as well as our prior clinical experience, suggests that fecal microbiota transplantation (FMT) could treat the inflammatory mass. We aimed to evaluate the efficacy and safety of multiple fresh FMTs for Crohn's disease (CD) complicated with intraabdominal inflammatory mass. The "one-hour FMT protocol" was followed in all patients. Twenty-five patients were diagnosed with CD and related inflammatory mass by CT or MRI. All patients received the initial FMT followed by repeated FMTs every 3 months...
July 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28680469/crohn-s-disease-first-diagnosis-in-pregnancy-and-management
#16
C Jamieson, M Morosan, M Cameron
This case addresses the difficulty in the initial diagnosis of severe Crohn's disease in pregnancy as well as the challenges of instituting remission therapy towards the end of second trimester. The patient's course was complicated by recurrent hospital admissions and intolerance to diet requiring temporary nasogastric feeding. Medical management included the use of biological agents during pregnancy, which allowed for better symptomatic control. She sustained no further complications and underwent a successful vaginal delivery of a healthy baby at 37 weeks' gestation...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28670609/symptomatic-isolated-terminal-ileal-ulcers-etiology-and-clinical-significance
#17
Varun Mehta, Ankita Gupta, Ramit Mahajan, Vikram Narang, Vandana Midha, Neena Sood, Harpreet Kaur, Kirandeep Kaur, Ajit Sood
BACKGROUND:  With an increasing number of ileal intubations, isolated terminal ileal ulcers (ITIU) are frequently found during colonoscopies. The present study aimed at studying the etiology and clinical significance of these ulcers in patients having gastrointestinal symptoms. METHODS:  This was a prospective observational study performed on consecutive patients who underwent ileocolonoscopy for various gastrointestinal symptoms between 1 January 2014 and 31 December 2014...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28670577/crohn-s-strictures-moving-away-from-the-knife
#18
REVIEW
Emily Stenke, Billy Bourke, Ulla Knaus
Crohn's disease (CD) is a lifelong inflammatory bowel disease with a rapidly rising incidence in the pediatric population. A common complication of CD is the development of fibrotic strictures, which may be present at initial diagnosis or develop many years later. Clinical presentation depends on stricture location and degree of obstruction, and strictures frequently contain a mixture of inflammatory and fibrotic tissue. Histological examination of Crohn's strictures shows thickening of the muscular layers and the submucosa, where increased collagen deposition by activated myofibroblasts is concentrated around islands of smooth muscle cells and at the superficial margin of the muscularis propria...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28670235/ophthalmologic-manifestations-in-patients-with-inflammatory-bowel-disease
#19
Hye Jin Lee, Hyun Joo Song, Jin Ho Jeong, Heung Up Kim, Sun-Jin Boo, Soo-Young Na
BACKGROUND/AIMS: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), has been reported to have various ophthalmologic manifestations. The aim of this study was to evaluate the prevalence of ophthalmologic manifestations associated with IBD in Korea. METHODS: Sixty-one patients were examined between May 2013 and October 2014. We performed complete ophthalmologic examinations. RESULTS: Findings included 36 patients with CD and 25 with UC...
July 2017: Intestinal Research
https://www.readbyqxmd.com/read/28670226/management-of-crohn-s-disease-in-taiwan-consensus-guideline-of-the-taiwan-society-of-inflammatory-bowel-disease
#20
REVIEW
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD...
July 2017: Intestinal Research
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