scholarly journals Genital and Intertriginous Rashes Refractory to Antimicrobial Treatments: Have You Thought about Crohn’s Disease?

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Candelaria O’Farrell ◽  
Annette Roberts ◽  
Claudia Riera Canales ◽  
Carrie Firestone Baum ◽  
Lina Maria Felipez

Crohn’s disease is an inflammatory bowel disease that can have multiple extraintestinal manifestations and can develop prior to, following, or simultaneously with gastrointestinal tract involvement (Aberumand et al. (2017), Georgious et al. (2006), Larsen et al. (2010), Levine and Burakoff (2011), Louis et al. (2018)). This report examines the case of a 16-year-old male with a rash of the genital, intergluteal, and inguinal regions refractory to antimicrobial treatments suspicious for an extraintestinal manifestation of Crohn’s disease. The patient was diagnosed with inflammatory, nonfistulizing colonic Crohn’s disease following presentation with gastrointestinal symptoms including abdominal pain and bloody stools 6 months after the onset of the rash. The genital lesions resolved after starting treatment for Crohn’s disease with adalimumab.

2021 ◽  
Vol 8 (6) ◽  
pp. 1121
Author(s):  
Pujitha Bandla ◽  
Bhakti Sarangi ◽  
Guruprasad H. Shankar ◽  
Varsha Sharma

Granulomatous vulvitis/cheilitis may occur rarely as an extraintestinal manifestation of Crohn’s disease (CD) and may precede the development of gastrointestinal symptoms. Guillain-Barre syndrome (GBS) is associated with a wide variety of illnesses including inflammatory bowel disease. Though the immunologic abnormalities in inflammatory bowel disease may encompass both granulomatous inflammation as well as autoimmune components, the combination of CD, GBS and granulomatous vulvitis/cheilitis in the same patient has not been described in literature. We hereby reported a 14 year old girl with granulomatous vulvitis/cheilitis for 4 years preceding the development of gastrointestinal manifestations of CD, who also had GBS during the course of hospitalization.


Author(s):  
Linda Atencio Ibarra ◽  
Roberto Navarro Quiroz ◽  
Gustavo Aroca Martinez ◽  
Joany Sarmiento Gutierrez ◽  
Andres Cadena Bonfanti ◽  
...  

Crohn's disease (CD) results from an aberrant immune response against the commensal microbiota in genetically susceptible hosts. However, the nature of the immune defects, the microflora involved and the genetic susceptibility remain incompletely defined and controversial. Extraintestinal manifestations occur in up to 25-35% of patients and generally precede the onset of gastrointestinal symptoms, which are often of a colonic nature and are influenced by disease activity. Renal manifestations can be considered dependent on the same immune mechanism that determines inflammatory bowel disease in CD. This review seeks to describe the current state of association between CD and kidney disease.


2020 ◽  
Vol 7 (1) ◽  
pp. e000526
Author(s):  
Elmer Hoekstra ◽  
Rudolf Keunen ◽  
Michael van der Voorn

A wide variety of extraintestinal manifestations of inflammatory bowel disease (IBD) have been described, with joint or dermatological complaints as most prevalent. However, also neurological manifestations can occur, which are rarely recognised and therefore under-reported. We present an very unusual case of a young man who presented with the inability to walk, as a first presentations of IBD.


2020 ◽  
Vol 7 (1) ◽  
pp. e000351 ◽  
Author(s):  
Ignacio Marin-Jimenez ◽  
Guillermo Bastida ◽  
Ana Forés ◽  
Esther Garcia-Planella ◽  
Federico Argüelles-Arias ◽  
...  

ObjectiveTo evaluate the impact of comorbidities and extraintestinal manifestations of inflammatory bowel disease on the response of patients with inflammatory bowel disease to antitumour necrosis factor alpha (anti-TNFα) therapy.DesignData from 310 patients (194 with Crohn’s disease and 116 with ulcerative colitis) treated consecutively with the first anti-TNFα in 24 Spanish hospitals were retrospectively analysed. Univariate and multivariate logistic regression analyses were performed to assess the associations between inflammatory bowel disease comorbidities and extraintestinal manifestations with anti-TNFα treatment outcomes. Key clinical features, such as type of inflammatory bowel disease and concomitant treatments, were included as fixed factors in the model.ResultsMultivariate logistic regression analyses (OR, 95% CI) showed that chronic obstructive pulmonary disease (2.67, 1.33 to 5.35) and hepato-pancreato-biliary diseases (1.87, 1.48 to 2.36) were significantly associated with primary non-response to anti-TNFα, as was the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn’s disease). It was also found that myocardial infarction (3.30, 1.48 to 7.35) and skin disease (2.73, 1.42 to 5.25) were significantly associated with loss of response, along with the use of corticosteroids and the type of inflammatory bowel disease (ulcerative colitis vs Crohn’s disease).ConclusionsOur results suggest that the presence of some comorbidities in patients with inflammatory bowel disease, such as chronic obstructive pulmonary disease and myocardial infarction, and of certain extraintestinal manifestations of inflammatory bowel disease, such as hepato-pancreato-biliary conditions and skin diseases, appear to be related to failure to anti-TNFα treatment. Therefore, their presence should be considered when choosing a treatment.Trial registration numberNCT02861118.


2020 ◽  
Vol 5 (2) ◽  
pp. 119-122
Author(s):  
A. Yu. Davydova ◽  
R. V. Repnikova

Inflammatory bowel disease, a group of inflammatory conditions of the colon and small intestine, principally includes ulcerative colitis and Crohn's disease. Current attention to inflammatory bowel disease is promoted by worldwide increase in its incidence and morbidity as well as shortcomings of existing treatment. Extraintestinal (musculoskeletal, skin, renal, hepatic etc.) manifestations of inflammatory bowel disease significantly complicate the diagnosis and may predict the development of intestinal symptoms. In certain cases, the severity of extraskeletal manifestations may exceed that of the main diagnosis. Here we describe a clinical example of this scenario.


2019 ◽  
Vol 7 ◽  
pp. 2050313X1989358
Author(s):  
Wasim Haidari ◽  
Sarah Al-Naqshabandi ◽  
Christine S Ahn ◽  
Richard S Bloomfeld ◽  
Steven R Feldman

IL-17 antagonism is among the most potent treatments for psoriasis. Generally safe, new onset and exacerbations of inflammatory bowel disease may occur in association with IL-17 therapy. We describe a patient with long-standing history of psoriasis and psoriatic arthritis in whom asymptomatic Crohn’s disease was identified during treatment with secukinumab. The patient underwent an elective colonoscopy for colorectal cancer screening which revealed inflammation and multiple ulcers in the terminal ileum suggestive of Crohn’s disease. While the patient did not have any gastrointestinal symptoms, he was diagnosed as having asymptomatic Crohn’s disease. Given the association of inflammatory bowel disease with secukinumab treatment, secukinumab was discontinued. Although in this patient, Crohn’s disease was identified during treatment with secukinumab, a direct causal relationship cannot be assumed. Medications that are effective for both psoriasis and inflammatory bowel disease may be a good choice in patients with psoriasis who have comorbid Crohn’s disease or develop inflammatory bowel disease during treatment with another biologic.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jingyi Ju ◽  
Yuanyuan Dai ◽  
Jiaolan Yang ◽  
Changqin Liu ◽  
Li Fan ◽  
...  

Abstract Background Previous studied revealed that psoriasis and Inflammatory bowel disease (IBD) have highly overlapping epidemiological characteristics, genetic susceptibility loci, disease risk factors, immune mechanisms, and comorbidities. More and more biologics have been used to treat psoriasis and IBD. Interleukin (IL)-17 inhibitors played an important role in the treatment of psoriasis, but induced and aggravated inflammatory bowel disease in some patients. IL-23 inhibitors have shown to be effective to both psoriasis and CD. Case presentation Forty-one year old Chinese male patient who came to the hospital for psoriasis, developed severe gastrointestinal symptoms after using an IL-17 inhibitor, and was diagnosed with Crohn’s disease (CD). The patient eventually used an IL-23 inhibitor to relieve both psoriasis and CD. Conclusion IBD patients and psoriasis patients have increased probability of suffering from the other disease. The case that patients had suffered from psoriasis and CD before the use of IL-17 inhibitor is quite rare. This case suggests that physicians need to be careful when treating patients with psoriasis and CD with biologics, and it is necessary to evaluate the gastrointestinal tract.


1988 ◽  
Vol 27 (03) ◽  
pp. 83-86 ◽  
Author(s):  
B. Briele ◽  
F. Wolf ◽  
H. J. Biersack ◽  
F. F. Knapp ◽  
A. Hotze

A prospective study was initiated to compare the clinically proven results concerning localization/extent and activity of inflammatory bowel diseases with those of 111ln-oxine leukocyte imaging. All patients studied were completely examined with barium enema x-ray, clinical and laboratory investigations, and endoscopy with histopathology. A total of 31 leukocyte scans were performed in 15 patients (12 with Crohn’s disease, 3 with ulcerative colitis). The scans were graded by comparing the cell uptake of a lesion (when present) and a bone marrow area providing a count ratio (CR). The inflammatory lesions were correctly localized on 26 leukocyte scans, and in 21 scans the scintigraphically estimated extent of disease was identical to endoscopy. In 5 cases the disease extent was underestimated, 4 scans in patients with relapse of Crohn’s disease were falsely negative, and in one patient with remission truly negative. The scintigraphically assessed disease activity was also in a good agreement with clinical disease activity based on histopathology in all cases. We conclude that leukocyte imaging provides valuable information about localization and activity of inflammatory bowel disease.


2020 ◽  
Vol 15 (3) ◽  
pp. 216-233 ◽  
Author(s):  
Maliha Naseer ◽  
Shiva Poola ◽  
Syed Ali ◽  
Sami Samiullah ◽  
Veysel Tahan

The incidence, prevalence, and cost of care associated with diagnosis and management of inflammatory bowel disease are on the rise. The role of gut microbiota in the causation of Crohn's disease and ulcerative colitis has not been established yet. Nevertheless, several animal models and human studies point towards the association. Targeting intestinal dysbiosis for remission induction, maintenance, and relapse prevention is an attractive treatment approach with minimal adverse effects. However, the data is still conflicting. The purpose of this article is to provide the most comprehensive and updated review on the utility of prebiotics and probiotics in the management of active Crohn’s disease and ulcerative colitis/pouchitis and their role in the remission induction, maintenance, and relapse prevention. A thorough literature review was performed on PubMed, Ovid Medline, and EMBASE using the terms “prebiotics AND ulcerative colitis”, “probiotics AND ulcerative colitis”, “prebiotics AND Crohn's disease”, “probiotics AND Crohn's disease”, “probiotics AND acute pouchitis”, “probiotics AND chronic pouchitis” and “prebiotics AND pouchitis”. Observational studies and clinical trials conducted on humans and published in the English language were included. A total of 71 clinical trials evaluating the utility of prebiotics and probiotics in the management of inflammatory bowel disease were reviewed and the findings were summarized. Most of these studies on probiotics evaluated lactobacillus, De Simone Formulation or Escherichia coli Nissle 1917 and there is some evidence supporting these agents for induction and maintenance of remission in ulcerative colitis and prevention of pouchitis relapse with minimal adverse effects. The efficacy of prebiotics such as fructooligosaccharides and Plantago ovata seeds in ulcerative colitis are inconclusive and the data regarding the utility of prebiotics in pouchitis is limited. The results of the clinical trials for remission induction and maintenance in active Crohn's disease or post-operative relapse with probiotics and prebiotics are inadequate and not very convincing. Prebiotics and probiotics are safe, effective and have great therapeutic potential. However, better designed clinical trials in the multicenter setting with a large sample and long duration of intervention are needed to identify the specific strain or combination of probiotics and prebiotics which will be more beneficial and effective in patients with inflammatory bowel disease.


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