Crohn's disease with gastroduodenal involvement: Diagnostic approach

作     者：Sachin B Ingle Baban D Adgaonkar Nawab P Jamadar Saleha Siddiqui Chitra R Hinge 

作者机构：Department of Pathology MIMSR Medical College Department of Physiology MIMSR Medical College Department of Anesthesia MIMSR Medical College 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2015年第3卷第6期

页      面：479-483页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Gastrointestinal tract Crohn’s disease Isolated gastric involvement Perinuclear anti-neutrophil cytoplasmic antibody Anti-Saccharomycescervisia antibody 

摘      要：Crohn s disease(CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterizedby segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a most common and account for 40% of cases and involvement of small intestine is about 30%. Isolated involvement of stomach is an extremely unusual presentation of the disease accounting for less than 0.07% of all gastrointestinal CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. The diagnosis is difficult to establish in such cases with atypical presentation. In the absence of any other source of disease and in the presence of nonspecific upper gastrointestinal endoscopy and histological findings, serological testing can play a vital role in the diagnosis of atypical CD. Recent studies have suggested that perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomycescervisia antibody may be used as additional diagnostic tools. The effectiveness of infliximab in isolated gastric CD is limited to only a few case reports of adult patients and the long-term outcome is unknown.