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)

The correlation of 22 commonly used clinical and laboratory abnormalities with linear extent of the lesion was studied in 70 patients with Crohn's ileitis, 16 of whom had inactive disease and 54 active disease. Extent was measured radiologically using a well-validated double-contrast technique. In the patients with active disease, lesion length was significantly correlated with weight loss, serum albumin, total protein, and serum iron. In the group without active inflammation, pain and abdominal mass were significantly correlated with lesion extent. No correlation was found between linear extent of lesion and the following: an index of inflammatory activity (New Crohn's Disease Activity Index), several acute-phase reactants, and the components of the complete blood count. Only total protein and serum iron had a significant regression coefficient following a procedure of stepwise regression. No mathematical model was found capable of satisfactorily predicting the length of lesion.
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PMID:Relationship between clinical and laboratory parameters and length of lesion in Crohn's disease of small bowel. 649 27

A survey of vitamin D status in 152 patients with chronic gastrointestinal conditions and 104 patients with chronic liver diseases is presented. Mild deficiency was common and severe deficiency, as judged by plasma 25-OHD levels less than 8 nmol/l, was encountered in every disease category tested. In the gastrointestinal disease patients, deficiency was significantly more common in patients following gastroenterostomy than other gastric surgery, in patients with active Crohn's disease than in those with inactive disease and in patients with chronic pancreatitis or pancreatic carcinoma with cholestatic features than in those without cholestatic features. Deficiency was as common in patients with Crohn's disease who had not been treated surgically as in those who had. There was no significant correlation between plasma 25-OHD levels and any laboratory index of malabsorption or malnutrition except for serum albumin in the gastric surgery patients, haemoglobin and ESR in the Crohn's disease patients and albumin and vitamin E in the group of patients with gastrointestinal disorders taken as a whole. In the chronic liver disease patients, those with late primary biliary cirrhosis had lower plasma 25-OHD levels than those with histological Stage I and II disease who all had normal levels, and those with pruritus and jaundice were more commonly severely deficient. Whatever the underlying disease process, patients with other coincidental medical conditions were much more likely to be deficient as were patients with cholestasis. Evidence of secondary hyperparathyroidism and osteomalacia on bone histology indicated the clinical relevance of the vitamin D deficiency. This study showed no relationship between abnormal plasma vitamin D binding protein levels and vitamin deficiency.
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PMID:A survey of vitamin D deficiency in gastrointestinal and liver disorders. 654

Circulating lymphocytes were enumerated in 28 patients with Crohn's disease and in 12 patients with other diseases by rosetting and by immunofluorescent staining using monoclonal antibodies for T-cell surface phenotypic markers [OKT3 (mature), OKT4 (helper), and OKT8 (suppressor/cytotoxic)] or polyvalent antisera for surface immunoglobulins (B cells). Total lymphocyte counts were reduced only in those with non-steroid-treated active Crohn's disease. Circulating monocyte counts, proportions of peripheral T and B cells, and percentages and absolute numbers of mature, helper, and suppressor T-cell subclasses in Crohn's disease were not significantly different than in the controls. Helper to suppressor T-cell ratios were comparable in all subjects, varying directly with numbers of helper T cells (p less than 0.05). Individual ratios of helper to suppressor T cells did not correlate with disease activity or location, the use of steroids, serum albumin, or total lymphocyte or monocyte counts. This study provides no evidence for underlying abnormalities of circulating lymphocyte subpopulations in Crohn's disease when compared to subjects with other illnesses. The characterization of lymphocyte subclasses in affected tissues is an important area of continuing investigation.
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PMID:Circulating lymphocyte subpopulations in Crohn's disease. 660 74

We evaluated fecal clearance of alpha 1-antitrypsin (alpha 1-AT) as a method of detecting and quantitating intestinal protein loss in patients with inflammatory bowel disease. We investigated alpha 1-AT clearance (C alpha 1-AT) in 14 patients (seven with Crohn's disease, seven with ulcerative colitis) and in 10 children with gastrointestinal disorders and normal serum albumin values who served as controls. The inflammatory bowel disease patients were analyzed for nutritional status, intestinal absorption, disease activity and distribution, and presence or absence of rectal bleeding. alpha 1-AT was measured in stool (72-h collections) and serum by radial immunodiffusion, and the clearance was calculated. The mean C alpha 1-AT in patients with inflammatory bowel disease was significantly (p less than 0.05) higher than that of the controls. C alpha 1-AT in the former patients was inversely related to the serum albumin level (p less than 0.001), but not to disease activity, medications, absorption, nutritional status, or moderate rectal bleeding. In the patients with Crohn's disease there was a trend to increased C alpha 1-AT from only ileal to diffuse small intestinal disease involvement. We conclude that in patients with inflammatory bowel disease, fecal clearance of alpha 1-AT is a useful method for quantitating intestinal protein loss, and that moderate rectal bleeding does not affect the C alpha 1-AT determination.
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PMID:Fecal alpha 1-antitrypsin clearance in patients with inflammatory bowel disease. 660 30

Fifty two patients with Crohn's disease (31 outpatients and 21 inpatients) were investigated for evidence of vitamin A deficiency. Eleven (21%) had low plasma retinol concentrations (less than 1.2 mumol/l (34.3 micrograms %)). Five of these were outpatients and plasma retinol was only slightly reduced (greater than 1.0 mumol/l (28.6%)). All outpatients weighed 80% or more of ideal, and were considered at low risk of developing vitamin A deficiency. In contrast, of the six inpatients with low plasma retinol concentration, five had a level of less than 1.0 mumol/l (28.6 micrograms %) and weighed less than 80% ideal. Three of these had impaired dark adaptation and a plasma retinol concentration of less than 0.8 mumol/l (less than 22.9 micrograms %). As a group, the inpatients were more protein depleted than the outpatients, with respect to serum albumin (p less than 0.01), transferrin (p less than 0.001), and prealbumin (p less than 0.001) but retinol binding protein levels were not significantly lower. It is suggested that patients with extensive small bowel Crohn's disease, who weigh less than 80% of ideal weight, merit measurement of plasma retinol concentration. Those with plasma retinol less than 0.8 mumol/l (less than 22.9 micrograms %) run a high risk of night blindness. Vitamin supplements should be given and protein depletion corrected.
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PMID:Vitamin A deficiency in Crohn's disease. 668 75

Serum zinc concentrations and urine zinc excretion have been studied in 10 patients with severe Crohn's disease before and during 59 patient-weeks of intravenous nutrition. Before serum zinc concentrations (9.9 +/- 1.0 mumol/l: mean +/- SEM) and urine zinc excretion (3-3 +/- 0.6 mumol/24h) were less than controls (p less than 0.01). No patients had clinical signs of zinc deficiency before intravenous nutrition and none developed signs during it. There was no overall change in serum zinc concentrations, despite improvements in body weight, skinfold thickness, and mid-arm circumference in all patients, and increased serum albumin and serum transferrin concentrations during all but two periods of intravenous nutrition. Nor was there any relationship between serum zinc concentrations and zinc uptake (up to 220 mumol/day), serum zinc concentrations remaining significantly lower than control levels. Urine zinc excretion during the first week of intravenous nutrition showed a 1.2 to 53-fold increase (mean 11-fold) over pre-intravenous nutrition levels, and a positive relationship was demonstrated between zinc intake and urine zinc excretion. It is suggested that zinc supplied by the intravenous route is inefficiently transported to the tissues, and that some is excreted in the form of small molecular weight chelates into urine. Recommendations are made for the supply of intravenous zinc, based on monitoring urine zinc excretion in individual patients.
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PMID:Clinical experience of zinc supplementation during intravenous nutrition in Crohn's disease: value of serum and urine zinc measurements. 681

Significant intracellular potassium depletion was documented in 57 patients with Crohn's disease by measurements of total body potassium, body water compartments, and red cell Na,K-ATPase units. Total body potassium deficits paralleled the activity of illness, but were not correlated to serum potassium levels. Treatment before surgery to improve individual body potassium content resulted in a reduced surgical mortality and complication rate compared with a retrospective series of 56 patients in whom pretreatment had simply been aimed at normalizing serum albumin and other standard serum parameters. In conclusion, preoperative nutritional support in Crohn's disease is recommended for patients with a total body potassium level less than 70% of normal. If whole body counting for direct measurement of total body potassium is not available, a Crohn's Disease Activity Index above 225 is proposed as the deciding level, and the parenteral administration of a standardized regimen consisting of 150 to 200 mval potassium plus 2500 to 3000 kcal daily for a two-week period is recommended.
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PMID:Total body potassium depletion and the need for preoperative nutritional support in Chrohn's disease. 681 56

The incidence of abdominal and pelvic abscess is reported from a consecutive series of 111 patients undergoing 124 resections for Crohn's disease. Preoperative abscesses were found as a complication of Crohn's disease in 13 patients (10%) and 8 were clinically unsuspected. The majority of preoperative abscesses were confined to one site (localized to bowel, psoas sheath, pelvis, or in the abdominal wall). All preoperative abscesses occurred in patients requiring an emergency or urgent operation. Patients with a preoperative abscess had significantly lower serum albumin levels and significantly increased serum alkaline phosphatase values than the patients without an abscess. Postoperative abscesses occurred in 17 patients (14%) and six were multiple. Five of the postoperative abscesses occurred in patients who had had a preoperative abscess; these recurrent abscesses all presented 6-14 wk after an uncomplicated initial operation. The principal bacterial isolates were Escherichia coli (54%), Bacteroides fragilis (44%), enterococci (41%), and viridans streptococci (31%). The incidence of abscess was unrelated to the use of preoperative steroid therapy.
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PMID:Incidence and microbiology of abdominal and pelvic abscess in Crohn's disease. 712 31

Sera from 111 patients with various gastro-intestinal (GI) diseases were studies for the presence of antibodies to human serum albumin (HSA), bovine serum albumin (BSA) and ovalbumin (OA) by passive haemagglutination assay. The antibody titre to BSA was higher than that to HSA or OA. The anti-BSA antibody was demonstrated in upper GI diseases i.e. esophageal cancer, gastric ulcer, gastric cancer and duodenal ulcer, and not in lower GI disease i.e. Crohn's disease, ulcerative colitis and colon cancer. Both the mean titre and the incidence of the anti-BSA antibody tended to be higher in women than in men, and the titre was in a positive correlation with serum gamma-globulin levels. Sephadex G-200 column chromatography revealed that the anti-BSA antibody was widely distributed between void volume and 7S fraction.
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PMID:Anti-albumin antibodies in sera of patients with gastro-intestinal disease. 714 Nov 96

Early postoperative mortality and morbidity and factors that might be of importance in this respect were studied in a series of consecutive patients resected for classical Crohn's disease (IPI) or mainly colonic disease (CPC). The operative mortality was comparatively low after surgery for both primary and recurrent disease (1.5 and 2.0% respectively). The complication rate was marked, particularly so after primary surgery for colonic disease. Weight loss, abnormally low serum albumin or TIBC referred to as nutritional markers, appeared to have no predictive value in determining patients at risk for postoperative complications. Steroid treatment prior to operation was not associated with increased postoperative complication rate. The important factor influencing postoperative complication rate was the occurrence of preoperative septic complications and surgery performed for urgency was associated with an increased complication rate only when associated with pre-existing septic complications. The observations would appear to speak in favour of surgery at an earlier stage in patients with Crohn's disease who do not respond to medical treatment.
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PMID:Early complications after surgical treatment for Crohn's disease with particular reference to factors affecting their development. 722 90


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