1.A Case of Optic Neuritis Associated with Crohn's Disease.
Sung Hee HAN ; Oh Young LEE ; Sun Young YANG ; Dae Won JUN ; Hang Lak LEE ; Yong Cheol JEON ; Dong Soo HAN ; Joo Hyun SOHN ; Byung Chul YOON ; Ho Soon CHOI ; Joon Soo HAHM ; Min Ho LEE ; Dong Hoo LEE ; Choon Suhk KEE
The Korean Journal of Gastroenterology 2006;48(1):42-45
In Crohn's disease, neurologic complications such as cerebrovascular accident, headache, peripheral neuropathy have been reported sporadically. The pathogenesis of these neurologic complications is still unknown and controversial. We experienced a 22-year-old man, with Crohn's disease accompanied by optic neuritis. Loss of visual acuity was developed during the worsening course of enterocutaneous fistula. After high dose steroid treatment, his visual acuity and neurologic symptoms improved immediately.
Adult
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Crohn Disease/*complications/drug therapy/pathology
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Humans
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Intestinal Fistula/complications
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Male
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Optic Neuritis/*complications/diagnosis
2.A Case of Crohn's Disease Presenting with Free Perforation and Portal Venous Gas.
Na Rae HA ; Hang Lak LEE ; Oh Young LEE ; Byung Chul YOON ; Ho Soon CHOI ; Joon Soo HAHM ; Dong Hoo LEE ; Min Ho LEE
The Korean Journal of Gastroenterology 2007;50(5):319-323
Crohn's disease is characterized by its chronic course and transmural inflammation of gastrointestinal tract. The accompanying fibrous reaction and adhesion to adjacent viscera appears to limit the complication of free perforation. The true incidence of free bowel perforation is difficult to assess, however, the anticipated occurrence rate is 1-2% during the course of illness. Moreover, portal venous gas is also an uncommon event in the natural history of Crohn's disease. Portal venous gas occurs when intraluminal gas from the gastrointestinal tract or gas-forming bacteria enters the portal venous circulation. The finding of portal venous gas associated with Crohn's disease does not always mandate surgical intervention. We experienced a case of Crohn's disease presenting with free perforation and portal venous gas. The literatures on the cases with perforation and portal venous gas associated with Crohn's disease were reviewed.
Adult
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Colonoscopy
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Crohn Disease/complications/drug therapy/*pathology
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Diagnosis, Differential
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Embolism, Air/*diagnosis/etiology
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Humans
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Intestinal Perforation/*diagnosis/etiology
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Male
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*Portal Vein
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Tomography, X-Ray Computed
3.Crohn's Disease Presenting with Erythema Nodosum as an Early Sign: A Case Report.
Seong Joo KANG ; Won MOON ; Moo In PARK ; Kyu Jong KIM ; Jong Bin KIM ; Mi Jung PARK ; Seun Ja PARK ; Hee Kyung CHANG
The Korean Journal of Gastroenterology 2011;58(2):103-106
Erythema nodosum is the most common form of septal panniculitis and the most frequent skin manifestation associated with inflammatory bowel disease, affecting up to 15% of Crohn's disease patients. Since the development of erythema nodosum is closely related with a variety of disorders and condition, it can serve as an important early sign of systemic disease. Here, we present the occurrence of erythema nodosum as an early sign of Cronh's disease in a 16-year-old woman.
Adolescent
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Anti-Inflammatory Agents/therapeutic use
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Azathioprine/therapeutic use
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Colonoscopy
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Crohn Disease/complications/*diagnosis/drug therapy
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Erythema Nodosum/complications/*diagnosis/pathology
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Female
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Humans
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Mesalamine/therapeutic use
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Prednisolone/therapeutic use
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Skin/pathology
4.A Case of Pleomorphic Liposarcoma in a Patient with Crohn's Disease Taking Azathioprine.
Soo Min AHN ; Seong O SUH ; Yu Mi OH ; Chang Yong YUN ; Hyoung Hun SIM ; Chae A PARK ; Cheol Min SONG ; Ji Yoon BAE
The Korean Journal of Gastroenterology 2013;62(4):248-252
Azathioprine is frequently used for the treatment of inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis. Lymphomas, squamous cell carcinomas, and undifferentiated pleomorphic sarcomas have been reported among patients receiving azathioprine therapy. Herein, we report a case of pleomorphic liposarcoma of chest wall which occurred in a 44-year-old man with Crohn's disease taking azathioprine. He was diagnosed with Crohn's disease 3 years ago after suffering from abdominal pain and hematochezia for 12 years. He had been taking 50 mg of azathioprine per day for 23 months when he visited the thoracic and cardiovascular surgery clinic due to right chest palpable mass that had rapidly grown during the past 2 months. Excisional biopsy was performed and the mass was diagnosed as pleomorphic liposarcoma. Therefore, he underwent radical excision of the right chest wall mass, which measured 11.0x6.5 cm in size. He is scheduled to receive radiation therapy and chemotherapy.
Adult
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Azathioprine/*therapeutic use
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Colonoscopy
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Combined Modality Therapy
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Crohn Disease/complications/*drug therapy
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Fluorodeoxyglucose F18/diagnostic use
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Humans
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Immunosuppressive Agents/*therapeutic use
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Liposarcoma/complications/*pathology/surgery
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Male
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Positron-Emission Tomography
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Radiopharmaceuticals/diagnostic use
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Tomography, X-Ray Computed
5.Herpes Simplex Virus Duodenitis Accompanying Crohn's Disease.
Byung Hoo LEE ; Wook Hyun UM ; Seong Ran JEON ; Hyun Gun KIM ; Tae Hee LEE ; Wan Jung KIM ; Jin Oh KIM ; So Young JIN
The Korean Journal of Gastroenterology 2013;62(5):292-295
Herpes simplex virus (HSV) is a recognized cause of gastrointestinal infection in immunodeficient patients. Although a few cases of HSV gastritis and colitis in immunocompromised patients have been reported, there are no reports of HSV duodenitis in patients with Crohn's disease (CD). A 74-year-old female was admitted with general weakness and refractory epigastric pain. She had been diagnosed with CD three years ago. Esophagogastroduodenoscopy (EGD) revealed diffuse edematous and whitish mucosa with multiple erosions in the duodenum. Considering the possibility of viral co-infection, cytomegalovirus (CMV) immunohistochemical staining, PCR, and cultures of duodenal biopsies were performed, all of which were negative with the exception of the isolation of HSV in culture. After administration of intravenous acyclovir for 1 week, follow-up EGD showed almost complete resolution of the lesions and the patient's symptoms improved. In CD patients with refractory gastrointestinal symptoms, HSV, as well as CMV, should be considered as a possible cause of infection, so that the diagnosis of viral infection is not delayed and the appropriate antiviral treatment can be initiated.
Acyclovir/therapeutic use
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Aged
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Antiviral Agents/therapeutic use
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Crohn Disease/complications/*diagnosis/virology
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DNA, Viral/analysis
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Duodenitis/complications/*diagnosis
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Endoscopy, Digestive System
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Female
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Herpes Simplex/*diagnosis/drug therapy/virology
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Humans
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Intestinal Mucosa/pathology
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Polymerase Chain Reaction
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Simplexvirus/genetics/*isolation & purification
6.A Case of IgG4-Related Sclerosing Mesenteritis Associated with Crohn's Disease.
Eui Jung KIM ; Eun Young KIM ; Jung Eun SONG ; Hyeon Chul LEE ; Gyu Hwan BAE ; Hoon Kyu OH ; Tae Sung LEE
The Korean Journal of Gastroenterology 2014;63(3):176-182
Sclerosing mesenteritis (SM) is a rare disease characterized by chronic nonspecific mesenteric inflammation and fibrosis of unknown etiology. Some tumefactive SM shows diffuse accumulation of IgG4-positive plasma cells and is considered as a part of the spectrum of IgG4-related disease. An association between inflammatory bowel disease and IgG4-related disease has been indicated. A 45-year-old woman visited our hospital due to weight loss with intermittent lower abdominal discomfort. Pelvic ultrasound revealed a mass-like lesion in the abdominal wall and pelvis MRI demonstrated a 5.9 cm sized wall-enhancing mass with heterogeneous signal intensity from right adnexa to the abdominal wall. Tumor resection and adhesiolysis was done because of severe adhesion with the small bowel, colon, bladder, uterus, and abdominal wall. Appendectomy was also performed due to adhesion and edematous change. Histological examination of the resected mass showed findings that were compatible with IgG4-related SM. The resected appendix showed chronic granulomatous inflammation without evidence of tuberculosis. She was diagnosed with Crohn's disease after undergoing colonoscopy and CT enterography. Herein, we report a rare case of IgG4-related SM that occurred in conjunction with Crohn's disease.
Anti-Inflammatory Agents/therapeutic use
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Appendix/pathology
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Azathioprine/therapeutic use
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Colonoscopy
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Crohn Disease/complications/*diagnosis/drug therapy
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Female
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Humans
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Immunoglobulin G/*blood
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Magnetic Resonance Imaging
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Mesalamine/therapeutic use
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Middle Aged
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Panniculitis, Peritoneal/*diagnosis/etiology/ultrasonography
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Prednisolone/therapeutic use
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Tomography, X-Ray Computed
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Urinary Bladder/pathology
7.Crohn's Disease in Association with IgA Nephropathy.
Ji Myoung LEE ; Kang Moon LEE ; Hyung Wook KIM ; Woo Chul CHUNG ; Chang Nyol PAIK ; Jeong Rok LEE ; Yeong Jin CHOI ; Jin Mo YANG
The Korean Journal of Gastroenterology 2008;52(2):115-119
Urological complications are not uncommon in Crohn's disease (CD). The most common manifestations are renal stones, enterovesical fistulas, and ureteral obstruction, but renal parenchymal disease has rarely been reported. IgA nephropathy, the most common form of primary glomerulonephritis, is usually isolated, but can be sometimes associated with chronic extrarenal disorders such as inflammatory bowel disease. We describe a case of 36 year-old man with CD associated with IgA nephropathy. He was diagnosed as CD 6 years ago and at that time, isolated proteinuria was observed. He presented recurrent proteinuria and elevation of creatinine level while he had been managed well with mesalamine and azathioprine. The renal biopsy was performed and IgA nephropathy (type IV) was diagnosed. Strict blood pressure control with angiotensin converting enzyme inhibitor and calcium channel blocker resulted in clinical improvement and normalization of serum creatinine level.
Adult
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Angiotensin-Converting Enzyme Inhibitors/therapeutic use
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Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
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Antimetabolites/therapeutic use
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Azathioprine/therapeutic use
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Blood Pressure
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Calcium Channel Blockers/therapeutic use
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Colonoscopy
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Crohn Disease/*diagnosis/drug therapy/etiology
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Glomerulonephritis, IGA/complications/*diagnosis/pathology
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Humans
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Male
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Mesalamine/therapeutic use
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Proteinuria/diagnosis/etiology