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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Paired direct immunofluorescence was used to localize and differentially enumerate immunocytes containing the various immunoglobulin (Ig) classes in ileal bowel walls of patients with Crohn's disease. In slightly inflamed mucosa the total number of Ig-containing cells of an average "tissue unit" increased threefold compared with normal controls, but only minor changes occurred in class ratios. In severely inflamed mucosa with persisting glands, the total immunocyte number was increased by a factor of 12.2 compared with the control unit. For IgA, IgM, and IgG cells this increase was 9.0, 12.0, and 60.9, respectively. The immunocyte ratios for these three major Ig classes were 57.5:14.7:27.7 in the inflamed mucosa, and 83.1:11.4:5.4 in the histologically normal control mucosa. When severely inflamed specimens from the ileum and from the colon were compared, there was no statistically significant difference in absolute immunocyte counts or class distributions. IgD and IgE immunocytes were extremely rare, and no consistent increase was found in the inflamed mucosae. In both the ileum and the colon fairly dense immunocyte populations with a marked IgG-cell predominance were encountered in the deeper layers of the inflamed bowel wall. The possible pathogenetic consequences of the pronounced local "over-production" of IgG in inflammatory bowel disease are discussed.
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PMID:Immunohistochemical characterization of local immunoglobulin formation in Crohn's disease of the ileum. 78 86

Lympho-plasmacytic infiltrates in cryostat sections (resected small intestine or colon specimens and rectal biopsies) from 29 patients with Crohn's disease (CD) were studied with the immunoperoxidase and immunofluorescence technique, by means of specific anti-human lymphocyte globulin (ALG) and specific anti-human T-lymphocyte globulin (ATG). Control specimens were obtained from 16 patients with ulcerative colitis (UC) and 12 subjects without inflammatory bowel disease. Characteristic transmural inflammatory infiltrates in CD consisted mainly of lymphocytes. A wide variation of the relative T-cell proportion was observed. However, in contrast with UC, abundant numbers of T-lymphocytes in CD were often detected, particularly in the deeper layers of the bowel wall. Furthermore, in serial sections immunoglobulin-containing plasma cells were counted, using specific anti-IgA, -IgM, and -IgG antisera. A significant reduction of the IgA/IgM plasma cell-ratio was found in CD in comparison with UC and controls. Our results indicate that in CD a chronic cellular immune reaction is going on within the diseases gut, involving increased numbers of lymphocytes and particularly T-cells. It remains to be established whether a deficient IgA barrier has to be considered of primary pathogenetic importance.
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PMID:Analysis of the lympho-plasmacytic infiltrate in Crohn's disease with special reference to identification of lymphocyte-subpopulations. 79 55

The effect of total parenteral nutrition on a group of thirty-four patients with inflammatory bowel disease over the past three and a half years was reviewed. Only patients in whom medical management had failed were included. Patients in whom the decision for surgery had been made and who were treated with total parenteral nutrition in an effort to prepare them for surgery were excluded. Of the group with Crohn's disease, those patients with small bowel involvement appeared to fare best; surgery was avoided in approximately 70 per cent of these admissions. Crohn's disease with colonic involvement had a less favorable prognosis, and 43 per cent of these patients underwent operation. Parenteral nutrition does not appear to affect the course of ulcerative colitis, as almost all patients in the group were treated by colectomy.
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PMID:Hyperalimentation in inflammatory bowel disease. 81 26

Thirty-four patients with chronic inflammatory bowel disease, 23 with ulcerative colitis, and 11 with crohn's disease, weretreated with elemental diet. thirty-one patients had been on high dose prednisonetherapy one to four weeks prior to the diet with no or insufficient response. Fifteen patients (44%) went into remission when elemental diet was introduced as the only change of treatment. Furthermore six patients (18%) went into remission when the dietary treatment was supplemented with high dose prednisone treatment (2 cases) or an increase of prednisone dose (4 cases). Remission occurred in 16 of 21 patients with disease of moderate activity, but in only 5 of 13 cases with severe disease. Remission rate was higher in patients with a limited extent of the lesion, but 8 patients with extensive colitis responded to treatment. There was no significant change of haemoglobin serum iron, transferrin, albumin, orosomucoid, or renal excretion of creatinine. However, significant decreases were observed of sedimentation rate, renal urea excretion, faecal volume and daily number of bowel movements. Colectomy was performed in 8 patients whose condition remained unchanged or aggravated during treatment. Follow-up studies of non-operated patients who went into remission showed that 6 of 13 patients with ulcerative colitis were perfectly well 7-28 months after the study, 3 patients suffered a mild recurrence after 4-24 months, and 4 patients were colectomized 5-10 months later due to severe attack. Of 8 patients with Crohn's disease 4 remained unoperated and free of symptoms 22-35 months after the study.
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PMID:Assessment of the therapeutic value of an elemental diet in chronic inflammatory bowel disease. 83 75

Seven cases of amoebiasis have been seen at the Royal North Shore Hospital of Sydney, over a nine-year period from 1968 to 1976. Six of these patients had intestinal amoebiasis; these included four with amoebic colitis, one of whom died, one patient with a rectal amoeboma, which was surgically resected, and one case of amoebic dysentery. The patients with amoebic colitis were considered initially to have either ulcerative colitis or Crohn's disease. All patients with inflammatory bowel disease should have rectal swabs or scrapings examined by warm-stage microscopy, rectal biopsy and indirect haemagglutination (IHA) tests to exclude amoebiasis. Three patients had extraintestinal amoebiasis in the form of liver abscesses and one also had pulmonary involvement. In one patient with a hepatic abscess who presented with pyrexia and no evidence of intestinal amoebiasis, the abscess ruptured intraperitoneally. Surgery was performed on three patients, in two cases before diagnosis. Metronidazole appears to be the treatment of choice for intestinal amoebiasis and amoebic liver abscesses. Amoebiasis should be considered in patients resident in Australia who have not recently travelled abroad.
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PMID:Amoebiasis: incidence at Royal North Shore Hospital, Sydney. 84 70

Surprisingly little has been written about the association of amyloidosis with inflammatory bowel disease. On reviewing the literature it appears that there is a correlation between amyloidosis and Crohn's disease, but little definitive evidence of such a relationship with ulcerative colitis could be found. No specific features emerge as aetiological factors in the amyloidosis of inflammatory bowel disease. The amyloidosis may arise after only a short duration of bowel disease, and there is evidence that the association may be commoner than is realized. The need for a prospective systematic search in a large number of patients with inflammatory bowel disease is emphasized.
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PMID:Amyloidosis and inflammatory bowel disease. 84 28

We have reported long-term results in the cases of 42 patients following total colectomy and ileorectal anastomosis for inflammatory bowel disease. In this group, 35 patients had Crohn's disease and seven had ulcerative colitis. Five of those seven patients with ulcerative colitis had carcinoma of the colon at the time of colectomy. A diverting loop ileostomy was constructed in 14 of the 35 patients who had Crohn's colitis at the time of operation, and none of these patients had any anastomotic leakage either before or after the ileostomy was closed. However, there patients with Crohn's colitis in whom anastomotic leaks developed postoperatively; all three patients died. In the group with ulcerative colitis, one patient had an anastomotic leak but there was no operative nortality. Of the 29 patients with Crohn's disease followed for one to 18 years, 12 (41 per cent) developed recurrences in the ileum and/or rectum, and seven of these patients had to have their anastomoses taken down.
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PMID:Ileorectal anastomosis for inflammatory disease of the colon. 84 95

Lysozyme concentrations in serum and urine were determined in 101 patients with Crohn's disease and 26 patients with ulcerative colitis. Lysozyme was assayed according to the lysoplate method of Osserman against a standard of humam lysozyme. The mean serum lysozyme concentrations (+/- S.E.M.) for each group were as follows: controls 8.4 +/- 1.8 (n equals 38), Crohn's disease 8.2+/-2.6 (n equals 101), ulcerative colitis 8.7+/-3.0 (n equals 26). No significant differences were found in serum lysozyme levels of the various groups of patients (2p is greater 0.05). There existed no correlation (r equals 0.12, n equals 129, p is greater than 0.05) with the activity of the disease. Serum lysozyme levels were significantly higher in patients affected by Crohn's disease of the small and the large bowel than in patients with involvement of the small intestine only and operated patients (2p is less than 0.05). The discriminative value of these findings with respect to the clinical course of such patients is limited because no significant differences are found between the levels of patients with Crohn's disease and controls. Neither in case of Crohn's disease nor ulcerative colitis were the mean urine lysozyme concentrations increased. These findings show that the determination of serum and urine lysozyme levels is unsuitable in respect of the differential diagnosis of inflammatory bowel disease as well as of the assessment of activity and extent of the disease.
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PMID:[Lysozyme levels in chronic inflammatory bowel diseases (author's transl)]. 84 83

From 1964 to 1973, 50 patients who initially underwent ileostomy for inflammatory bowel disease at the Lahey Clinic required 84 revisions. The commonest reason for revision was stenosis. Fistula, prolapse, and retraction followed in order of frequency. Patients with Crohn's disease seemed to have a higher incidence of revision, but this was not statistically significant. Other reasons for revision were analyzed, and recommendations for treatment were discussed. Retrospective study revealed that 50% of ileostomy revisions were performed for probably preventable complications.
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PMID:Ileostomy complications requiring revision: Lahey clinic experience, 1964-1973. 84 90

The level of 3H-labelled thymidine ([3H]TdR) incorporation of blood cells of patients with coeliac disease was shown in two separate studies to be significantly lower than that of a normal control group. In the first study the 'background' DNA synthesis in unstimulated cultures containing a standard number of blood lymphocytes was measured on days 4, 5 and 6. In the second study a standard volume of freshly drawn whole blood was added to culture medium and the [3H]TdR incorporation measured over the first 24 hr and from 48 to 72 hr. In all cases the [3H]TdR incorporation of cells of coeliac patients on a normal or a gluten-free diet was lower than that of the control group. It is suggested that sequestration of DNA-synthesizing cells in the mucosa of the small bowel may partly explain these results. In whole-blood cultures from patients with inflammatory bowel disease in remission [3H]TdR incorporation over the first 24 hr was raised in Crohn's disease but normal in ulcerative colitis.
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PMID:DNA-synthesizing cells in the blood in coeliac disease and inflammatory bowel disease. 89 Oct 23


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