1/24. Anaerobic bacteremia and necrotizing fasciitis in a patient with Crohn's disease.Crohn's disease is a chronic, granulomatous disease that affects the gut that is frequently treated with immunosuppressive therapy. Infectious complications are common and are usually related to the transmural nature of the inflammation, frequently manifesting as abscesses or perianal sepsis. Necrotizing fasciitis has not been reported in Crohn's disease. A case of a fatal necrotizing fasciitis in a patient with Crohn's disease after gut biopsies and corticosteroid therapy is reported.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
2/24. Are renal microgranulomas related to inflammatory tubular destruction?Two cases of renal microgranuloma formation are reported, one in a patient with known Crohn's disease and another in a case of acute renal allograft rejection. In both cases, the microgranulomas arose as a result of inflammatory tubular destruction, in a manner analogous to that seen in patients with ulcerative colitis arising adjacent to ruptured epithelial crypts in the large intestine. Microgranulomas may occur at multiple anatomical sites in Crohn's disease, although renal microgranulomas are very rare. Non-specific inflammatory tubular destruction should be considered as a cause of renal microgranuloma formation, in addition to systemic granulomatous diseases, such as tuberculosis, sarcoid, or Crohn's disease, when granulomas are seen in the presence of inflammatory tubular destruction in renal biopsies.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
3/24. Chronic granulomatous disease caused by a deficiency in p47(phox) mimicking Crohn's disease.We describe 2 cases of autosomal recessive chronic granulomatous disease (CGD) in 2 sisters presenting with a picture consistent with inflammatory bowel disease. The index case is a 10-year-old girl with a history of refractory Crohn's colitis treated with aggressive immunosuppressive therapy whose course subsequently was complicated by central nervous system aspergillosis. Additional evaluation showed a diagnosis of CGD, an underlying immunodeficiency in which phagocytes fail to produce microbicidal reactive oxygen intermediates because of inherited defects in the reduced form of nicotinamide-adenine phosphate dinucleotide (NADPH) oxidase. The diagnosis of a typically X-linked inherited disease in our female patient suggested that she had 1 of the 3 less common autosomal recessive forms of the disease. This was confirmed by studies showing the absence of the p47(phox) subunit of nadph oxidase in her neutrophils and the presence of a homozygous dinucleotide deletion in the neutrophil cytosolic factor 1 gene that encodes p47(phox). Additional analyses of members of the patient's immediate family showed the same homozygous mutation in 2 siblings, 1 of whom also developed chronic colitis consistent with a diagnosis of Crohn's disease. These 2 cases emphasize the importance of high clinical suspicion for an alternative diagnosis of immune deficiency in the setting of presumed inflammatory bowel disease and opportunistic infection.- - - - - - - - - - ranking = 5keywords = granulomatous disease (Clic here for more details about this article) |
4/24. hypercalcemia due to excess 1,25-dihydroxyvitamin D in Crohn's disease.hypercalcemia has been described in patients with a number of granulomatous diseases, including sarcoidosis and mycobacterial infection. Disordered vitamin D metabolism is the root cause for the elevated serum calcium levels. A similar mechanism of abnormal vitamin D metabolism explained the hypercalcemia occurring in patients with lymphoma. Crohn's disease is a granulomatous disorder that is more commonly associated with hypocalcemia caused by poor calcium intake and decreased intestinal calcium absorption related to vitamin d deficiency as a consequence of malabsorption. A man with Crohn's disease who presented with hypercalcemia and acute renal failure is described. Biochemical parameters showed an elevated 1,25-dihydroxyvitamin D level, with a low-normal 25-hydroxyvitamin D level and decreased parathyroid hormone level. Inflammatory bowel disease had been clinically active during the preceding 2 months. With resolution of gastrointestinal symptoms, serum calcium, vitamin D, and parathyroid hormone levels returned to normal. serum creatinine levels decreased toward normal. Angiotensin-converting enzyme (ACE) levels have been reported to be elevated in patients with sarcoidosis, particularly in the setting of active disease with hypercalcemia. Controversy exists about ACE levels in the face of active Crohn's disease: 1 report noted elevated levels, whereas other publications reported depressed levels. Our patient had an elevated ACE level in the setting of active bowel disease and hypercalcemia, and ACE levels returned to normal with resolution of gastrointestinal symptoms.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
5/24. Newly diagnosed chronic granulomatous disease in a 53-year-old woman with crohn disease.BACKGROUND: Chronic granulomatous disease (CGD) is characterized by defective bactericidal activity of white blood cells, specifically, a defect in superoxide production. patients experience infections, predominantly caused by catalase-positive bacteria and fungal organisms, that may be severe and life-threatening. Most cases of CGD are diagnosed in children; however, it may rarely go undiagnosed until adulthood in individuals with unexplained infections and granulomatous inflammation. OBJECTIVE: To describe an adult with crohn disease and recurrent infections who was newly diagnosed as having CGD. methods: A 53-year-old woman with a history of liver abscesses and crohn disease presented with burkholderia cepacia pneumonia and required a right middle lobe resection. nitroblue tetrazolium test results confirmed the diagnosis of CGD, and Western blot analysis revealed the absence of the 47-phagocyte oxidase protein. Levels of Crohn-associated specific antibodies to saccharomyces cerevisiae and Escherichia coli outer membrane porin C were elevated. RESULTS: The patient, newly diagnosed as having CGD, was given intravenous trimethoprim-sulfamethoxazole, after which she improved clinically and was discharged from the hospital in stable condition to receive daily oral trimethoprim-sulfamethoxazole treatment. CONCLUSIONS: The concomitant occurrence of crohn disease and CGD, both characterized by granulomatous inflammation, is noteworthy. This case study demonstrates that CGD should be considered in adults with recurrent infections, especially those caused by catalase-positive organisms, such as B cepacia.- - - - - - - - - - ranking = 5keywords = granulomatous disease (Clic here for more details about this article) |
6/24. Neutrophil dysfunction in glycogen storage disease Ib: association with Crohn's-like colitis.Two cases of patients with Crohn's-like colitis and glycogen storage disease Ib have been reported previously. In the current report, chronic inflammatory bowel disease that developed in another adolescent with this glycogenosis is described, thereby corroborating the association. The neutrophil dysfunction observed in glycogen storage disease Ib is the most likely predisposing factor. Neutrophil function was investigated in our patient in an attempt to shed light on the pathogenesis of his intestinal inflammation. The patient displayed reduced neutrophil chemotaxis to zymosan-activated serum, N-formyl-methionine-phenylalanine, and escherichia coli bacteria-derived factor and reduced intracellular killing of staphylococcus aureus 502A. Others have found this defective bacteriocidal activity to be caused by impaired oxidative metabolism. The recent recognition of chronic inflammatory bowel disease in glycogen storage disease Ib, as well as in chronic granulomatous disease, suggests that further study of respiratory burst activity of neutrophils in Crohn's disease is warranted.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
7/24. Crohn's disease of the lung.Two years after developing colonic Crohn's disease, a 17 year old boy presented with focal pulmonary consolidation. A lung biopsy specimen showed areas of non-caseating epithelioid granuloma. Although some respiratory abnormalities appear to be associated with inflammatory bowel disease, granulomatous disease affecting the lung has not previously been reported in a child.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
8/24. oral manifestations of chronic granulomatous disease.Chronic granulomatous disease (CGD) has been recognized as a specific entity since 1957. Although a significant number of patients with this inherited disorder of leukocyte function exhibit oral manifestations which might be seen by the dentist, the dental literature contains no descriptions of this disease. The purpose of this article is to present a case of CGD exhibiting oral lesions, to document these lesions clinically and histopathologically, and to discuss the differential diagnosis of this disorder.- - - - - - - - - - ranking = 5keywords = granulomatous disease (Clic here for more details about this article) |
9/24. Crohn's disease of the esophagus: a case report and review of the literature.Esophageal involvement with Crohn's disease has been rarely reported and pathologic documentation of granulomatous disease is often missing. A 12-year-old boy who presented initially with dysphagia, odynophagia, and weight loss was found to have granulomatous esophagitis, gastritis, and subsequent colitis by endoscopic examination. Esophageal manometry showed a hypertensive lower esophageal sphincter with normal peristalsis and sphincter relaxation. The esophageal symptoms responded to oral steroids and sulfasalazine without any specific treatment for acid peptic disease. This case is the youngest reported patient with Crohn's disease of the esophagus. A review of the medical literature illustrates salient clinical, radiographic, endoscopic, and pathologic features of esophageal involvement in Crohn's disease. This case and the summarized cases emphasize the potential significance of esophageal symptoms in patients with Crohn's disease.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
10/24. Oral inflammatory changes as an initial manifestation of Crohn's disease antedating abdominal diagnosis. Report of a case.The case of a 14-year-old boy who had oral ulcers with histologic proof of granulomatous disease nine months before the diagnosis of intestinal Crohn's disease is presented. Additional extraintestinal manifestations of this case were cheilitis, anal fissures, and "metastatic" disease to the umbilicus. The diagnosis was established after the onset of abdominal symptoms. All manifestations responded rapidly to systemic prednisone, sulfasalazine, and metronidazole.- - - - - - - - - - ranking = 1keywords = granulomatous disease (Clic here for more details about this article) |
| | Next -> |