Incidence and Risk Factors for Urolithiasis in Patients with Crohn's Disease

2015 ◽  
Vol 95 (3) ◽  
pp. 314-319 ◽  
Author(s):  
Min Jung Kim ◽  
Sook-young Woo ◽  
Eun Ran Kim ◽  
Sung Noh Hong ◽  
Dong Kyung Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Urinary Tract ◽  
Crohn's Disease ◽  
Medical Center ◽  
Cox Models ◽  
Radiologic Findings ◽  
Plain Films ◽  
Urinary Tract Calculi ◽  
Few Data

Background: The incidence of urinary tract calculi is thought to be higher in patients with inflammatory bowel disease (IBD) than that in the general population. However, few data are available about urolithiasis in patients with Crohn's disease (CD). We investigated the incidence of urolithiasis and the risk factors for urolithiasis in patients with CD. Methods: We examined the records of 387 patients with CD followed at Samsung Medical Center from July 2011 to June 2013. Evidence for the presence of calculi was obtained from radiologic findings (plain films, ultrasonography, or computed tomography), urinary colic symptoms, or a treatment history of urolithiasis after diagnosis of CD. Demographic variables, phenotype, concurrent medications, and previous CD-related surgery were analyzed. Results: Urinary tract calculi were found in 18 (4.7%) patients, which developed after the CD diagnosis. The incidence of urolithiasis in CD was 706 per 100,000 patient-years. Cox models with a time-dependent covariate showed that azathioprine (AZA)/6-mercaptopurine (6-MP) treatment (hazard ratio = 0.963; 95% CI: 0.931, 0.996; p = 0.030) was negatively associated with urolithiasis. Conclusions: The annual incidence rate of urolithiasis in patients with CD was 0.7%. AZA/6-MP therapy was associated with a low risk of urolithiasis in these patients.

scholarly journals Cross-disorder analysis of schizophrenia and 19 immune-mediated diseases identifies shared genetic risk

2019 ◽  
Vol 28 (20) ◽  
pp. 3498-3513 ◽  
Author(s):  
Jennie G Pouget ◽  
Buhm Han ◽  
Yang Wu ◽  
Emmanuel Mignot ◽  
Hanna M Ollila ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Genetic Risk ◽  
Genetic Risk Factors ◽  
Phenotypic Correlation ◽  
Biliary Cirrhosis ◽  
Genome Wide ◽  
Shared Genetic

Abstract Many immune diseases occur at different rates among people with schizophrenia compared to the general population. Here, we evaluated whether this phenomenon might be explained by shared genetic risk factors. We used data from large genome-wide association studies to compare the genetic architecture of schizophrenia to 19 immune diseases. First, we evaluated the association with schizophrenia of 581 variants previously reported to be associated with immune diseases at genome-wide significance. We identified five variants with potentially pleiotropic effects. While colocalization analyses were inconclusive, functional characterization of these variants provided the strongest evidence for a model in which genetic variation at rs1734907 modulates risk of schizophrenia and Crohn’s disease via altered methylation and expression of EPHB4—a gene whose protein product guides the migration of neuronal axons in the brain and the migration of lymphocytes towards infected cells in the immune system. Next, we investigated genome-wide sharing of common variants between schizophrenia and immune diseases using cross-trait LD score regression. Of the 11 immune diseases with available genome-wide summary statistics, we observed genetic correlation between six immune diseases and schizophrenia: inflammatory bowel disease (rg = 0.12 ± 0.03, P = 2.49 × 10−4), Crohn’s disease (rg = 0.097 ± 0.06, P = 3.27 × 10−3), ulcerative colitis (rg = 0.11 ± 0.04, P = 4.05 × 10–3), primary biliary cirrhosis (rg = 0.13 ± 0.05, P = 3.98 × 10−3), psoriasis (rg = 0.18 ± 0.07, P = 7.78 × 10–3) and systemic lupus erythematosus (rg = 0.13 ± 0.05, P = 3.76 × 10–3). With the exception of ulcerative colitis, the degree and direction of these genetic correlations were consistent with the expected phenotypic correlation based on epidemiological data. Our findings suggest shared genetic risk factors contribute to the epidemiological association of certain immune diseases and schizophrenia.

scholarly journals Capsule Retentions and Incomplete Capsule Endoscopy Examinations: An Analysis of 2300 Examinations

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Charlotte M. Höög ◽  
Lars-Åke Bark ◽  
Juan Arkani ◽  
Jacob Gorsetman ◽  
Olle Broström ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Male Gender ◽  
Large Series ◽  
Older Age ◽  
Safe Procedure ◽  
Capsule Retention

Aim. To evaluate capsule endoscopy in terms of incomplete examinations and capsule retentions and to find risk factors for these events.Material and Methods. This retrospective and consecutive study includes data from 2300 capsule enteroscopy examinations, performed at four different hospitals in Stockholm, Sweden from 2003 to 2009.Results. The frequency of incomplete examinations was 20%. Older age, male gender, suspected, and known Crohn's disease were risk factors for an incomplete examination. The PillCam capsule had the highest rate of completed examinations. Capsule retention occurred in 1.3% (). Risk factors for capsule retention were known Crohn's disease and suspected tumor. Complications of capsule retention were acute obstructive symptoms in six patients and one death related to complications after acute surgical capsule retrieval.Conclusion: Capsule endoscopy is considered a safe procedure, although obstructive symptoms and serious complications due to capsule retention can be found in a large series of patients.

scholarly journals Management of Crohn’s disease in an immunosuppressed COVID-19-positive patient: safety-driven prioritisation of nutritional therapy as a bridge to restarting immunosuppression

2021 ◽  
Vol 14 (3) ◽  
pp. e239404
Author(s):  
Clare Harris ◽  
Richard James Harris ◽  
Louise Downey ◽  
Markus Gwiggner
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Patient Safety ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Therapy ◽  
Interleukin 12 ◽  
Inflammatory Bowel ◽  
Term Maintenance

Active inflammatory bowel disease (IBD), combined immunosuppression and corticosteroid therapy have all been identified as risk factors for a poor outcome in COVID-19 infection. The management of patients with both COVID-19 infection and active IBD is therefore complex. We present the case of a 31-year-old patient with Crohn’s disease, on dual immunosuppression with infliximab and mercaptopurine presenting with inflammatory small bowel obstruction and COVID-19 infection. The case highlights the use of nutritional therapy, which remains underused in the management of adults with IBD, to manage his flare acutely. Following negative SARS-CoV-2 PCR testing and SARS-CoV-2 IgG testing confirming an antibody response, ustekinumab (anti-interleukin 12/23) was prescribed for long-term maintenance.

scholarly journals P050 Work Disability, Indirect Costs and Risk Factors in Patients With Crohn’s Disease in a Rio De Janeiro Tertiary Care Center

2020 ◽  
Vol 115 (1) ◽  
pp. S13-S13
Author(s):  
Fróes Renata ◽  
Moreira Andre ◽  
Carneiro Antônio José ◽  
Moreira Jessica ◽  
Luiz Ronir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Work Disability ◽  
Rio De Janeiro ◽  
Care Center ◽  
Tertiary Care ◽  
Indirect Costs ◽  
Tertiary Care Center

scholarly journals Crohn’s disease complicated with a bladder-fistula – a case report

2021 ◽  
Vol 19 (1) ◽  
pp. 76-80
Author(s):  
Grzegorz Pasternak ◽  
◽  
Dorota Bartusik-Aebisher ◽  
David Aebisher ◽  
Rafał Filip ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Urinary Tract ◽  
Crohn's Disease ◽  
Bladder Wall ◽  
Clinical Manifestations ◽  
Lower Abdominal Pain ◽  
Abdominal Ultrasound ◽  
Intestinal Loop ◽  
Ultrasound Computed Tomography ◽  
Bladder Fistula

Introduction. Entero-bladder fistula (fistula entero-vesicalis) is a pathological connection between the lumen of the gastrointestinal tract and the bladder. Entero-bladder fistulas are not a common condition. The main reason for the formation of entero- bladder fistulas are intestinal diseases occurring within the intestinal loop adjacent to the bladder resulting in the formation of an abnormal channel, the connection between the above structures Aim. The aim is to present the causes of the fistulas can be divided into congenital and acquired (intestinal infection, cancer, Crohn’s disease, resulting from trauma and iatrogenic). Clinical manifestations of the biliary-bullous fistulae may be from the digestive or urinary tract. The most characteristic ailments are pneumaturia, fecuria, urge to urinate, frequent urination, lower abdominal pain, hematuria, urinary tract infection. Description of the case. The article discusses the case of a patient with Leśniowski-Crohn disease complicated with a bladder- fistula. The treatment of entero-bladder fistulas is primarily surgical, it consists in resection of the fistula together with resection of the affected intestine and bladder wall fragment. Conclusion. The test confirming the presence of an entero-bladder fistula is a test with oral administration of poppies, although it happens that the test result may be negative, especially in the case of a bladder-follicular fistula. Among the tests useful in the diagnosis of entero-bladder fistula include abdominal ultrasound, computed tomography, magnetic resonance imaging, endoscopic tests (colonoscopy or cystoscopy).

scholarly journals Short-term tolerability and effectiveness of methotrexate monotherapy in adult patients with Crohn’s disease: a retrospective study

2021 ◽  
Vol 14 ◽  
pp. 175628482110430
Author(s):  
Hee Seung Hong ◽  
Kyuwon Kim ◽  
Kyunghwan Oh ◽  
Jae Yong Lee ◽  
Seung Wook Hong ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Oral Administration ◽  
Clinical Response ◽  
Activity Index ◽  
Medical Center ◽  
Retrospective Chart Review ◽  
Asian Population ◽  
Aminosalicylic Acid ◽  
Parenteral Injection

Introduction: Immunomodulators remain fundamental for the medical treatment of Crohn’s disease (CD). Methotrexate (MTX) is widely used as a second-line immunomodulator; however, there is a lack of recent data on MTX monotherapy among the Asian population with CD. Therefore, in this study, we aimed to investigate the tolerability and clinical outcomes of MTX in Korean patients with CD. Methods: A retrospective chart review was performed for CD patients treated with MTX monotherapy or in combination with 5-aminosalicylic acid (5-ASA), at the Asan Medical Center, Seoul, South Korea. The tolerability of MTX monotherapy within 6 months was assessed and the clinical effectiveness of MTX was evaluated based on the Crohn’s disease activity index (CDAI). Results: In total, 85 patients were included, of which 29 (34.1%) discontinued MTX due to intolerability during the follow-up. Adverse events (AEs) were reported in 41 (48.2%) patients. The most common AE was gastrointestinal disorders (17/41) and only one patient experienced a serious AE, a systemic infection that required hospitalization. Among the 56 patients who tolerated MTX within 6 months, 44 (65.9%) showed a clinical response. Moreover, no factor was significantly associated with intolerability. The administration method was the only factor significantly associated with a response to MTX ( p = 0.041). The adjusted odds ratio of parenteral injection compared to oral administration was 5.68 (95% confidence interval (CI), 1.07–30.08). Conclusion: In this study, one-third of patients were intolerant to MTX; nonetheless, the response rate was as high as 65.9% among tolerant patients. In addition, no significant factors affected intolerability. In terms of the clinical response, parenteral injection could be better than oral administration.

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