Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021831 (enteropathy)
 4,403 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although corticosteroid therapy is associated with the development of osteopenia, it is unclear whether the cause of osteopenia in inflammatory bowel disease (Crohn's disease and ulcerative colitis) is related to corticosteroid therapy or other disease-related variables. Patients with Crohn's disease (a diffuse gastrointestinal disease) could have greater osteopenia than patients with ulcerative colitis because of small bowel disease and secondary malabsorption of calcium and vitamin D. A cross-sectional analysis of consecutive patients with Crohn's disease and ulcerative colitis was undertaken. Bone density was determined by measurements of the L2-L4 spine, the total hip, and Ward's triangle using dual energy X-ray absorptiometry (DXA). A number of clinical parameters were recorded prior to bone density evaluation and analyzed by univariate and subsequently multivariate analysis to determine possible predictors of osteopenia. Of the 26 patients with Crohn's disease, diminished bone density (a Z score of at least -1) was found at the hip in 64% and at the spine in 44%; and of the 23 patients with ulcerative colitis diminished bone density was found at the hip in 43% and at the spine in 48%. Among all the variables tested, only corticosteroid use was a statistically significant predictor of diminished bone density (p = 0.025 for the spine and hip and p = 0.005 for Ward's triangle). Disease diagnosis (Crohn's disease compared with ulcerative colitis) did not predict or correlate with diminished bone density. No obvious associations were seen between the measurements of any serum hormones or biochemistries and bone density, although the patients using corticosteroids had lower serum calcium levels than the nonusers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Decreased bone density in inflammatory bowel disease is related to corticosteroid use and not disease diagnosis. 775 4

The use of T1-weighted sequences with reduced artifacts such as breath-hold gradient echo and fat-suppressed spin echo imaging has rendered MR imaging an effective technique for the evaluation of bowel disease. Various malignancies are depicted on MR images with diagnostic information comparable to CT images; concurrent evaluation for liver metastases are better performed by MR imaging. The high sensitivity for uptake of intravenous gadolinium suggests that MR imaging may play an important role in the evaluation of inflammatory bowel disease.
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PMID:MR imaging of the gastrointestinal tract. 776 48

We compared the diagnostic accuracy of a new immunological marker of celiac sprue (CS), the antijejunum antibody (JAB), with that of antigliadin (AGA) and antiendomysium (EmA) antibodies. One hundred untreated adults with biopsy-proven CS, 52 healthy controls, and 57 patients with inflammatory bowel disease, lymphoma of the small bowel, Whipple's disease, and irritable bowel syndrome were investigated. Only JAB and EmA were detected at a similar titer in all patients with untreated CS but in no controls (100% sensitivity and specificity). Sensitivity of AGA was, respectively, 55% for IgA and 78% for Ig class, with a 100 and 82% specificity. The differences in frequencies between both EmA and JAB with IgA and IgG AGA were highly significant. We conclude that JAB and EmA provide a reliable noninvasive screening test for clinically significant gluten-sensitive enteropathy. The lower cost of IgA-JAB is a major advantage, owing to the different availability of the lower third of the esophagus and jejunum from primates. The sensitivity and specificity of the two tests are almost identical, but we find interpreting EmA easier than JAB especially when the titer is low.
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PMID:Comparison of serum anti-gliadin, anti-endomysium, and anti-jejunum antibodies in adult celiac sprue. 788 70

The differential diagnosis of diarrhea in patients infected with HIV is broad, and includes a variety of bacterial, viral, and parasitic pathogens, as well as malignancies including lymphoma and Kaposi's sarcoma. Idiopathic non-specific inflammatory bowel disease rarely occurs in association with HIV infection. A recent case report described a patient with longstanding Crohn's disease who experienced remission of his bowel disease upon infection with HIV (6). The authors inferred that the remission was secondary to a depressed CD4 (T helper) lymphocyte count. We report the first case of Crohn's ileitis developing in a patient with established HIV infection, depressed CD4 lymphocyte count, and no prior history of inflammatory bowel disease. This case raises questions about the role of CD4 cells in the pathogenesis of Crohn's disease.
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PMID:Crohn's ileitis in a patient with longstanding HIV infection. 780 35

This study newly introduces anti-VH mAbs to assess the role of clonal B cell activity in inflammatory bowel disease. Immunohistochemistry of colonic biopsies in ulcerative colitis (UC) and Crohn's disease (CD), but not unaffected individuals, demonstrated uniform staining of intravascular erythrocytes with BK2, a monoclonal specific for the VH3-15 Ig heavy chain gene product. Staining was caused by erythrocytes opsinized in vivo by anti-erythrocyte Abs present in patient sera and by using the VH3-15 gene product. The erythrocyte Ag was identified by immunoprecipitation as 22- and 28-kDa membrane proteins. A direct flow cytometric assay was developed to measure this serum autoantibody and was tested in 101 individuals with UC, CD, other acute or chronic colitis, and healthy controls. Compared with normal subjects, BK2+ anti-erythrocyte Abs were elevated in most sera from patients with CD and UC (including postcolectomy). BK2+ anti-erythrocyte Abs also were elevated in 10 of 38 noninflammatory bowel disease patients, all of whom had Campylobacter jejuni enterocolitis. These findings suggest that a common immunopathogenetic factor, manifested by VH3-15 B cell activation may be shared in UC, CD, and Campylobacter jejuni enterocolitis.
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PMID:Expression of a novel autoantibody defined by the VH3-15 gene in inflammatory bowel disease and Campylobacter jejuni enterocolitis. 793 May 92

The management of inflammatory bowel disease depends on knowledge of the site, extent and severity of inflammation. Early work showed that 111In-labelled white cells could fulfil this role. More recently. 99mTc-HMPAO white cell scanning was introduced. Several studies have shown that this test can reliably detect disease and can assess extent. Simple visual grading of uptake intensity can also be used to assess severity. The improved image resolution allows assessment of small bowel disease in addition with high sensitivity in the detection of ulcerating Crohn's disease. Other causes of bowel inflammation should be excluded. Complicating abscesses can be detected and the inflammatory component of strictures can be assessed. False positive activity can be avoided by imaging early at one hour, before such non-specific excretion occurs. Later images are also useful in order to help localize disease, but only in addition to the initial one hour scan. 99mTc-HMPAO white cell scanning, a simple non-invasive, highly informative test should be added to the armamentarium of every gastroenterologist.
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PMID:99mTc-HMPAO planar white cell scanning. 797 47

The objective assessment of inflammatory bowel disease activity is important for optimal management. The mucosal neutrophil infiltrate in acute bowel inflammation can be detected and quantified using 99mTc-HMPAO-radiolabelled leucocytes. Planar quantification methods have inherent inaccuracies due to variable depth and overlapping activities. SPECT (single-photon emission computerized tomography) is a technique which can quantify the three-dimensional distribution of radioactivity. We have applied this novel imaging technique to 23 patients with suspected colitis and 13 with small bowel disease. The SPECT activity score correlated well with the histological activity score for colonic segments with significant separation of grades. The total SPECT score for disease activity in both large and small bowel also correlated with clinical parameters. SPECT offers a non-invasive and objective approach to the assessment of disease activity which may be useful in the assessment of novel therapies for IBD.
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PMID:Assessment of inflammatory bowel disease activity using 99mTc-HMPAO single-photon emission computerized tomography imaging. 797 52

We review the adverse effect of non-steroidal anti-inflammatory drugs (NSAIDs) on the small and large intestine. NSAIDs cause small intestinal inflammation in 65% of patients receiving the drugs long-term. The clinical implications of NSAID-induced enteropathy are that patients bleed and lose protein from the inflammatory site, contributing to iron deficiency and hypoalbuminemia, respectively. Some patients develop intestinal strictures, which may require surgery, and the occasional one may develop discrete ulcers with perforations. There are a number of therapeutic options available to treat the enteropathy and the attendant complications, including antibiotics, sulphasalazine and misoprostol. The colon, by comparison, is only rarely affected by NSAIDs, but colitis is well recognized and NSAIDs may be an important factor in diverticular complications and the relapse of inflammatory bowel disease. There is an association between NSAID intake and appendicitis in the elderly.
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PMID:Intestinal toxicity of non-steroidal anti-inflammatory drugs. 799 40

The radiological investigations relevant to chronic IBD are described briefly with emphasis placed on compression techniques in small bowel studies. A classification for reporting small bowel Crohn's disease is proposed, where the disease is staged as early, advanced or complicated, and the extent of involvement measured directly from the film. The terminal ileum may be normal in 20% of children with proximal Crohn's disease, so that ileoscopy should not be used to exclude small bowel disease. Radiological assessment of the small bowel is important in management. Surgical referral was based on the radiological changes in 6% of patients, and in 24% the presence of extensive uncomplicated small bowel Crohn's disease led to treatment with elemental diet. The use of some specialized examinations, such as the instant and ileostomy enema, are discussed.
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PMID:Radiological investigation of chronic inflammatory bowel disease in childhood. 800 38

In order to examine the presentation and course of Crohn's disease (CD) versus those of ulcerative colitis (UC) in children < or = 10 years of age, a retrospective review of children < or = 10 years old with inflammatory bowel disease singled out 40 patients and compared their findings with those of 38 children with UC. The mean age at onset was 7.5 years for CD, as compared with 5.9 years for UC. A family history of inflammatory bowel disease was present in 13 patients (32%). Abdominal pain (97%), diarrhea (78%), and weight loss (88%) were the major initial complaints, with growth retardation present in 12 (30%) children. At onset, four children had diffuse small-bowel disease, nine had terminal ileal disease, 15 had ileocolitis, and 12 had colitis; at the end of the study two had diffuse small-bowel disease, four had terminal ileal disease, 25 had ileocolitis, and seven had colitis. Extra-intestinal manifestations increased with duration of disease. Although the number of recurrences did not differ greatly between groups, those with ileocolitis and colitis needed longer steroid therapy and more days in hospital than did those with only small-bowel disease. Operation was required in 42.5% of children with CD, as compared with 5% of those with UC, with six CD children (35%) requiring later reoperation for recurrent disease or fistula and abscess. Two children died from causes unrelated to their disease (gastric volvulus, carcinoma of the breast).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Crohn's disease in children 10 years old and younger: comparison with ulcerative colitis. 857 7


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