Crohn Disease ; diagnosis ; drug therapy ; Humans ; Remission Induction

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 ; Crohn Disease/*complications/drug therapy/pathology ; Humans ; Intestinal Fistula/complications ; Male ; Optic Neuritis/*complications/diagnosis

No abstract available.
Azathioprine/*therapeutic use ; Crohn Disease/*drug therapy ; Female ; Humans ; Immunosuppressive Agents/*therapeutic use ; Leukocytes/*cytology ; Male

No abstract available.
Antibodies, Monoclonal/*therapeutic use ; Crohn Disease/*drug therapy ; Female ; Gastrointestinal Agents/*therapeutic use ; Humans ; Male

Intestinal tuberculosis presents with nonspecific and variable clinical manifestations. It is rarely seen in current clinical practice and the diagnosis may be missed or confused with many other disorders such as Crohns disease and intestinal neoplasms. The route of infection by tuberculous enteritis is variable and the treatment regimens used for treating pulmonary tuberculosis are generally effective for tuberculous enteritis as well. Uncomplicated tuberculous enteritis can be managed with a nine to 12- month course of antituberculous chemotherapy. If not treated early, the prognosis for intestinal tuberculosis is poor, with an overall mortality of between 19 percent and 38 percent. However, 90 percent of patients will respond to medical therapy alone if started early. Therefore, early detection and treatment is essential. Here we report a case of intestinal tuberculosis secondary to miliary tuberculosis.
Crohn Disease ; Diagnosis ; Drug Therapy ; Enteritis ; Humans ; Intestinal Neoplasms ; Mortality ; Prognosis ; Tuberculosis* ; Tuberculosis, Miliary* ; Tuberculosis, Pulmonary

OBJECTIVETo evaluate the efficacy and safety of infliximab in the treatment of Crohn's disease in children.

METHODSThirteen children who were diagnosed with Crohn's disease and received routine comprehensive treatment and infliximab (5 mg/kg) between January 2011 and December 2014 were enrolled. The changes in their clinical manifestations, laboratory indices, and Pediatric Crohn's Disease Activity Index (PCDAI) after the 30-week treatment were analyzed retrospectively. Meanwhile, endoscopy was performed to evaluate therapeutic effects.

RESULTSThe symptoms such as abdominal pain, diarrhea, and bloody stool were relieved soon after infliximab treatment, with no recurrence observed; after the 30-week treatment, the white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and the PCDAI decreased, while the hemoglobin increased significantly compared with those before treatment (P<0.05). After infliximab treatment, two children underwent endoscopy. The endoscopy showed that one child was cured, and the other child failed to respond to the treatment. No adverse drug reactions were seen in all patients.

CONCLUSIONSInfliximab treatment has significant clinical effects in children with Crohn's disease, with no obvious adverse reactions, and therefore, it can be applied as one of the preferred alternatives for treatment of Crohn's disease in children.

Adolescent ; Child ; Child, Preschool ; Crohn Disease ; blood ; drug therapy ; pathology ; Female ; Humans ; Infliximab ; therapeutic use ; Male

Vitamin D can not only regulate calcium and phosphorus metabolism, but also exert an immunoregulatory effect. Vitamin D deficiency is common in patients with Crohn's disease (CD). Studies have shown that vitamin D is associated with CD and other autoimmune diseases and can improve the condition of patients with CD and promote their recovery by regulating intestinal immunity, repairing the intestinal mucosal barrier, inhibiting intestinal fibrosis, enhancing the response to infliximab, and regulating intestinal microbiota. Exogenous vitamin D supplementation can induce disease remission while increasing the serum level of vitamin D. However, only a few randomized, double-blind, and placebo-controlled trials have investigated the therapeutic effect of vitamin D in CD, and the optimal form of vitamin D supplementation, the specific dosage of vitamin D supplementation, and the optimal serum maintenance concentration of vitamin D remain to be clarified. This article mainly discusses the mechanism of action of vitamin D in CD and the beneficial effect of exogenous vitamin D supplementation on CD.
Humans ; Calcium, Dietary ; Crohn Disease/drug therapy* ; Dietary Supplements ; Infliximab ; Vitamin D/therapeutic use*

OBJECTIVETo systematically evaluate the safety and efficacy of natalizumab in treating multiple sclerosis (MS) and Crohn's disease(CD).

METHODSLiteratures from 1998 to 2009 were searched in databases including MEDLINE,EMBASE,The Cochrane Library, and CBM for randomized controlled trials (RCTs) and quasi-randomization controlled trials. Quality assessment and data extraction were conducted using the Cochrane Collaboration's RevMan 5.0 software and then a Meta analysis was performed. The main indicators included the rate of adverse reactions, the rate of serious adverse reactions,response rate,and remission rate.

RESULTSThirteen trials entered the final analysis. The main findings in the MS trials included: the rate of serious and general adverse effects were no significantly different among different groups (P>0.05). The new lesions rate was not significantly different within 3 months after treatment [RR=0.99, 95%CI (0.82, 1.18), P=0.87], but was significantly lower in 6 months in the treatment group [RR=0.45, 95%CI (0.33, 0.60), P<0.00001], and such advantage was maintained till 2 years later [RR=0.49, 95%CI (0.45, 0.53), P<0.00001]. The 2-year relapse rate was also significantly lower in the treatment group [RR=0.51, 95%CI (0.38, 0.69), P<0.0001]. The main findings in CD trials were as follows: The incidences between serious reactions and general adverse reactions were not significantly different (P>0.05). The remission rate was not significantly different between treatment group and control group in the 2nd week [RR=4.67, 95%CI (0.65, 33.26), P=0.12], but became significantly higher in the treatment group after 12 weeks [RR=1.46, 95%CI (1.26, 1.70), P<0.00001]. The response rate was significantly higher in the treatment group [RR=1.53, 95%CI (1.15, 2.03), P=0.004].

CONCLUSIONSThe rates of serious and general adverse reactions are not remarkably increased after natalizumab treatment for both MS and CD. The new lesions rate and 2-year relapse rate of MS as well as the response rate and remission rate of CD are all improved after natalizumab treatment,especially after long-term administration. Although severe adverse effect such as progressive multifocal leukoencephalopathy may occur,its clinical application can be further promoted after cautiously balancing the benefits and risks.

Antibodies, Monoclonal, Humanized ; therapeutic use ; Crohn Disease ; drug therapy ; Humans ; Multiple Sclerosis ; drug therapy ; Natalizumab ; Treatment Outcome

Vesicoileal fistula develops in less than 10% of all vesicointestinal fistulas. The causative disorders were recorded as regional enteritis, bladder tumor, trauma, ileal tuberculosis and complication of radiation therapy of cervical carcinoma, but the literatures recording vesicoileal fistula caused by malignant lymphoma are surpassingly few. We report a case of vesicoileal fistula originated primarily from malignant lymphoma in a 74 years old man who was seen with the chief complaints of pneumaturia and fecaluria. The diagnostic procedures such as IVP, cystography, gastrointestinal series, barium enema and rectosigmoidoscopy were performed and the vesicoileal fistula was suspected. The diagnosis was confirmed by operation and histologic examination. The operation consisted of one stage resection of the ileal lymphoma and adhered sigmoid colon, end to end anastomosis of ileum, end to end anastomosis of sigmoid colon and partial cystectomy. The patient underwent anticancer chemotherapy and was discharged at the postop. third week.
Aged ; Barium ; Colon, Sigmoid ; Crohn Disease ; Cystectomy ; Diagnosis ; Drug Therapy ; Enema ; Fistula* ; Humans ; Ileum ; Lymphoma* ; Tuberculosis ; Urinary Bladder Neoplasms

No abstract available.
Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Crohn Disease/*complications/*drug therapy ; Female ; Humans ; Intestinal Obstruction/*etiology ; Male