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1.
Mark Fleisher Jan Marsal Scott D. Lee Laura E. Frado Alyssa Parian Burton I. Korelitz Brian G. Feagan 《Digestive diseases and sciences》2018,63(4):825-833
Background
Approximately 15–20% of ulcerative colitis patients and 20–40% of those with Crohn’s disease experience extraintestinal manifestations (EIMs) of their inflammatory bowel disease (IBD). Clinicians who treat IBD must manage EIMs affecting multiple organs that variably correlate with intestinal disease activity. Vedolizumab is a monoclonal antibody for the treatment of IBD with a gut-selective mechanism of action.Aims
This report evaluates whether vedolizumab is an effective treatment of EIMs, given its gut-specific mechanism of action.Methods
We report 8 case studies of patients with various EIMs, including pyoderma gangrenosum, peripheral arthralgia/arthritis, axial arthropathies, erythema nodosum, and uveitis, who received vedolizumab therapy.Results
Vedolizumab therapy was effective for pyoderma gangrenosum in ulcerative colitis, uveitis, erythema nodosum, polyarticular arthropathy, and ankylosing spondylitis/sacroiliitis but did not provide sustained benefit for the treatment of pyoderma gangrenosum in a patient with Crohn’s disease.Conclusions
These cases demonstrate the potential of vedolizumab as a treatment of EIMs in patients with IBD.2.
Rachel Gingold-Belfer Nir Peled Sigal Levy Neriel Katz Yaron Niv Ronnie Fass Gerald Fraser Ram Dickman 《Digestive diseases and sciences》2014,59(1):146-151
Background
Little is known concerning the relationship of disease activity and sleep disturbances in inflammatory bowel disease (IBD) and specifically in patients with Crohn’s disease.Aim
This study examined the prevalence of poor sleep quality in patients with active and inactive Crohn’s disease compared with healthy controls.Methods
Participants included 108 patients with Crohn’s disease attending the IBD clinic of a tertiary medical center in 2009–2010 and 36 healthy volunteers. All prospectively completed a demographic questionnaire and the Pittsburgh sleep quality index (PSQI). Patients with Crohn’s disease completed the Crohn’s disease activity index (CDAI) and were divided into two groups accordingly: inactive disease (CDAI ≤150) and active disease (CDAI >150). Data on disease duration, medications, complications, and treatment were collected from the medical files.Results
Seventy-one patients had inactive Crohn’s disease and 37 had active disease. All three groups were similar in mean age, sex distribution, and body mass index. Mean duration of Crohn’s disease was 10.22 ± 8.6 years; 40 patients (37 %) had ileal disease, 16 (15 %) colonic disease, and 56 (50 %) ileo-colonic disease. Patients with active disease had a significantly higher mean ± SD global score on the PSQI (8.6 ± 2.4; indicating poorer sleep quality) than patients with inactive disease (4.6 ± 1.9) or control subjects (5.1 ± 1.7) (p < 0.0001 for both), with no significant difference between the inactive-disease and control groups. The correlation between the CDAI and PSQI scores was statistically significant (p < 0.001).Conclusions
Impaired sleep quality is associated with active Crohn’s disease, but not inactive disease. 相似文献3.
Hutfless S Li DK Heyman MB Bayless TM Abramson O Herrinton LJ 《Digestive diseases and sciences》2012,57(8):2149-2156
Background
The majority of studies that report early life risk factors for pediatric-onset inflammatory bowel disease (IBD) do not account for potential confounding, which can lead to spurious associations and incorrect inferences.Aims
To assess the relationship between prenatal and perinatal characteristics and the risk of pediatric-onset IBD accounting for potential confounding.Methods
We conducted a nested case–control study of 189 cases aged ≤18 years and 3,080 age- and membership-matched controls born at a Kaiser Permanente Northern California facility between 1984 and 2006. The cases were diagnosed with IBD between 1996 and 2006 and diagnosis was confirmed by chart review. We obtained prenatal and perinatal characteristics from the electronic clinical records of the mother and child. Conditional logistic regression was used to assess the associations between these factors and risk of incident IBD, Crohn’s disease, and ulcerative colitis.Results
In analyses accounting for confounding, maternal IBD (odds ratio [OR] 5.1, 95 % confidence interval [CI] 2.0–12.9) and white race (OR 2.3, 95 % CI 1.6–3.2) were the only factors statistically associated with pediatric-onset IBD. Maternal respiratory infection during pregnancy (OR 2.0, 95 % CI 1.0–4.0), age < 20 years (OR 2.0, 95 % CI 0.8–4.7) and gestational hypertension (OR 1.7, 95 % CI 1.0–2.7) were associated with pediatric-onset IBD, but did not achieve statistical significance.Conclusions
Maternal history of IBD and race were the only characteristics of those that we examined that were associated with the development of pediatric IBD in this well-documented population of cases and matched controls. 相似文献4.
Marc F. J. André Olivier Aumaître Gilles Grateau Mathias Chamaillard Nathalie Costedoat-Chalumeau Marie-Céleste Cardoso Joëlle Henry-Berger Balakrishnan S. Ramakrishna Marc Delpech Jean-Charles Piette Isabelle Creveaux 《Digestive diseases and sciences》2010,55(6):1681-1688
Purpose
Aseptic abscesses syndrome (AA) is an inflammatory disease in which non-infectious deep abscesses develop; these respond quickly to corticosteroids. AA is associated with Crohn disease (CD) in 57% of cases and with neutrophilic dermatosis (ND) in 20%. Pyoderma gangrenosum is usually a sporadic ND. A hereditary autosomal dominant syndromic kind of pyoderma gangrenosum, the PAPA syndrome, is linked to mutations in the CD2BP1/PSTPIP1 gene. We systematically screened this gene in French AA patients.Results
One microsatellite (CCTG)n with 3 alleles was identified in the promoter. The longest form (CCTG)7 was significantly more frequent in AA patients than in French controls (P = 0.0154). We also found an association of the (CCTG)7 allele with CD in French patients (P = 0.0351). This association was not found in a sample of Indian patients.Conclusions
The CCTG repeat in the PSTPIP1 promoter may play a role in the pathogenesis of AA and of CD. Further investigations are required to demonstrate the possible modulation of gene expression by the (CCTG)n motif. 相似文献5.
Barratt SM Leeds JS Robinson K Lobo AJ McAlindon ME Sanders DS 《Digestive diseases and sciences》2011,56(11):3270-3275
Introduction
We aimed to determine the prevalence and duration of prodromal periods in patients with celiac disease and inflammatory bowel disease (Crohn??s disease and ulcerative colitis). Furthermore, we explored to what extent vague abdominal symptoms consistent with both disorders were attributed to irritable bowel syndrome (IBS) and if the presence of prodromal IBS (P-IBS) had an impact on prodrome duration.Methods
In the study, 683 biopsy-proven patients (celiac n = 225, ulcerative colitis n = 228, Crohn??s disease n = 230) completed a postal survey including an assessment of prodromal periods and IBS symptoms during both the prodrome and at present (achieved by completion of the ROME II criteria). Results were compared to age/sex-matched controls (n = 348).Results
Crohn??s disease patients had the highest prevalence of prodromes (94%) in comparison to ulcerative colitis (48%) and celiac disease (44%). However, Crohn??s disease patients have the lowest prevalence of P-IBS (29%) in comparison to ulcerative colitis (38%) and celiac disease (67%). Prodrome duration in patients with P-IBS Crohn??s disease was 4 years in comparison to 2 years without (p = 0.018). Prodrome duration in P-IBS celiac disease was 10 years in comparison to 7 years without (p = 0.046). Prodrome duration in patients with ulcerative colitis was not affected by P-IBS (p ?? 0.05). Age and sex were not confounding factors.Conclusions
This is the first study to make direct comparisons of prodrome periods between celiac disease and IBD. Prodrome duration in celiac disease is significantly longer and more often characterized by P-IBS than IBD. In celiac disease and CD, P-IBS increases prodrome duration. This may represent a failure to understand the overlap between IBS and celiac disease/IBD. 相似文献6.
Rasika Bhamre Sangeet Sawrav Shilpa Adarkar Rishika Sakaria Shobna J Bhatia 《Indian journal of gastroenterology》2018,37(4):307-312
Background
Psychiatric comorbidities are associated with inflammatory bowel disease (IBD). We conducted an observational study to evaluate the prevalence of depression and anxiety in patients with IBD.Methods
Seventy consecutive consenting patients with IBD (62 ulcerative colitis [UC], 8 Crohn’s disease [CD]; 40 males, mean age [SD] 36.2 [11.3] years) and 100 healthy volunteers (44 males, age 31.22 [SD] [10.5] years) as controls were enrolled. All participants were directed to take self-assessment tests, Patient Health Questionnaire -9 (PHQ-9) and Symptom Checklist Anxiety Scale (SCL-A20). Participants having a score ≥ 10 on PHQ-9, or ≥ 29 on SCL-A20 were administered the Hamilton Depression Rating Scale (HAM-D) or Hamilton Anxiety (HAM-A) scales, respectively. The severity of depression and anxiety was graded with HAM-D and HAM-A scales, respectively. The protocol was approved by the Institutional Ethics Committee.Results
The prevalence of depression (34.3% vs. 5%, p?<?0.0001, OR 9.7) and anxiety (18.6% vs. 2%, p?=?0.0002, OR 11.17) was higher in patients with IBD as compared to controls. The severity of depression was higher in patients compared to controls (mean rank 17 vs. 7, p?=?0.04). The prevalence of depression was not different between UC and CD; all IBD patients with anxiety had UC. The mean duration of disease and history of corticosteroid treatment or surgery for IBD were not associated with the presence of depression or anxiety. Patients with severe CD (Crohn’s disease activity index, CDAI?>?450) had more severe depression. The severity of UC did not correlate with severity of anxiety or depression in UC.Conclusions
Anxiety and depression are more prevalent in IBD patients as compared to healthy individuals.7.
Atakan Yeşil Can Gönen Ebubekir Şenateş Nurcan Paker Yasemin Gökden Koray Koçhan Emrullah Düzgün Erdem Feyza Gündüz 《Digestive diseases and sciences》2013,58(9):2587-2593
Background and Aim
Neutrophil gelatinase associated lipocalin (NGAL) is a recently identified molecule, which is bacteriostatic, has tissue destructive effects and is pro-inflammatory with chemoattractant molecule binding properties. Our aim was to investigate the relationship between serum NGAL levels and the type and level of disease activity of IBD.Methods
A total of 92 patients [43 with Crohn’s disease (CD) and 49 with ulcerative colitis (UC)], and 30 age- and sex-matched healthy controls (HC) were included in this study. Serum NGAL levels were measured using ELISA.Results
Serum NGAL levels were elevated in the IBD group [median 171, range (57–312) ng/mL] compared to the HC group [107 (45–234) ng/mL] (p < 0.0001) and were elevated in UC patients [188 (74–312) ng/mL] compared to CD patients [168 (57–279) ng/mL] (p = 0.006). When NGAL levels were further analysed based on localization of the CD and UC, the levels in ulcerative pancolitis [233 (144–312) ng/mL] were significantly higher (p = 0.004) than the left-sided colitis [156 (103–309) ng/mL]. Similarly, NGAL levels were significantly higher in colonic CD [207 (125–249) ng/mL] than ileal CD [114 (78–210) ng/mL], and also in ileocolonic CD [198 (57–279) ng/mL] than ileal CD (p = 0.033). When CD and UC groups were further categorized as active and inactive according to clinical and endoscopic activity indices, serum NGAL concentrations did not differ between inquiescent versus active stages. When a cut-off level of 129 ng/mL was used to distinguish IBD from HC, a sensitivity of 76.1 % and a specificity of 60.9 % was reached.Conclusions
The serum NGAL levels in the IBD group was significantly higher than the HC group. Serum NGAL levels were higher in more extensive colonic involvement. 相似文献8.
Duk Hwan Kim Soo Jung Park Jae Jun Park Young Hoon Yun Sung Pil Hong Tae Il Kim Won Ho Kim Jae Hee Cheon 《Digestive diseases and sciences》2014,59(10):2514-2522
Background
Little is known about the role of follow-up endoscopy in patients with inflammatory bowel disease (IBD).Aim
The present study aimed to evaluate whether repeated endoscopies would be beneficial in improving outcomes of patients with IBD.Methods
Patients who had been initially confirmed to have IBD at two tertiary hospitals in Korea were regularly followed and included in this study. The clinical impact as assessed by the presence or absence of a change in management after endoscopy and cumulative hospitalization rate was compared between two groups classified according to the presence or absence of indications.Results
A total of 188 patients with IBD were enrolled [69 patients with Crohn’s disease (CD) and 119 with ulcerative colitis (UC)]. Of these patients, 130 underwent follow-up endoscopy (48 with CD and 82 with UC). The rate of management change was significantly higher in the group with indications for follow-up endoscopy (p = 0.001 in CD and <0.001 in UC). The presence of any indications for follow-up endoscopy was found to be a significant predictor of hospitalization risk in patients with UC (p = 0.015), but not in those with CD. However, there was no significant difference in cumulative hospitalization hazard with respect to treatment change in patients without any endoscopic indications (p = 0.561 in CD and 0.423 in UC).Conclusions
Follow-up endoscopy might not have a significant impact on the overall clinical course and outcomes in patients with IBD. However, the presence of endoscopic indications predicts a poor clinical outcome in UC. 相似文献9.
S. V. Rana S. Sharma A. Malik J. Kaur K. K. Prasad S. K. Sinha K. Singh 《Digestive diseases and sciences》2013,58(9):2594-2598
Background
Inflammatory bowel disease (IBD) consists of Ulcerative colitis (UC) and Crohn’s disease (CD). These two conditions share many common features—diarrhea, bloody stools, weight loss, abdominal pain, fever and fatigue. Small intestinal bacterial overgrowth (SIBO) is frequent in patients with CD but it has not been studied in UC Indian patients.Aim
The study was planned to measure orocecal transit time (OCTT) and SIBO in UC and CD patients.Methods
One hundred thirty-seven patients of IBD (95 UC and 42 CD) and 115 healthy controls were enrolled. OCTT and SIBO were measured by lactulose and glucose hydrogen breath test respectively. Concentration of hydrogen and methane were measured by SC microlyser from Quintron, USA.Results
Mean ± standard deviation (SD) of OCTT in patients of IBD was significantly higher as compared to controls. Furthermore, OCTT was significantly higher in CD patients as compared to UC patients. It was also observed that occurrence of SIBO was significantly higher in IBD patients as compared to controls. The occurrence of SIBO in CD (45.2 %) was significantly higher as compared to patients in UC (17.8 %) group. Percentage of methane positive IBD patients (2.9 %) was significantly lower as compared to methane positive controls (24.4 %).Conclusion
OCTT was significantly delayed in IBD patients as compared to controls and in CD patients as compared to UC patients. OCTT was significantly higher in SIBO positive IBD patients as compared to SIBO negative patients. Thus, we can suggest that delayed OCTT would have been the cause of increased SIBO in these patients. 相似文献10.
Recent Trends in the Prevalence of Crohn’s Disease and Ulcerative Colitis in a Commercially Insured US Population 总被引:1,自引:0,他引:1
Michael D. Kappelman Kristen R. Moore Jeffery K. Allen Suzanne F. Cook 《Digestive diseases and sciences》2013,58(2):519-525
Purpose
Most US inflammatory bowel disease (IBD) epidemiology studies conducted to date have sampled small, geographically restricted populations and have not examined time trends. The aim of our study was to determine the prevalence of Crohn’s disease (CD) and ulcerative colitis (UC) in a commercially insured US population and compare prevalences across sociodemographic characteristics and time.Methods
Using claims data from approximately 12 million Americans, we performed three consecutive 2-year cross-sectional studies. Cases of CD and UC were identified using a previously described algorithm. Prevalence was estimated by dividing cases by individuals in the source population. Logistic regression was used to compare prevalences by region, age, and sex.Results
In 2009, the prevalences of CD and UC in children were 58 [95 % confidence interval (CI) 55–60] and 34 (95 % CI 32–36), respectively. In adults, the respective prevalences were 241 (95 % CI 238–245) and 263 (95 % CI 260–266). Data analysis revealed that IBD prevalences have slightly increased over time. Based on census data, an estimated 1,171,000 Americans have IBD (565,000 CD and 593,000 UC).Conclusions
Analysis of the epidemiological data revealed an increasing burden of IBD in recent years, which may be used to inform policy. 相似文献11.
Lilani P. Perera Ashwin N. Ananthakrishnan Corinne Guilday Kristin Remshak Yelena Zadvornova Amar S. Naik Daniel J. Stein Benson T. Massey 《Digestive diseases and sciences》2013,58(12):3600-3605
Background
Introduction of biologic agents in inflammatory bowel disease (IBD) has increased the likelihood of disease remission. Despite resolution of active inflammation, a subset of IBD patients report persistent defecatory symptoms.Aim
To evaluate a group of patients with inflammatory bowel disease with suspected functional defecatory disorders, by use of anorectal manometric testing and subsequent biofeedback therapy.Methods
A group of IBD patients with persistent defecatory problems despite clinical improvement were included in this study. These patients had no evidence of left-sided disease. Endoscopic and radiographic study findings and timing in relation to the manometry study were recorded. Anorectal manometry was performed by the standard protocol and included rectal sensory assessment, ability to expel a balloon, and pressure dynamics with simulated defecation.Results
Thirty IBD patients (Crohn’s 23 patients; ulcerative colitis six patients) presented with defecatory disorders including constipation (67 %) increased stooling (10 %), and rectal urgency and/or incontinence and rectal pain (6 %). All but one patient had anorectal manometric criteria of dyssynergia (presence of anismus motor pattern and inability to expel the balloon). Of the patients who completed biofeedback therapy, 30 % had a clinically significant (≥7-point) improvement in SIBDQ score, with a reduction in health-care utilization after a six-month period (p = 0.02).Conclusions
Despite remission, some inflammatory bowel disease patients have persistent defecatory symptoms. Defecatory symptoms may not be predictive of an underlying inflammatory disorder. Lack of inflammatory activity and absence of left-sided disease should prompt investigation of functional disorders. Anorectal manometric testing and biofeedback therapy for patients with a diagnosis of dyssynergia may be a useful therapy. 相似文献12.
Simone Saibeni Maria J. Etchevers Dolors Tassies Julián Panés Joan C. Reverter Silvio Danese Josep M. Piqué Savino Bruno Maurizio Vecchi Antonio Gasbarrini Miquel Sans 《International journal of colorectal disease》2013,28(9):1281-1286
Purpose
In inflammatory bowel diseases (IBD), risk of thrombosis and production of antibodies are increased. In autoimmune and inflammatory disorders, a role of anti-prothrombin (aPT) antibodies in developing thrombosis has been hypothesised. The aim of the study is to evaluate the prevalence of aPT antibodies in IBD patients, with and without thrombosis.Methods
Thirty-three IBD patients with thrombosis, 33 IBD patients without thrombosis matched for sex, age, diagnosis and disease activity and 66 sex- and age-matched healthy controls were enrolled. Thrombosis was considered recent when blood sample was obtained within 3 months from the event.Results
Prevalence of aPT antibodies in thrombotic IBD patients (3/33, 9.1 %), non-thrombotic IBD patients (4/33, 12.1 %) and in healthy subjects (3/66, 4.5 %) did not result significantly different (p?=?0.377). The prevalence of aPT antibodies was more frequent in ulcerative colitis (6/32, 18.7 %) than in Crohn’s disease (1/34, 2.9 %) and healthy controls (p?=?0.022). Among thrombotic IBD patients, the prevalence of aPT antibodies was higher in those with recent (2/9, 22.2 %) than in those with previous thrombosis (1/24, 4.2 %) (p?=?0.103). All thrombotic IBD patients with aPT antibodies were affected by ulcerative colitis with previous history of deep venous thrombosis.Conclusions
aPT antibodies do not appear to play a relevant role in thrombosis complicating IBD course. A possible association in ulcerative colitis patients with DVT could not be excluded. 相似文献13.
Objectives
Adults with inflammatory bowel disease (IBD) have a high prevalence of Clostridium difficile infection (CDI). CDI in children with IBD may differ from adults. We aim to compare the prevalence of CDI in hospitalized pediatric and adult IBD patients and patients without IBD.Methods
The rates of CDI per 1,000 IBD and non-IBD hospitalizations between 1993 and 2012 were examined using the Maryland Health Services Cost Review Commission database. Age, sex and calendar year adjusted incidence rate ratios comparing CDI in pediatrics and adults by type of IBD and with patients without IBD were calculated. p values for trend identifying changes in rates over time were calculated.Results
Among children, the rate of CDI was over 12 times greater in IBD than non-IBD hospitalizations (p < 0.0001) and among adults, the rate of CDI was four times greater in IBD than non-IBD hospitalizations (p < 0.0001). In adults, CDI was significantly higher in ulcerative colitis (UC) than Crohn’s disease (60.4 per 1,000 vs. 19.8 per 1,000, p < 0.0001) but in children there was no difference in CDI in UC compared with Crohn’s disease (32 per 1,000 vs. 27 per 1,000, p = 0.45). The prevalence of CDI increased in pediatric and adult IBD patients, and patients without IBD, between 1993 and 2012 (p for trend <0.0001).Conclusions
CDI was more common in adult patients with UC, and no difference was found between CDI and IBD type in pediatrics. There may be different risk factors for CDI during hospitalization between adults and children with IBD. 相似文献14.
Farhi D Cosnes J Zizi N Chosidow O Seksik P Beaugerie L Aractingi S Khosrotehrani K 《Medicine》2008,87(5):281-293
Erythema nodosum and pyoderma gangrenosum are the most common cutaneous manifestations in inflammatory bowel diseases (IBD). We conducted the current study to assess the cumulative prevalence of erythema nodosum and pyoderma gangrenosum in patients with IBD and to appraise their association with demographic, clinical, and prognostic factors related to IBD. Between 2000 and 2005, data for all patients with IBD at our gastroenterology department were prospectively and systematically collected using a standardized protocol. Among 2402 patients (1521 diagnosed with Crohn disease [63.3%] and 744 with ulcerative colitis [31.0%]), 140 (5.8%) had at least 1 skin manifestation. The most frequent dermatologic symptoms were erythema nodosum (4.0%) and pyoderma gangrenosum (0.75%). In multivariate analyses, erythema nodosum was significantly and independently associated with a diagnosis of Crohn disease (p < 0.001), female sex (p < 0.001), eye and joint involvement (p < 0.001), and pyoderma gangrenosum (p < 0.0001). Among patients with Crohn disease, erythema nodosum was associated with isolated colonic involvement (p = 0.0001). Pyoderma gangrenosum was significantly and independently associated with black African origin (p = 0.003), familial history of ulcerative colitis (p = 0.0005), uninterrupted pancolitis as the initial location of IBD (p = 0.03), permanent stoma (p = 0.002), eye involvement (p = 0.001), and erythema nodosum (p < 0.0001). It is noteworthy that the association between pyoderma gangrenosum and permanent stoma persisted after exclusion of patients with peristomal pyoderma gangrenosum (p = 0.07). In conclusion, neither erythema nodosum nor pyoderma gangrenosum was significantly associated with the severity criteria in IBD; however, their occurrence may reflect a peculiar phenotype among affected patients. 相似文献
15.
Arthur Barrie Marwa El Mourabet Katherine Weyant Kofi Clarke Mahesh Gajendran Claudia Rivers Seo Young Park Douglas Hartman Melissa Saul Miguel Regueiro Dhiraj Yadav David G. Binion 《Digestive diseases and sciences》2013,58(1):222-228
Background and Aims
Eosinophils are implicated in the pathogenesis of inflammatory bowel disease (IBD). A subset of IBD patients develops blood eosinophilia, and the clinical profile of these patients is undefined. We sought to characterize IBD patients with and without eosinophilia.Methods
We studied a prospective registry of 1,176 IBD patients followed in a tertiary referral center. Patients who developed eosinophilia at any time were identified by electronic medical record query. We performed a chart review case–control study comparing patients with recurrent eosinophilia versus randomly selected disease-matched patients with no history of eosinophilia. Histological analysis was performed on selected cases and controls.Results
Eosinophilia at any time was more prevalent in ulcerative colitis (UC) patients than Crohn’s disease patients (22.2 versus 12.7 %), as was recurrent eosinophilia (3.4 versus 0.7 %). UC patients with recurrent eosinophilia were predominantly male compared with the control UC population (81.3 versus 46.9 %) and had higher rates of colectomy for either medically refractory disease or dysplasia/cancer than control UC patients (56.3 versus 15.6 %). Primary sclerosing cholangitis (PSC) occurred in 37.5 % of UC patients with recurrent eosinophilia compared with only 3.1 % in the UC controls. Histological analysis of random diagnostic samples from UC patients with recurrent eosinophilia demonstrated a normal eosinophil pattern as seen in the control UC population.Conclusions
Eosinophilia-associated UC is a subgroup of IBD associated with severe colitis and PSC. Further studies are warranted to characterize molecular mechanisms underlying eosinophilia-associated UC and to determine optimal approaches for therapy. 相似文献16.
Background/Aims
Radiographic imaging studies are important in the management of patients with inflammatory bowel disease (IBD), but are associated with radiation exposure. IBD patients in a safety-net health-care system may be at risk of high exposure to radiation. Our purpose was to identify associations of high-dose radiation exposure among an ethnically diverse cohort of IBD patients in a safety-net health-care system.Methods
A study was performed on patients with IBD receiving care from the Harris County Hospital District. Radiation exposure was calculated using total number of imaging studies performed between from 2000 and 2010 and estimates of radiation dose per study. Associations of high-dose radiation exposure, defined as a cumulative effective dose (CED) >50 mSv, were identified by using univariate and multivariate logistic regression.Results
The study cohort of 278 patients with IBD was ethnically diverse, with 30 % Caucasian, 44 % African–American, and 26 % Hispanic. The median CED was 10.40 mSv (SD 20.02). Annualized radiation doses were 3.45 mSv/year among patients with Crohn’s disease (CD) and 1.27 mSv/year among patients with ulcerative colitis, p < 0.02. Approximately 13 % of IBD patients received a CED >50 mSv. There were no differences in radiation exposure based on age, gender, or race/ethnicity.Conclusions
A small proportion of IBD patients in a safety-net health-care system received high doses of diagnostic radiation exposure. Use of diagnostic imaging studies that limit radiation exposure should be encouraged. 相似文献17.
Juan E. Naves Eduard Cabré Míriam Mañosa Dolors Grados Alejandro Olivé Eugeni Domènech 《Digestive diseases and sciences》2013,58(8):2138-2147
Background
The association between inflammatory bowel disease (IBD) and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome (SAPHO syndrome) was first reported in 1992. To date, only case reports and short series have been published.Aims
The purpose of this study was to report new cases and systematically review the literature on this association.Materials and Methods
All patients with concomitant diagnosis of SAPHO syndrome and IBD were identified from the databases of the rheumatology and gastroenterology departments of our institution. In addition, we systematically searched for published full articles in Medlars Online International Literature via PubMed. Relevant information of each positive match was collected and all authors were contacted for additional clinical data.Results
Three patients sharing both SAPHO syndrome and IBD were identified among the 62 patients with SAPHO syndrome (4.8 % of the SAPHO cohort) and the 1,309 patients with IBD (0.2 % of the IBD cohort) from our hospital database. After a systematic review, a total of 39 reported patients with concomitant diagnosis of SAPHO syndrome and IBD were identified. There was a female predominance and most had Crohn’s disease with colonic involvement.Conclusions
The association of SAPHO syndrome and IBD seems to be rare among IBD patients but not so among SAPHO patients. SAPHO could be underdiagnosed because of the similarity of its clinical manifestations and some more common extraintestinal manifestations or drug-related side effects in IBD. 相似文献18.
Kaija-Leena Kolho Taina Sipponen Elsa Valtonen Erkki Savilahti 《International journal of colorectal disease》2014,29(1):43-50
Purpose
Fecal MMP-9 and human beta-defensin-2 (HBD-2) levels, potential markers of intestinal inflammation, are insufficiently explored in pediatric inflammatory bowel disease (IBD). The aim was to study fecal MMP-9 and HBD-2 in pediatric IBD to compare their performance to calprotectin and to study whether they would provide additional value in categorizing patients according to their disease subtype.Methods
Fecal calprotectin, MMP-9, and HBD-2 levels were measured with ELISA in 110 pediatric patients with IBD (Crohn’s disease, n?=?68; ulcerative colitis (UC), n?=?27; unclassified, n?=?15; median age, 14). To compare the performance of the fecal markers, the area under the receiver operating characteristics curve (±95 % CI) was used. In addition, the best cut-off values of each measure to differentiate IBD patients and controls (n?=?27 presenting with diarrhea, abdominal pain, and/or anemia) were derived by maximizing sensitivity and specificity.Results
Of the fecal markers studied, calprotectin performed best for separation of IBD and non-IBD patients with the area under curve (AUC) of 0.944 (95 % CI, 0.907 to 0.981). For MMP-9, AUC was 0.837 (95 % CI, 0.766 to 0.909), the levels being significantly higher in active IBD and in UC compared with Crohn’s disease (p?=?0.0013), but categorization of these patient groups did not take place. HBD-2 did not categorize any of the studied groups.Conclusions
Calprotectin was the best fecal marker in pediatric IBD, but MMP-9 showed almost comparable performance in UC, suggesting applicability as a surrogate marker of inflammation. Fecal HBD-2 did not bring information to the disease characteristics of pediatric IBD patients. 相似文献19.
M. Anthony Sofia David T. Rubin Ningqi Hou Joel Pekow 《Digestive diseases and sciences》2014,59(9):2228-2235
Background
While the incidence of inflammatory bowel disease (IBD) among African-Americans (AAs) is increasing, there is limited understanding of phenotypic differences and outcomes by race.Aim
To describe disease characteristics of AA patients compared to Caucasian (Ca) patients in a tertiary care population.Methods
We performed a cross-sectional review of the IBD registry at the University of Chicago from January 2008 to January 2013. Data regarding race, phenotype, disease onset, disease duration, medical therapy, and surgical treatment were abstracted from the database, then compared via Pearson’s chi-square analysis, Kruskal–Wallis analysis, and logistic regression with a significance level of p < 0.05.Results
A total of 1,235 patients with Crohn’s disease (CD) and 541 patients with ulcerative colitis (UC) included 108 AA CD patients and 28 AA UC patients. AA CD patients had an increased rate of IBD-related arthralgias (36.5 vs. 23.9 %, p < 0.01) and surgery (p < 0.01), less ileal involvement (57.8 vs. 71.0 %, p < 0.01), and no differences for other extraintestinal manifestations or disease locations compared to Ca CD patients. AA UC patients were older at diagnosis, had an increased rate of arthralgias (28.6 vs. 14.6 %, p = 0.047) and ankylosing spondylitis/sacroiliitis (7.1 vs. 1.6 %, p = 0.035), with no differences for disease extent or rate of IBD-related surgeries compared to Ca UC patients. There were no differences in medication usage by race for CD and UC patients.Conclusion
We identified significant differences in disease characteristics and extraintestinal manifestations between AA and Ca IBD patients in a large tertiary care population. These results have implications for future genotype-phenotype studies. 相似文献20.
Sotirios Terzoudis Christos Zavos John Damilakis John Neratzoulakis Daphne Anna Dimitriadi Maria Roussomoustakaki Elias A. Kouroumalis Ioannis E. Koutroubakis 《Digestive diseases and sciences》2013,58(1):216-221