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Serologic and laboratory markers in prediction of the disease course in inflammatory bowel disease

World Journal of Gastroenterology 2010年第21期16卷 2604-2608页

作者： Marla Cindy Dubinsky Pediatric IBD Center Department of PediatricsCedars-Sinai Medical CenterLos AngelesCA 90048United States

The search for biologic markers that can assess the natural history and perhaps predict the course of individual's disease including response to treatments over time has become an important focus of inflammatory bowel disease *** knowledge of an individual's prognosis can help physicians and patients make important management decisions and aid communication on risk and benefits of disease and treatment.

关键词： Inflammatory bowel disease Ulcerative colitis Crohn’s disease Perinuclear anti-neutrophil antibody anti-saccharomyces cerevisiae antibody Pouchitis Internal penetrating Fibrostenosing

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Diagnosis of Crohn's disease in India where tuberculosis is widely prevalent

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World Journal of Gastroenterology 2008年第5期14卷 741-746页

作者： Deepak N Amarapurkar Nikhil D Patel Priyamvada S Rane Department of Gastroenterology Bombay Hospital & Medical Research Centre Mumbai 400025 India

AIM:To define the parameters that positively predict diagnosis of Crohn's disease (CD) and differentiate it from gastrointestinal tuberculosis (GITB). METHODS:This prospective study over 3 years was carried out in the consecutive Indian patients with definite diagnosis of CD and equal numbers of patients with definite diagnosis of GITB. Demographic, clinical, laboratory, morphological and histological features were noted in all the patients. Serological tests such as p-ANCA, c-ANCA, IgA ASCA and IgG ASCA, were performed. Endoscopic biopsy and/or surgical tissue specimens were subjected to smear and culture for acid-fast bacilli (AFB) and tissue polymerase chain reaction for tuberculosis (TB PCR). Diagnosis of CD and GITB was based on the standard criteria. Data were analyzed using univariate Chi-square test and multiple logistic regression (MLR). RESULTS:The study is comprised of 26 patients with CD (age 36.6 ± 8.6 year, male:female, 16:10) and 26 patients with GITB (age 37.2 ± 9.6 year, male:female, 15:11). The following clinical variables between the two groups (CD vs TB) were significant in univariate analysis:duration of symptoms (58.1 ± 9.8 vs 7.2 ± 3.4 mo), diarrhoea (69.2% vs 34.6%), bleeding per rectum (30.7% vs 3.8%), fever (23.1% vs 69.2%), ascites (7.7% vs 34.6%) and extra-intestinal manifestations of inflammatory bowel disease (61.5% vs 23.1%). Of these, all except ascites and extra-colonic manifestations were found statistically significant by MLR. Accuracy of predicting CD was 84.62% based on the fever, bleeding P/R, diarrhoea and duration of symptoms while it was 63.4% when histology was reported as inflammatory bowel disease and 42.3% when there was recurrence of disease after surgery. Accuracy of predicting GITB was 73.1% when there was co-existing pulmonary lesions and/or abdominal lymphadenopathy;75% when tuberculosis was reported in histology;63.4% when granuloma was found in histology;82.6% when TB PCR was positive;and 61.5% when smear and/ or c

关键词： Crohn's disease Gastrointestinal tuberculosis Differential diagnosis Inflammatory bowel disease anti-neutrophil cytoplasmic antibody anti-saccharomyces cerevisiae antibody Tissue polymerase chain reaction Mycobacterium Tuberculosis Acid-fact bacilli

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Celiac disease and microscopic colitis:A report of 4 cases

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World Journal of Gastroenterology 2011年第16期17卷 2150-2154页

作者： Zsolt Barta Eva Zold Arpad Nagy Margit Zeher Istvan Csipo 3rd Department of Medicine Institute for Internal MedicineMedical and Health Science CenterUniversity of Debrecen

Celiac disease (CD) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people at all ***,it can be associated also to other immunopathological disorders,and may be associated with abnormal histology in segments of the gut other than the small bowel including colonic *** guidelines for endoscopic investigation of the jejunum are well defined,no indication is defined for colonic *** describe four cases of concurrent CD and microscopic colitis (MC) diagnosed at our department over a 10-year period and analyzed the main features and outcomes of CD in this *** symptoms of these patients were improved initially by a gluten-free diet before the onset of MC *** of the patients were siblings and had an atypical form of *** other two patients with CD and MC also presented with fibrosing alveolitis and were anti-saccharomyces cerevisiae antibody *** co-existence of immune-mediated small bowel and colonic inflammatory and pulmonary diseases are not well-known,and no systematic approach has been used to identify the lifelong patterns of these immune-based *** can develop,or present with CD at any stage in life,which can co-exist with other gastrointestinal diseases of (auto-) immune *** addition,the fa-milial co-existence and prevalence of MC in patients with a prior diagnosis of CD are *** managing celiac disease should be aware of these associations and understand when to consider colon investigation.

关键词： Collagen colitis Lymphocytic colitis Celiac disease Fibrosing alveolitis anti-saccharomyces cerevisiae antibody

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