Metastatic Crohn's disease with arthritis and without intestinal activity: case report (original) (raw)

Metastatic Crohn's disease despite infliximab therapy

Anais brasileiros de dermatologia, 2017

Metastatic Crohn's disease is a rare extraintestinal manifestation of Crohn's disease. It is characterized by polymorphic skin lesions formed by non-caseating granulomas located on anatomical sites distant from the gastrointestinal tract. We report a rare case of metastatic Crohn's disease, simultaneously displaying multiple clinically heterogeneous cutaneous lesions, in a patient with previously diagnosed Crohn's disease in remission due to anti-TNF-α use. This case highlights the need for high clinical suspicion and early biopsy in the setting of a patient with Crohn's disease and persistent skin lesions, even under biologic therapy. Furthermore, it reinforces the need of monitoring of the serum level of infliximab, increasing the dose in case it is low or undetectable.

Cutaneous Crohn's disease: ‘metastatic Crohn's is a misnomer’

Journal of the European Academy of Dermatology and Venereology, 1999

Cost effectiveness in testing for sensitization in cases of leg ulcers To the Editor: In the literature the frequency of sensitization in subjects with leg ulcers is reported to range from 14 to 84% [14]. We did patch tests on 34 consecutive subjects (13 males and 21 females, mean age 71 years, range 42-87), with leg ulcers (24

CROHN'S DISEASE AND EXTRA INTESTINAL GRANULOMATOUS LESIONS

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

Rapid response of severe refractory metastatic Crohn's disease to infliximab

Journal of Gastroenterology and Hepatology, 2001

A 57-year-old female was admitted to hospital (St Vincent's Hospital, Melbourne, Victoria, Australia) in June 1998 with a 6-month history of painful vegetating skin lesions affecting the inguinal creases, perineum, and submammary folds. Crohn's disease of the colon and ano-rectum had been first diagnosed in 1972. Because her condition deteriorated in spite of medical treatment, she eventually underwent a proctocolectomy and end-ileostomy in 1984. Postoperatively, she had an unhealed perineal wound, and later developed recurrent perianal abscesses and fistulae.

Pediatric Metastatic Crohn's Disease

Journal of Coloproctology

Crohn's disease (CD) is a chronic, relapsing, idiopathic condition, characterized by granulomatous, transmural inflammation of the gastrointestinal tract, which can affect its entire length, from mouth to anus. Metastatic Crohn's disease (MCD) is a rare form of skin involvement and is defined by skin lesions without contiguity with the gastrointestinal tract. A 9-year-old patient presented with gastrointestinal complaints and gross skin lesions in the vulva and perianal region. The diagnosis of Crohn's disease was made when the patient was 11 years old, after being evaluated by the colorectal surgeon. Treatment was started with a “top-down” approach, with a sustained response for four years. Afterwards, there was a relapse of the skin disease in previously normal areas, without overt symptoms. Treatment consisted of steroids and local infiltration of infliximab, without improvement. A year later, there was a rapid progression of the skin lesions, and the drug changed to ...

A Crohn’s Disease Patient with Extraintestinal Manifestations: A Case Report

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy, 2022

Crohn’s disease (CD) is a chronic debilitating inflammatory disease which mostly affect gastrointestinal tract, but due to its unique features, CD enables to affect extraintestinal organs. Pathophysiology of extraintestinal manifestations is still debatable as many experts propose immune-related hypotheses. It is still unpredictable which manifestation precedes another as studies ongoing. Diagnosing CD is difficult since no gold standards available, therefore clinicians must combine history taking, diagnostic modalities, and a good clinical judgement to diagnose CD. Treatment for CD is not only to treat disease activity, but also to prevent complications to preserve patients’ quality of life.