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Query: UMLS:C0009319 (colitis)
 19,384 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pyoderma gangrenosum is a cutaneous disorder associated with systemic diseases such as ulcerative colitis, Crohn's disease, rheumatoid arthritis, and blood dyscrasias. We are reporting two cases of pustular pyoderma gangrenosum associated with ulcerative colitis. One patient had inactive bowel disease when she developed her third episode of pustules, erosions, and nodules on the left leg. The other patient exhibited a widespread painful vesiculopustular eruption that coincided with the onset of her colitis. Both patients presented with pustules as the primary manifestation of their pyoderma gangrenosum. Histologic examination of skin from both patients revealed an acute perifollicular inflammation. Pyoderma gangrenosum should be considered in the differential diagnosis of pustular disorders in children with underlying conditions such as ulcerative colitis.
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PMID:Pustular pyoderma gangrenosum associated with ulcerative colitis in childhood. Report of two cases and review of the literature. 377 39

Parameters in the differential diagnosis of enterocolitis have been poorly evident for many years. Development and profitable employment of endoscopic instruments were the first step towards advancing the diagnostic facilities in inflammatory bowel disease. The microbiologic examination of mucosal biopsies creates a new diagnostic dimension, and it distinctly seems to increase the diagnostic sensitivity for pathogens. Within fifteen months 152 patients admitted to the gastroenterologic unit with acute, or symptoms of exacerbated, bowel disease were examined for the aetiologic agents. Compared with former reports, idiopathic inflammatory bowel disease (IIBD) such as Crohn's disease (32.2%) and ulcerative colitis (18.4%) were decreased. Infectious colitis (22.3%), mostly Campylobacter or Yersinia infections, was, sometimes exclusively, diagnosed by bioptic microbiology, non-classifiable forms of colitis (21.7%), and rare forms (5.4%) were diagnosed more often. It proved to be important that IIBD was frequently superinfected by Campylobacter, Yersinia and Chlamydia, and the differential diagnosis was complicated, since these microorganisms can mimic IIBD. The results suggest that coloileoscopy combined with bioptic microbiologic investigation additional to faecal samples should include a search for Campylobacter and Yersinia. It appears indispensable that the final diagnosis "Crohn's disease" or "ulcerative colitis" should be confirmed by sequential coloileoscopy and microbiologic examination.
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PMID:Bioptic microbiology in the differential diagnosis of enterocolitis. 378 May 83

The pathology of the alimentary tracts of nine patients dying of Salmonella typhimurium infection is reviewed. Two patients had previous gastric operations, supporting previous reports that such patients are more susceptible to food poisoning. Four had no parietal (oxyntic) cells in the gastric mucosa, suggesting hypo- or anacidity. Only one had acute gastritis. None had acute enteritis, but in half of the patients, subtle histological changes suggested an 'enteropathy'. Acute diffuse colitis with abundant crypt abscesses, without stromal abscesses in the lamina propria, was the most constant finding and reparative features started very early, and occurred in later deaths. Under ideal circumstances this crypt abscess is readily distinguished from that of idiopathic ulcerative colitis, but can be confused with the crypt abscess of acute bacillary (sonne) dysentery. While the florid colonic changes may have settled in the late deaths, active inflammation is commonly present in the appendix mucosa on histology. The pathology of the alimentary tract in S typhimurium infection differs from that of S typhi and S paratyphi infections. There is little evidence of gastroenteritis, although subtle changes occur in the stomach and small intestine. The features are those of acute diffuse colitis with histological appendicitis, distinguishable from idiopathic ulcerative colitis.
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PMID:Pathology of the alimentary tract in Salmonella typhimurium food poisoning. 389 61

Food allergy in childhood is a popular subject which has attracted disapprobation from certain quarters because of overinflated claims based on flimsy evidence. In this article food intolerance and allergy are defined and the pathogenesis of food allergic reactions is considered. There is a description of the role that food allergy may play in urticaria, angioedema, anaphylaxis, eczema, asthma, rhinitis, cow's milk sensitive enteropathy, infantile colitis, inflammatory bowel disease, migraine and hyperactivity. Factitious food allergy is discussed and the general unhelpfulness of 'allergy testing' commented upon. Finally there is a description of the use of various exclusion diets in the diagnosis and treatment of food allergic disorders. It is concluded that food allergy is important in an increasing number of childhood diseases, but it is not clear what proportion of children with a given condition will respond to dietary measures. The importance of ensuring that exclusion diets are nutritionally adequate is stressed, and there is a plea to remember that an exclusion diet might be worse than the disease itself.
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PMID:Food allergy in childhood. 390 3

Evidence for autoimmunity in diarrhoeal disease is reviewed. Firstly, coeliac disease (CD) is considered. The incidence of tissue-reactive autoantibodies in both adults and children with CD (68% and 65%, respectively) is higher than the incidence of these autoantibodies in controls (6% in normal adults, and 14% and 9% in disease controls drawn respectively from adult and child populations). The R1 antireticulin antibody, when present, was found to disappear after several weeks on a gluten-free diet, but in contrast, other autoantibodies persisted. Secondly, a case is argued for a new disease category, namely "autoimmune enteropathy." Seven cases are reviewed in which patients presented with protracted diarrhoea, a small intestinal enteropathy which failed to heal during periods of total parenteral nutrition, and evidence of a predisposition to autoimmunity (namely, the presence of high titre autoantibodies including one specific for gut epithelium, and/or the presence of associated diseases regarded to be autoimmune). Thirdly, evidence for autoimmunity in inflammatory bowel disease is reviewed and includes discussion of serum goblet cell antibodies and of circulating T cells which participate in antibody-dependent cellular cytotoxicity in vitro using colonic epithelial cells as targets. Finally, an unusual child is described who presented with chronic diarrhoea and a flat small intestinal mucosa, who responded to gluten withdrawal but who later relapsed spontaneously during a strict gluten-free diet. Her mucosa healed only after a period of total parenteral nutrition and treatment with oral steroids. This child's enteropathy was also associated with thyrotoxicosis and a microscopic colitis.
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PMID:Autoimmunity in diarrhoeal disease. 402 May 70

The authors examined 1132 patients with chronic ulcerative colitis (CUC) seen at the Cleveland Clinic to clarify the relationship between the clinical features of colitis and the incidence and severity of erythema nodosum (EN) and pyoderma gangrenosum (PG). There were 21 patients (2%) with EN and 21 (2%) with PG, both of which affected those with active and extensive colitis. CUC was inactive in only 10% of the EN group and 20% of the PG group; it was left-sided in 20% of the EN group and 15% of the PG group. The mean duration of CUC before the appearance of EN and PG was 5 and 10 years, respectively. Three patients had consulted a dermatologist for PG before a clinical diagnosis of CUC was made. EN and PG recurred in 20 and 33% of cases, respectively. EN appeared almost exclusively on the legs, while PG appeared on various areas of the skin, including the site of ileostomy in one patient. EN was controlled with adequate medical or surgical treatment of CUC, but PG was relatively refractory, requiring specific treatment of its own in 30% of patients. In one case each, EN and PG recurred after subtotal colectomy but had resolved completely after proctectomy. In one patient, PG developed for the first time 1 year after total colectomy. Less than half of EN patients and two-thirds of PG patients ultimately had to undergo colectomy because of bowel disease. No patient required colectomy because of skin lesions.
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PMID:Clinical course and evolution of erythema nodosum and pyoderma gangrenosum in chronic ulcerative colitis: a study of 42 patients. 402 77

Cryptosporidial oocysts were identified by modified Ziehl-Neelsen stain in the stools of seven (3.2%) of 213 children with acute or chronic diarrhoea and one (0.9%) of 112 controls. All children with cryptosporidia were immunocompetent. Four of the index cases had a short illness (3-14 days) with watery diarrhoea, vomiting (2), and abdominal pain (2). Two index cases had chronic diarrhoea for over four months and failure to thrive. Both had a small intestinal enteropathy; one had cryptosporidial oocysts in stool specimens two months apart and the other had cryptosporidial schizonts attached to the jejunal mucosa. One index case had a colitis of indeterminate cause. Four of the index cases had recently travelled abroad. There had been an outbreak of gastroenteritis in the family of one of the index cases, and three affected sisters and an asymptomatic brother had oocysts in their stools. Cryptosporidial infestation seems to be associated with acute gastroenteritis and sometimes with chronic diarrhoea and small bowel damage in immunocompetent children.
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PMID:Cryptosporidiosis in immunocompetent children. 403 4

Gastrointestinal food allergies may be defined as clinical syndromes which are characterised by the onset of gastrointestinal symptoms following food ingestion where the underlying mechanism is an immunologically mediated reaction within the gastrointestinal tract. These gastrointestinal symptoms, principally vomiting and diarrhoea, sometimes abdominal colic, may be accompanied by other symptoms outside the alimentary tract. The clinical spectrum of these disorders ranges from acute anaphylaxis (rarely leading to death in infancy) to relatively minor symptoms which are difficult to distinguish from other disorders such as toddler's diarrhoea or psychologic disorders. The same food, e.g. cow's milk, may produce a wide range of clinical manifestations. In the one individual, clinical features may change with age. The incidence of gastrointestinal food allergic disease is greatest in the first year of life and decreases with age. There are, broadly speaking, two categories of clinical syndromes which are related to speed of onset of symptoms: immediate and delayed. Those syndromes which manifest immediately after food ingestion are usually easy to diagnose and specific IgE tests and skin prick tests are frequently positive. Those which have a delayed onset of up to several days are difficult to diagnose, and currently available investigations may be unsatisfactory for routine use. In current clinical practice, gastrointestinal syndromes which can be manifestations of food allergy, may be grouped as follows: 1) immediate syndromes, including anaphylaxis and b) acute vomiting +/- diarrhoea in association with cutaneous and respiratory manifestations; and 2) delayed syndromes, including a) food-sensitive small intestinal enteropathies, b) food-sensitive colitis, c) multiple food allergy +/- enteropathy, and d) infantile colic.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The spectrum of gastrointestinal allergies to food. 639 Dec 92

There is a variable temporal relationship between the presenting symptoms of inflammatory bowel disease and associated hepatic disease: hepatobiliary disease may precede, occur with, or occur many years after the onset of the bowel disease. We describe six patients in whom hepatobiliary disease of initially obscure origin preceded the development of inflammatory bowel disease. The colitis which subsequently developed in these patients was symptomatically mild. In our series, there was a high prevalence of sclerosing cholangitis. We conclude that in patients with chronic hepatobiliary disease of obscure origin, evaluation should include detailed questioning about bowel symptoms and routine sigmoidoscopy to screen for subclinical colitis. If a diagnosis of colitis is made in such a patient, endoscopic retrograde cholangiography may be indicated to evaluate the biliary tree for sclerosing cholangitis.
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PMID:Hepatobiliary disease that precedes ulcerative colitis. 650 28

One hundred and six consecutive subjects were seen in hospital a few days after undergoing surgery for bowel disease that necessitated the formation of a stoma. They consisted of patients with cancer (74), colitis (17) and diverticular disease (15). At this initial assessment details of psychological and social functioning were obtained for the preceding three months before operation. At 3 months post-operatively the subjects were interviewed in their own homes, 87 subjects were available (12 died, 7 refused) and again psychological and social assessments were made. Seventeen per cent of males and 19% of females had moderate or severe psychiatric disturbance and there was also a significant number of patients with various social disturbances. Physical diagnosis did not significantly affect psychiatric outcome. There was, however, high pre-operative psychiatric disturbance and the relevance of this in assessing post-operative symptoms is discussed.
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PMID:Psychosocial morbidity in the first three months following stoma surgery. 654 64


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