Is Crohn’s Disease a Rightly Used Eponym?

In 1932 Burrill B. Crohn, a gastroenterologist at Mount Sinai Hospital in New York City, described, together with two surgical colleagues, a series of 14 patients with an inflammatory condition of the terminal ileum. All patients were operated on by Dr Albert Berg, the Chief Surgeon of the hospital, whose name did not appear on the initial publication. The ‘new’ disease was called ‘regional ileitis’, but was rapidly referred to as ‘Crohn’s disease’. From earlier accounts and publications it has become clear that the condition had already existed for many centuries and was ‘discovered’ several times before 1932, most notably by Giovanni Morgagni in 1769, Antoni Lesniowski in 1903 and Thomas K. Dalziel in 1913. ‘Crohn’s disease’ might reasonably be known by another eponym. Nevertheless, the 1932 publication of Crohn was pivotal, as were his later contributions to the knowledge of ‘his’ disease. Therefore the worldwide use of the eponym is rightly to be continued. Present researchers and clinicians with an interest in inflammatory bowel disease [IBD] might learn from the complicated story summarised in this contribution. Apart from an interesting historical overview, there are some lessons for today: the importance of thorough clinical observation and pattern recognition, the need for communication between colleagues and multidisciplinary approaches, and the need for broad access to valuable data, past or present, regardless of the journal or language of publication. It should ultimately bring us some humility, despite great achievements in treating this chronic disease, which defies all our efforts yet to find a cure.

The challenge in diagnosing Crohn’s disease in TB endemic region – A case report with review of literature

The challenge in diagnosing the regional ileitis existed since 1932 when Crohn, Ginzberg and Oppenheimer first reported their case1. Many Indian researchers accepted that during last decade there was considerable increase in the incidence of Crohn’s disease (CD) in India which poses great challenge in diagnosing it, due to high prevalence of tuberculosis2. In this perspective we report a case which made a stimulus to review the literature. The purpose of this manuscript is 1. To document the occurrence of an additional case of CD in India, 2. To report that CD can rarely present as post operative enterocutaneous fistula, 3. To discuss the criteria in diagnosing the CD in Tuberculosis (TB) endemic area.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.688-690

Mycobacterium avium Subspecies Paratuberculosis and Crohn’s Regional Ileitis: How Strong is Association?

ABSTRACT Mycobacterium avium subsp. paratuberculosis (MAP) is a well-established etiological agent of Johne’s disease in animals. In humans, similar clinical condition, first described by Crohn as regional ileitis in 1932, now known as Crohn’s diseases (CD), has also been associated with this mycobacterial species. However, there are two schools of thoughts, one favoring MAP as its etiological agent while the second considers it as an immune-inflammatory condition triggered by an external factor. Onset of CD requires a series of events including predisposition of certain inherited genetic traits, associated environmental stimuli, and immune-inflammatory response. A combination of these factors probably leads to this disease. Recently, some human genes have also been identified which regulate ability to respond appropriately to the external factors. Added to these factors are concerns about the selection of clinical specimens and poor adherence to laboratory quality controls. The literature is full of contradictory findings, but there a lack of uniformity in the materials and methods used by many of these researchers. In this review, we provide our perspective under above circumstances and give our point of view which may open a platform for debate regarding the MAP as the etiological agent of human CD.

Somatose, psychose et relations d'objet*

This paper presents a case who successively suffered from regional ileitis followed by a reactive psychosis. The author looks at the object relations of a patient afflicted by a narcissistic defect. The fundamental narcissistic disorder models the object relations of the somatic patient and of the psychotic patient. Less différenciation is found in the object representation of the psychotic patient. A comparison is suggested for the two modes of relating to objects.