Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Crohn's disease (regional enteritis) is a chronic non-specific inflammatory intestinal disorder of unknown etiology. Most commonly the terminal ileum in involved, a segmentary involvement of the bowel wall is rather characteristic. Main symptoms are recurrent abdominal pain, fever, diarrhea and weight loss. Radiological and endoscopic examination confirms the diagnosis, granulomas in the biopsy specimen are pathognomonic. In differential diagnosis ulcerative and ischaemic colitis have to be ruled out. Conservative therapy with prednisolone and salazopyrin is the method of choice, however, complications like small bowel obstruction, toxic megacolon and fistulae ask for surgical intervention.
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PMID:[Morbus Crohn (enteritis regionalis)]. 0 46

The course of 86 children with Crohn's disease was examined during a 10-year period between 1966 and 1976. Patients were classified according to the initial site of disease. Ileocolitis was the most (52%) and colitis the least (9%) common form of disease with diffuse small bowel or ileal disease each comprising nearly 20% of the study group. These figures show a reversal from those of a previous decade when 42% of the patients had only terminal ileal disease and 17% had ileocolitis. Children with ileocolitis had the highest number of extracolonic manifestations and operations and required steroid therapy the longest. Those with only small bowel disease (with the exception of duodenal involvement) had fewer extraintestinal symptoms and operations and showed a consistently good response to medical treatment.
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PMID:Prognosis in children with Crohn's disease. 2 21

On-study barium radiographs of 535 patients in the National Cooperative Crohn's Disease Study have been analyzed for the pattern of distribution of bowel disease and the individual features that characterized bowel involvement. On-study and off-study radiographs of 403 of these patients were compared under code to judge radiographic response to drug treatment and discover correlations of radiographic findings with clinical response. Patients with more clinically active disease had more colonic disease on x-ray. Duodenal abnormalities were recognized in 22% of the patients and radiographically typicaly Crohn's disease of the duodenum in 8%. Recurrent Crohn's disease and that characterized by small bowel obstruction each displayed a characteristic appearance. Overall there was little evidence of radiographic improvement during the study, and little correlation between clinical response and evidence of radiologic improvement. Only patients treated with prednisone for more than 6 mo showed statistically significant radiologic improvement. Patients with definite radiographic progression or regression were found in each treatment group. Both fistula and stricture with obstruction were associated with a poor clinical response to all therapies. In view of the evidence from this study that radiographic findings do not correlate with clinical symptoms or response, the ritual use of x-ray to follow patients with Crohn's disease is unnecessary.
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PMID:Radiographic findings of the National Cooperative Crohn's Disease Study. 3 81

The diagnostic value of angiography was studied in 116 patients with Crohn's disease. Angiograms showed abnormalities in over 90% of the cases. Many angiographic features were nonspecific; only the "zoning sign" and the presence of paraintestinal mesenteric neovasculature were considered diagnostic. Crohn's colitis could be distinguished from ulcerative colitis in only 30% of the cases. Angiography, as a diagnostic adjunct to barium studies, will reveal the presence of lesions and their extent. This is particularly important in suspected postoperative recurrence of Crohn's disease. Angiography is a potential differential diagnostic aid in doubtful cases of inflammatory and malignant bowel disease.
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PMID:Angiography in Crohn's disease revisited. 17 37

One-hundred-and-twenty-two patients with Crohn's disease were admitted to Royal Prince Alfred Hospital from 1966 to 1977. Thirty-seven had disease confined to small bowel, 37 to colon and 48 had combined small and large bowel involvement. The disease was twice as common in females as in males. Pain was the major symptom in patients with small bowel disease and was associated with diarrhoea if both small and large bowel were involved. Disease confined to the colon most commonly produced diarrhoea with bleeding. Perianal disease occurred more often in patients with colonic disease. Systemic complications were also more frequent in the group with disease confined to colon, and these complications were often multiple. Medical treatment with corticosteroids, salazopyrine or azathioprine, was generally unsuccessful. One in two patients required surgery, usually in the form of resection. Following resection, recurrence occurrred in more than one half of the patients but was less frequent in those with colonic disease. Three-quarters of patients with a recurrence required a further resection, emphasising the unsatisfactory long-term results of surgery in this disease.
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PMID:Crohn's disease: a review of 122 cases. 28 55

There is conflicting evidence regarding the adequacy of hypothalamic-pituitary function in children and adolescents with chronic inflammatory bowel disease complicated by growth retardation and delayed sexual maturation. A child with Crohn's disease, who has never received corticosteroid therapy, had delay of both growth and sexual maturation and has been investigated over the course of his disease. In addition to a skull X-ray (normal) and thyroid function tests (normal), a standard insulin tolerance test (insulin 0.15 u/kg) and a standard gonadotropin-releasing hormone (Gn-RH) test (100 microgram Gn-RH i/v) were performed when the bowel disease was in relapse and again during a remission of the bowel disease, achieved by surgery. When the bowel disease was in relapse (coincident with growth arrest) results showed an inadequate release of gonadotrophins and of growth hormone (even after pre-treatment with stilboestrol) but normal release of cortisol and prolactin. During a remission of the bowel disease coinciding with a period of rapid "catch-up" growth, release of growth hormone was normal and that of gonadotrophins supranormal. The demonstration of a reversible apparent partial hypopituitarism in this boy not only re-questions the adequacy of hypothalamic-pituitary function in inflammatory bowel disease but also indicates a potential diagnostic pitfall in the routine investigation of growth retardation if gastrointestinal symptoms are not prominent at presentation.
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PMID:A case of apparent hypopituitarism complicating chronic inflammatory bowel disease in childhood and adolescence. 33 54

Difficulties arise in the interpretation of liver tests in the pregnant subject, since some values increase (alkaline phosphatase) whilst others remain unchanged (transaminases) or fall during pregnancy. The diagnosis and management of some causes of jaundice in pregnancy, such as viral hepatitis, gall stones, benign intrahepatic cholestasis and acute fatty liver of pregnancy are discussed. Little is known about the commonest symptoms of pregnancy (nausea, vomiting and constipation) other than that they might be due to hormonally induced alteration of sphincter tone. However, pre-existing bowel disease has a greater effect on pregnancy. Fertility is reduced in poor nutritional states (e.g. coeliac and Crohn's diseases) and an increased occurrence of spontaneous abortion has been noted. For inflammatory bowel diseases, the time of onset is important in determining the outcome of pregnancy. Relapse in the disease is commonest in the first trimester and in the puerperium. Treatment of these conditions is essentially as in the non-pregnant subject. The controversial subject of sulphasalazine and steroid usage in pregnancy is discussed.
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PMID:Liver and gastrointestinal function in pregnancy. 38 67

In a prospective study of liver function in 19 patients with Crohn's disease, examination of liver biopsies showed a sinusoidal dilatation in 16 patients. This dilatation was moderate in 5 cases and pronounced in 6 cases and was associated with a closely parallel dilatation of the centrilobular vein. There was no correlation between these diffuse vascular changes and the site of the bowel disease, the clinical presentation, and the course of the disease. The pathogenesis of this sinusoidal dilatation is unknown.
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PMID:Hepatic sinusoidal dilatation in Crohn's disease. 53 18

Normal and immunodeficient CBA and A2G strain mice were inoculated with crude (100 to 20 to 30 micrometer), cell-free (0.2 micrometer) filtrates of Crohn's or noninflammatory bowel disease tissue homogenates, which were either fresh or frozen to -70 degree C. Mice of each strain developed epithelioid and giant cell granulomas both locally at the site of injection and systemically in response to crude and cell-free filtrates of Crohn's tissues. Control mice did not develop such changes. The granulomas evolved slowly, predominantly between 9 and 27 months. The granuloma-inciting agent has been shown to be present in ileum, colon, and mesenteric lymph nodes of patients with Crohn's disease and it withstands freezing to -70 degree C. The use of Crohn's tissues common to this study and one in rabbits previously reported, suggests that the induction of granulomas by this agent is not strain- or species-specific, and is independent of the immune status of CBA mice.
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PMID:Induction of granulomas in mice by Crohn's disease tissue. 56 79

Serum lysozyme (muramidase) concentrations were determined in 55 patients with inflammatory bowel disease, 6 with miscellaneous bowel disease, 40 with pulmonary tuberculosis, and in 20 normal subjects. The mean (+/- SE) lysozyme concentration for each group was as follows: controls 6,95 +/- 0,36 microgram/ml; ulcerative colitis 9,61 +/- 1,02 microgram/ml; inactive Crohn's disease 7,61 +/- 0,53 microgram/ml; active Crohn's disease 20,77 +/- 2,17 microgram/ml; sputum-negative tuberculosis 13,05 +/- 1,06 microgram/ml; and sputum-positive tuberculosis 20,35 +/- 2,08 microgram/ml. The mean enzyme levels were significantly higher in patients with Crohn's disease than in those with ulcerative colitis (P less than 0,05) or in normal controls (P less than 0,01). Our findings suggest that serum lysozyme levels may be useful in differentiating active Crohn's disease from ulcerative colitis, but the results overlap somewhat. However, the enzyme level may be a useful index of disease activity in following up patients with Crohn's disease. As tuberculosis is endemic in this country it must first be excluded, because patients with pulmonary tuberculosis have similarly high levels of serum lysozyme.
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PMID:Serum lysozyme in Crohn's disease and ulcerative colitis. 60 77


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