CROHN'S DISEASE AND EXTRA INTESTINAL GRANULOMATOUS LESIONS (original) (raw)

F.C. and A.L. share last authorship Crohn's disease (CD) is an inflammatory bowel disease with a multifactorial etiology. Clinical features include mucosal erosion, diarrhea, weight loss and other complications such as formation of granuloma. In CD, granuloma is a non-neoplastic epithelioid lesion, formed by a compact aggregate of histiocytes with the absence of a central necrosis, however, the correlation among CD and the formation of granulomas is unknown. Many cases of granulomas in the extracellular site, related to CD, have been reported in the literature. These granulomas, at times, represented the only visible manifestation of the pathology. Extra intestinal granulomas have been found on ovaries, lungs, male genitalia, female genitalia, orofacial regions and skin. From the data in the literature it could be hypothesized that there is a cross-reaction of the immune system with similar antigenic epitopes belonging to different sites. This hypothesis, if checked, can place CD not only among inflammatory bowel disease but also among inflammatory diseases with systemic involvement. Crohn's disease (CD) is an inflammatory bowel disease (IBD) characterized by a chronic inflammatory process. The etiology of CD is multifactorial and involves a combination of genetic and environmental factors. The set of these factors generates a condition known as dysbiosis that, by altering the eubiotic equilibrium of the intestinal flora, leads to a continuous and massive activation of the lymphoid tissue associated with the intestine (GALT) (1, 2), and the establishment of a chronic inflammatory state, characterized by the release of various chemical mediators of inflammation, such as heat shock proteins (HSP) (2, 3). CD involves the entire gastrointestinal tract from the mouth to the anus and manifests itself with clinical features including mucosal erosion, mucus-bloody ulcers, diarrhea, weight loss, and abdominal pain (1-3). Among the complications of the disease, the most important are predisposition to dysplasia and colorectal cancer (due to the generation by TNF-alpha of a metaplasic alteration of the genetic material of the enterocyte and/or colonocyte), visceral stenosis and onset of granulomas (4). This article focuses on the general