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)

One of the most important therapeutic goal in anorexia nervosa is to define with the patient a body weight to obtain. To do so, objective criteria are needed. For this purpose, we studied in a longitudinal way, 9 nutritional parameters in 23 patients with anorexia nervosa, as compared with 23 age - and sex - matched patients with Crohn's disease: body weight, tricep's skinfolds, mid-arm muscle circumferences; serum albumin, prealbumin, transferrin, hemoglobin, cholesterol; urinary creatinine and calcium, magnesium, zinc and copper serum levels and urinary outputs. Despite losses of body weight, of lean body mass and of fatty mass higher in patients with anorexia nervosa than in those with Crohn's disease, the former had higher nutritional protein's serum levels than the latter. These nutritional protein markers were not in anorexia nervosa different from normal values. In anorexia patients, zinc and copper serum levels and urinary outputs were very low. This study suggests that nutritional protein markers of hepatic synthesis are not sensitive markers for malnutrition evaluation and can not be used to follow renutrition efficacy.
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PMID:[Anorexia nervosa: absence of sensitivity to nutritional protein markers. Study of 23 patients and comparison to a paired group with colonic Crohn's disease]. 250 Aug 81

Restorative proctocolectomy and ileal reservoir, performed as a two-stage procedure, has the advantages of a shorter hospital stay, one less anesthetic, and a shorter time with a stoma when compared with the three-stage procedure. In a prospective, nonrandomized study of 152 consecutive patients undergoing restorative proctocolectomy (57 two-stage and 95 three-stage), the complication rates for the ileal reservoir phase and the functional results of the two- and three-stage operations were compared. The results suggest that there is no advantage to the three-stage procedure except in the following circumstances: when urgent surgery is required for the complications of ulcerative colitis, when malignancy or Crohn's disease cannot be ruled out, and when a patient with active colitis has a combination of a low hemoglobin value (male less than 13.5 g/dl, female less than 11.5 g/dl), a low serum albumin level (less than 40 g/l), and is taking oral steroids.
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PMID:Restorative proctocolectomy with ileal reservoir. Comparison of two-stage vs. three-stage procedures and analysis of factors that might affect outcome. 253 99

The effect of perioperative blood transfusion on recurrence of Crohn's disease was investigated retrospectively in 60 patients with Crohn's disease who underwent small-bowel resection. 28 patients received 1-8 units of blood; the others were not transfused. Both groups were similar in age, duration of Crohn's disease, and preoperative serum albumin, but preoperative haemoglobin, length of intestine resected, and location of small-bowel involvement were different. The patients who received perioperative blood transfusion had a significantly lower recurrence rate by life-table analysis, although the site and greater length of bowel involvement in the transfused patients would normally indicate an increased likelihood of recurrence. 5 years after bowel resection, the cumulative recurrence rate in transfused patients was 19%, compared with 59% in controls. The immunosuppressive effect of blood transfusion may modify the progression of Crohn's disease.
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PMID:Effect of perioperative blood transfusion on recurrence of Crohn's disease. 257 Mar 31

Serum antibodies to five cow's milk proteins (alpha-casein, bovine serum albumin, beta-lactoglobulin A and B, and alpha-lactalbumin) were investigated in young patients with inflammatory bowel disease (56 Crohn's disease, 24 ulcerative colitis). IgG antibodies against bovine serum albumin, beta-lactoglobulin A and beta-lactoglobulin B were higher in Crohn's disease patients than in those with ulcerative colitis or the controls. IgG anti-bovine serum albumin antibodies were higher in those Crohn's disease patients who had higher scores of disease activity. Finally, IgA antibodies to alpha-casein were higher in patients with Crohn's disease and ulcerative colitis when compared to controls. These findings may be due to increased uptake of dietary antigens or enhanced immunological response occurring in Crohn's disease patients.
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PMID:Serum antibodies to cow's milk proteins in pediatric inflammatory bowel disease. Crohn's disease versus ulcerative colitis. 274 81

The effect of cyclosporin A in acute and chronically active inflammatory bowel disease was tested in 11 patients with Crohn's disease and two with ulcerative colitis who had exhibited a poor response to at least eight weeks of conventional therapy. Trough levels of the drug in the therapeutic range were obtained in 12 of 13 patients. Cyclosporin A, which was usually added to the continued previous medication, including corticosteroids (11 of 13) or metronidazol (1 of 13), prompted an apparent clinical improvement in all but one patient. In six of the nine Crohn's disease patients with an initial Best index of greater than 150, a definite fall by at least 100 points was observed after 2-10 weeks of treatment, but the van Hees index declined only in two patients. All four patients with chronic perineal fistulation experienced symptomatic relief. Both patients with ulcerative colitis had a clinical remission. Erythrocyte sedimentation rate or serum albumin improved in eight of 13 patients. However, two of the nine responders with Crohn's disease relapsed during cyclosporin A therapy and three immediately after the medication was discontinued. Common side effects included hypertrichosis, tremor, and hyperesthesia; hypertension and epigastric pain each occurred only in one patient.
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PMID:Cyclosporin A treatment in inflammatory bowel disease. 276 6

Eleven patients with severe refractory Crohns disease were treated with a high calorie, whole diet. Eight patients achieved remission with a drop in DAS from 13 to 4 (t = 6.31, p less than 0.001) and reversal of subacute obstruction in all cases. Nutritional parameters including weight, triceps skinfold thickness, arm muscle area, and serum albumin increased in all patients. The diet was well tolerated with a mean treatment period of 20 days. Clinical relapse of disease occurred in all cases within 9 months (mean 6 +/- 2 months). The mechanism of action of a high calorie diet (HCD) is unclear and warrants further study but antigen or specific food exclusion does not appear to be required as judged by this study.
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PMID:Remission induction in refractory Crohns disease using a high calorie whole diet. 277 40

The prevalence of abnormal values of initial screening laboratory tests was assessed for 24 children who eventually proved to have Crohn's disease. The screening tests included in this analysis were fecal alpha 1-antitrypsin (FA) concentration, erythrocyte sedimentation rate (ESR), total leukocyte count, serum albumin level, hemoglobin concentration, and qualitative testing of stool for the presence of blood. Of the 24 patients, 21 had abnormal FA values, 17 had anemia, 19 had an increased ESR, 14 had hypoalbuminemia, rectal bleeding was found in 8, and none had leukocytosis. All 24 patients had at least one abnormal screening test value; the most frequently abnormal result was the FA concentration. Pediatric patients without elevated FA values, anemia, a high ESR, bloody stools, or hypoalbuminemia are unlikely to have active Crohn's disease.
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PMID:Screening laboratory tests for Crohn's disease. 274 58

We have investigated the correlation of 24 h and 48 h faecal Indium-111 excretion with each other and with several clinical activity indices for Crohn's disease (CD): Crohn's disease activity index (CDAI), activity index (AI), simple index (SI), Oxford score, and laboratory parameters, such as ESR, serum albumin, orosomucoid, C-reactive protein, alpha-l-antitrypsin (alpha 1-AT) faecal concentration, and alpha 1-AT clearance in 58 CD patients (37 with small bowel and 21 with colonic disease). A significant correlation was found between 24 and 48 h faecal Indium-111 excretion for small bowel (r = 0.708, p less than 0.0001) and colonic disease (r = 0.994, p less than 0.0001). The median faecal Indium-111 excretion for colonic involvement (4%; 0.15-50% median and range) was significantly (p less than 0.005) higher than that for small bowel disease (0.45%; 0.03-2.9%). No significant correlation was found between faecal Indium-111 excretion and any activity index in the patients with small bowel disease, while in the group of patients with colonic localisation only the AI showed a significant correlation (r = 0.593, p less than 0.02). Faecal Indium-111 excretion was significantly correlated with alpha 1-AT clearance (r = 0.712, p less than 0.0001) and faecal alpha 1-AT concentration (r = 0.750, p less than 0.0001) in small bowel and in colonic localisation (r = 0.530, p less than 0.02 and r = 0.444, p less than 0.05). Serum albumin was significantly correlated only in the group of patients with colonic disease (r = -0.593, p less than 0.05). The present study shows poor agreement between activity indices, serum parameters of activity and faecal Indium-111 excretion. As a good correlation was found with the alpha1-clearance, which reflects losses into the gut, these results may suggest that faecal Indium excretion does not only reflect activity of inflammation, but my relate to the extent of intestinal ulceration.
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PMID:Are activity indices helpful in assessing active intestinal inflammation in Crohn's disease? 280 91

Fifty patients with fibrotic small bowel strictures secondary to long-standing Crohn's disease underwent a total of 225 strictureplasties during the period from June 1984 to July 1988. Forty-two patients (84%) presented with obstructive symptoms. Patients had a 1- to 30-year history of Crohn's disease (mean, 14 years). Sixty-two per cent of patients were taking steroids at the time of admission, and 70% had had previous small bowel resections. All patients had one or more areas of small bowel affected with a fibrotic stricture and partial obstruction. Short strictures were treated by Heinecke-Mikulicz strictureplasties, and longer strictures by Finney side-to-side strictureplasties. In 30 patients (60%), 6- to 65-cm segments of small bowel were also resected due to acute inflammation with phlegmon or fistulae. Patients were discharged from the hospital 5 to 20 days after operation (mean, 10 days). After operation all patients with obstructive symptoms reported relief of symptoms and weight gain. Steroid doses could be tapered and nutritional parameters, such as total lymphocyte count, and serum albumin improved. Strictureplasty had 0% mortality and 16% morbidity rates. Complications included 3 enterocutaneous fistulae, 2 intra-abdominal abscesses, 2 hemorrhages requiring transfusion, 1 prolonged postoperative ileus that could be treated conservatively in 2 patients, and 1 restricture of a strictureplasty. Patients were followed for 1 to 40 months after operation (mean, 8 months). Resection of small bowel disease, especially that associated with perforation, is usually required in Crohn's disease. However, strictureplasty minimizes the need for bowel resection in patients with short fibrotic strictures resulting in recurrent small bowel obstruction.
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PMID:Strictureplasty in Crohn's disease. 281 31

Intestinal alpha 1-antitrypsin clearance was quantified in 17 patients with clinically active Crohn's disease before and after a six-week period of treatment with sulfasalazine and methylprednisolone. Before the study, alpha 1-antitrypsin clearance and, hence, enteric protein loss was elevated as being above control values in 16 patients. After therapy, clearance values decreased in 11 and were normalized in five patients. Serum albumin level was normalized in 11 of 12 patients who had hypoalbuminemia before the study. Clinical condition was improved in all but 1 patient after treatment. There was no close correlation between alpha 1-antitrypsin clearance and disease activity index. These results indicate that antiinflammatory therapy has a beneficial effect on enteric protein loss in Crohn's disease. The measurement of alpha 1-antitrypsin clearance provides a useful adjunctive technique in evaluating intestinal inflammatory activity, and it seems to be of use in following the efficacy of treatment in the course of illness in Crohn's disease.
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PMID:Antiinflammatory treatment and intestinal alpha 1-antitrypsin clearance in active Crohn's disease. 285 32


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