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

Anemia is the most commonly haematologic disorder observed in Crohn's disease. Secondary megaloblastic anemia related to a nutritional deficiency of vitamin B 12 and/or folic acid is a rare condition as well as auto-immune haemolytic anemia. Iron lack microcytic hypochromic anemia is far more frequent. It is probably due to several causes as microscopic or macroscopic haemorrhages, inflammatory syndrome, disturbance of iron absorption. Hyperleucocytis, hypereosinophilia, hypoprothrombinemia related to the inflammatory syndrome and/or lesions of the bowels are frequently observed in such patients. Anyhow, heamatologic disorders seem markedly correlated with the activity of the disease and should be useful in the follow up patients with Crohn's disease.
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PMID:[Haematologic disorders in Crohn's disease (author's transl)]. 22 71

Aim of the study was the evaluation of the diagnostic value of the parameters of iron metabolism in normal adults and also in patients suffering from uncomplicated iron deficiency, iron overload due to repeated blood transfusions, malignant lymphoma and Crohn's disease. In these patients, the determination of serum ferritin increased the diagnostic efficiency only in poly-transfused patients with iron overload.
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PMID:[Serum ferritin and its diagnostic significance in iron metabolism disorders]. 29 34

Circulating immune complexes were determined in 59 consecutive patients with Crohn's disease and 100 blood donors by a double method based on the inhibition of the agglutinating activity of CIq and/or rheumatoid factor on the IgG-coated polystyrene particles. In patients, the incidence of positive immune complexes was 63% and 61% at first testing, 85% and 78% at subsequent determinations; there was a good correlation between the inhibition titres of CIq and those of rheumatoid factor (p less than 0.001). In blood donors, the incidence was 22% and 14% at low titre. The incidence of immune complexes was the lowest (36%) in the group of resected patients without signs of relapse; repeat determinations showed absence of immune complexes three months postoperatively. In patients medically treated for primary disease or relapse, rheumatoid factor titre higher than 1/1 was less frequent than in medically untreated patients with active disease (p less than 0.01). A significantly higher concentration of serum alpha-1-antitrypsin and orosomucoid, and a significantly lower level of serum iron were found in patients with an IC titre exceeding 1/1; longitudinal studies showed in most cases a concordance between the evolution of immune complex titres, inflammatory parameters and clinical status.
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PMID:Circulating immune complexes and disease activity in Crohn's disease. 30 30

The case is reported of a patient who presented with an occult anemia that was due to Crohn's disease of the duodenum. The initial evaluation revealed low serum levels of iron, folate, and carotene, and a small bowel series was abnormal but not diagnostic of Crohn's disease. Numerous small intestinal biopsy specimens were obtained from the duodenum and proximal jejunum in an unsuccessful attempt to make a diagnosis. It was shown by radiography and laparotomy 2 yr later that the patient had Crohn's disease of the proximal small intestine. This report provides a detailed analysis of the spectrum of abnormalities found by peroral mucosal biopsy in this patient. These abnormalities were patchy and included flattened mucosa, an abnormal surface epithelium which was infiltrated by large numbers of polymorphonuclear leukoyctes, increased plasma cells and polymorphonuclear leuckocytes within the lamina propria, crypt abscesses, erosions, granulation tissue, and pyloric gland metaplasia, all in the absence of granulomas. Crohn's disease should always be considered in the differential diagnosis of a proximal small bowel mucosal disease, especially when a constellation of acute inflammatory changes is present.
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PMID:Small intestinal biopsy in a patient with Crohn's disease of the duodenum. The spectrum of abnormal findings in the absence of granulomas. 43 5

The case of a 9-year-old girl treated elsewhere for anemia due to iron deficit is described. The first diagnosis of Crohn's disease made by us and for which the girl received treatment had to be revised, because an intestinal tuberculosis was later accepted to be the correct diagnosis. The authors emphasize the importance of safe diagnostic distinctions between Crohn's disease and intestinal tuberculosis. Diagnostic and therapeutic procedures are discussed.
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PMID:[Intestinal tuberculosis and differential diagnosis against Crohn's disease in children (author's transl)]. 56 45

Nineteen children and 160 adults with Crohn's disease were examined. The children had been under treatment between 1972 and 1974. There were 11 boys and 8 girls. Their main symptoms were general malaise, diarrhea, abdominal pains, anemia and weight loss. Clinical examination showed pallor, malnutrition, and abdominal tenderness on palpation. In 7 of 19 cases, rectosigmoidoscopy showed pathological changes. Radiologically, the most frequent site of the disease was observed to be in the ileocecal area. Since conservative therapy is associated with the risk of grave local and general complications, resection of the affected intestinal segment was the method of choice. Resection must be carried out through healthy tissues. Although the intestinal absorption of B12, fat and bile acids deteriorated after resection of the ileum, the general state of health of the patient improved. Body weight, serum albumin, serum iron concentration and the total iron binding capacity increased and the patient developed normally. Relapses occurred in 8 of the 19 cases. From the large number of adult patients who were studied, it could be shown that the risk of a relapse was greater in the ileal and ileocolic disease than in disease restricted to colon.
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PMID:Long-term study of Crohn's disease. 62 61

On the basis of own clinical material, consisting of 32 patients with Crohn's disease the picture of this disease is discussed. Patients with an acute terminal ileitis in whom no development in the sense of a Crohn's disease took place were not included in the study. It is typical that also in the number of our own patients that the perferred terminal ileum alone or in connection with other parts of the intestinum as well as a high coefficient of relapses could be proved. Of the complaints cramplike pains in the abdomen were the most frequent symptom. Of the laboratory findings an increased blood sedimentation rate, a decreased iron level, an anaemia and a pathologicial Schilling test were foremost. In 2 patients during a short period a toxic megacolon developed. In the two patients it was the first shift of the disease. In another patient the relatively seldom affection of the duodenum and the stomach by Crohn's disease could be diagnosed.
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PMID:[Crohn's disease--observations on own patient material]. 64 36

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

To identify potentially remediable abnormalities in Crohn disease, 63 patients had evaluations performed for anemia, electrolyte deficiencies, defects of carbohydrate, fat, nitrogen, and vitamin B12 absorption, and jejunal bacterial overgrowth. Ninety percent of the group had two or more potentially correctable defects. More than 50% had anemia associated with iron or folate deficiency of vitamin B12 malabsorption; 33% had low levels of serum sodium, potassium, calcium, or magnesium either singly or in combination; 22% had lactose intolerance, fat malabsorption was persent in 31%; 75% had evidence of disturbed protein metabolism; and bacterial overgrowth of the upper part of the small bowel was identified in 30% of 47 patients.
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PMID:Remediable defects in Crohn disease: a prospective study of 63 patients. 105 64

Simultaneous studies with 131-I-albumin and 125-I-immunoglobulin G (IgG) were made in 48 cases of chronic inflammatory bowel disease. Twenty-one had ulcerative colitis and 27 had Crohn's disease which was confirmed at laparotomy in every case. Intestinal protein loss was measured simultaneously by means of 59-Fe-iron dextran in 44 patients. All patients had abnormal intestinal protein loss. A high correlation was shown between fecal 59-Fe clearance and fractional catabolic rate of albumin, confirming the validity of 59-Fe-iron dextran as a test substance to measure intestinal protein loss. Fecal radioiodide excretion of 131-I from 131-I-albumin (A) and 125-I from 125-I-IgG (G) was significantly different in ulcerative colitis and Crohn's disease. The ratio G/A was close to unity (smaller than 1.60) in ulcerative colitis and Crohn's disease with exclusive or predominant involvement of the colon, whereas it was high in Crohn's disease of the small intestine and highest in cases with jejunal involvement. Thus, the ratio may be valuable in topographic diagnosis of chronic inflammatory bowel disease. A high ratio was found in 2 patients with Crohn's disease of the small intestine and normal radiography of the small intestine, and a low ratio was present in 7 cases of ulcerative colitis with normal radiographic findings. In all 9 patients with normal radiography, fecal 59-Fe clearance was elevated as evidence of abnormal intestinal protein loss. No correlation was present between the size of protein loss and the pathoanatomic extent of the lesions on subsequent laparotomy in 25 patients with Crohn's disease. Fecal radioiodide excretion (131-I from 131-I-albumin and 125-I from 125-I-IgG) was positively correlated with diarrhea (daily stool mass) in both ulcerative colitis and Crohn's disease. Intestinal protein loss was not.
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PMID:Fecal radioiodide excretion following intravenous injection of 131-I-albumin and 125-I-immunoglobulin G in chronic inflammatory bowel disease. An aid to topographic diagnosis. 113 26


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