Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although systemic vasculitis can be a complication of inflammatory bowel disease at several locations (skin, eyes, brain, mesentery, and lung) the association of retinal vasculitis with Crohn's disease is rare. We studied a 26-year-old woman with biopsy-demonstrated Crohn's disease who developed a severe bilateral retinal arteritis and phlebitis, with acute loss of vision.
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PMID:Retinal vasculitis associated with Crohn's disease. 774 79

The Inflammatory Bowel Disease Study Group at the Royal Free Hospital School of Medicine has tested the hypothesis that the primary pathological abnormality in Crohn's disease is in the mesenteric blood supply. Early morphological studies involved arterial perfusion-fixation and either resin casting and scanning electron microscopy or vascular immunostaining of resected intestine affected by Crohn's disease. Granulomatous and lymphocytic damage to intramural blood vessels, even in macroscopically normal areas, was observed. We put forward possible mechanisms by which a chronic ischemic process might account for many of the idiosyncracies of Crohn's disease. It was proposed that persistent viral infection of the mesenteric microvascular endothelium might underly this vasculitic process; based on certain behavioral characteristics of measles virus, including its tropism for the submucosal endothelium of the intestine, this agent was investigated further. This report reviews the preliminary evidence from both epidemiological and basic scientific data for persistent measles virus in the intestine of patients with Crohn's disease. Possible mechanisms for virus persistence and subsequent reactivation are discussed. In conclusion, we believe that Crohn's disease may be a chronic granulomatous vasculitis in reaction to a persistent infection with measles virus within the vascular endothelium. This granulomatous inflammation, perhaps aggravated by either a hypercoagulable state or mechanical stress, results in the clinical features of Crohn's disease.
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PMID:Crohn's disease: pathogenesis and persistent measles virus infection. 787 95

Antineutrophil cytoplasmic autoantibodies (ANCA) have been used as markers of systemic vasculitides, including microscopic polyarteritis (MPA) and Wegener's granulomatosis. The diagnostic potential of ANCA assays together with antibodies against the neutrophil enzymes myeloperoxidase (MPO) and proteinase 3 for detecting a systemic vasculitis was tested in a Chinese patient population. 672 sera were received for ANCA assay, and ANCA detected by indirect immunofluorescence was positive in 73 sera from 42 patients. Of the 42 patients, 3 had cytoplasmic ANCA, while 39 had a perinuclear pattern. There was no patient with Wegener's granulomatosis. Two cytoplasmic ANCA positive patients suffered from ulcerative colitis. Another cytoplasmic ANCA positive patient was a carrier of human immunodeficiency virus. Of the 39 perinuclear ANCA positive patients, 10 had MPA. Eight of them were tested for anti-MPO antibody, and all were positive. Other immune disorders that were perinuclear ANCA positive included: 13 patients with systemic lupus erythematosus, 3 with mixed connective tissue disease, 1 with Goodpasture's syndrome, 2 with inflammatory bowel disease, and 2 patients with IgA nephropathy. Anti-MPO antibody was not specific for MPA, and 7 out of the 13 patients with systemic lupus erythematosus were anti-MPO antibody positive. Our study suggests that ANCA and anti-MPO antibody are not specific for MPA in a Chinese population. They would alert the clinician of the possibility of vasculitis, but a clinicopathological correlation is essential in making the diagnosis.
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PMID:Use of antineutrophil cytoplasmic autoantibodies in diagnosing vasculitis in a Chinese patient population. 791 85

This paper describes a program of research undertaken by the Inflammatory Bowel Disease Study Group at the Royal Free Hospital School of Medicine. The Group has tested the hypothesis that the primary pathological abnormality in Crohn's disease is in the mesenteric blood supply. The first experiments involved microcorrosion resin casting of the arterial supply of specimens of resected intestine affected by Crohn's disease. This revealed severe damage to submucosal blood vessels, even in areas that were not affected macroscopically by Crohn's disease. Resected specimens of bowel were examined after perfusion-fixation: 85% of granulomas were associated with blood vessels, demonstrating that Crohn's disease is a granulomatous vasculitis. Patients with Crohn's disease usually have one or more features of a hypercoagulable state, which may increase the risk of ischemic damage. A model of Crohn's disease was developed in the ferret intestine, by embolizing mesenteric blood vessels using latex particles. Acute embolization results in patchy necrosis of the mucosa, with subsequent recovery. Surgical incision and anastomosis in a previously embolized area results in intense ulceration--suggesting that recurrent Crohn's disease after surgery is due to a second ischemic insult to an already damaged intestine. Finally, electron microscope studies have investigated the mesenteric vascular endothelium associated with granulomata in Crohn's disease. Viral particles have been identified within the vascular endothelium, with the appearance of paramyxoviridae. In situ hybridization and other studies suggest that these particles are measles virus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The pathogenesis of Crohn's disease. 792 Nov 40

Perinuclear antineutrophil cytoplasmic antibodies (pANCAs) have previously been demonstrated in patients with various forms of vasculitis and more recently in those with inflammatory bowel disease (IBD) by an indirect immunofluorescence technique. Sera from 194 patients were tested for pANCAs: 101 with ulcerative colitis (43 with varying grades of disease severity, 19 after subtotal colectomy, 39 following restorative proctocolectomy), 40 with Crohn's disease, five with indeterminate colitis, 24 patients without IBD and 24 healthy volunteers (controls). The overall prevalence of pANCAs in patients with ulcerative colitis was 70.3 per cent (71 of 101). These antibodies were still present in 29 of 39 patients after restorative proctocolectomy, in whom the median follow-up after surgery was 2 years. All five patients who had pouchitis after restorative proctocolectomy were pANCA positive. By contrast, only ten of 40 patients with Crohn's disease had pANCAs, nine of whom had Crohn's colitis. No pANCAs were detected in controls. These results show that pANCAs are more prevalent in colonic IBD, especially ulcerative colitis. The persistence of pANCAs in the sera for 2 years after restorative proctocolectomy suggests that the antigens are not fully eradicated and, therefore, that it is not just the colon that is targeted immunologically in ulcerative colitis.
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PMID:Influence of total colectomy on serum antineutrophil cytoplasmic antibodies in inflammatory bowel disease. 804 63

Evidence of a humoral immune response to endothelium was sought in the sera of patients with inflammatory bowel disease. In an ELISA, IgG binding to human umbilical vein endothelial cells was found in 21% of Crohn's disease sera, 10% of ulcerative colitis sera, 6% of sera from patients with acute infective diarrhea, and 8% of normal control sera. The increased prevalence in Crohn's disease sera was significant (P < 0.05). IgG-endothelial cell binding was cell specific, was not Fc-mediated, and did not mediate complement-dependent cell lysis. It was not increased by pretreatment of cells with interleukin-1 or tumor necrosis factor. Endothelial cell binding was retained by IgG F(ab')2 fragments from one of three reactive Crohn's sera, but none of three nonreactive sera. The low prevalence of this interaction, even in patients with immunohistochemically confirmed vasculitis, makes it unlikely that Crohn's disease is determined by a humoral autoimmune response to endothelium.
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PMID:Serum immunoglobulin G reactive with endothelial cells in inflammatory bowel disease. 808 97

The clinical, biochemical, morphological, and evolutive features of autoimmune hepatitis associated with serum smooth muscle antibodies of anti-actin specificity were retrospectively analyzed in 31 children and adolescents. Cirrhosis was present at diagnosis in all but six patients, including nine of the 12 diagnosed within 6 months from the onset. In 15 children, one or more associated diseases of an immune-mediated mechanism were present, including chronic arthritis, sclerosing cholangitis, inflammatory bowel disease, and cutaneous vasculitis. All patients were treated with prednisone and azathioprine with normalization or improvement of liver function tests: 28 children are currently alive after a mean follow-up of 4 years, 10 months. Treatment was interrupted in four patients only. Two patients died of liver failure in spite of immunosuppressive therapy before the era of liver transplantation. In spite of prolonged therapy, five other patients ultimately required liver transplantation during adolescence or early adulthood. These results (a) further define a group of autoimmune hepatitis in children characterized by the presence of serum anti-actin antibodies; (b) indicate that immunosuppressive therapy improves liver function, although in most cases it must be continued for a long period to maintain remission; and (c) suggest that progressive liver failure may occur in early adulthood and may require liver transplantation.
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PMID:Autoimmune hepatitis associated with anti-actin antibodies in children and adolescents. 814 91

This paper provides a summary of a 6-year program of research by the Inflammatory Bowel Disease Study Group at the Royal Free Hospital and School of Medicine, London. Research has demonstrated: 1. That Crohn's disease is associated with profound damage to the mesenteric vascular blood supply, even in areas where tissue or bowel appear macroscopically normal; 2. That Crohn's disease is a granulomatous vasculitis; 3. That aphthous ulceration is due to damage to underlying blood vessels; 4. That Crohn's disease is associated with a hypercoagulable state, and that patients with hemophilia rarely develop Crohn's disease; 5. That measles virus genome is localized to foci of granulomatous vasculitis and lymphoid follicles in the bowel of patients with Crohn's disease. In conclusion, we have not proved that measles virus is the cause of Crohn's disease. Proof may be difficult until there is a specific anti-viral drug that is able to eradicate this RNA virus.
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PMID:Measles virus and Crohn's disease: research from the Royal Free Hospital in London. 856 89

A patient who showed a disseminated pustular eruption compatible with pustular vasculitis and concomitant bullous lesions with the features of superficial bullous pyoderma gangrenosum during an exacerbation of ulcerative colitis is described. These clinical findings could be an expression of a common immunopathogenic mechanism of inflammatory bowel disease and the neutrophilic dermatoses. It is suggested that pustular vasculitis is another skin manifestation of ulcerative colitis.
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PMID:Pustular vasculitis and superficial bullous pyoderma gangrenosum in a patient with ulcerative colitis. 856 18

IgG anti-endothelial cell antibodies (AECA) have been described in sera from patients with vasculitis and other immune disorders such as systemic lupus erythematosus. Presence of AECA may be relevant to the hypothesis that Crohn's disease (CD) is a form of intestinal vasculitis. The aim of this study was to search for IgG AECA among 141 patients with CD, 94 patients with ulcerative colitis (UC) and 71 healthy blood donors and to assess the relationship between AECA and demographic or disease data. The cut-off point was defined from the mean OD values + 2 SD obtained from healthy blood donors. Seventeen percent of sera from patients with CD were positive for IgG AECA, whereas 24.5% of sera from patients with UC were positive. Among disease data, only a significant relationship between presence of IgG AECA and CD activity was noticed. These results might reinforce the hypothesis that intestinal vascular injury may be an important event in CD. However, detection of AECA in an almost similar percentage of patients with UC is more suggestive of an immune response to hidden endothelial self-antigen exposed after endothelial cell damage or a further marker of disturbed immunoregulation in inflammatory bowel disease.
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PMID:Anti-endothelial cell antibodies in sera from patients with inflammatory bowel disease. 874 43


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