Cutaneous manifestation in the vulvar area as an early symptom of Crohn's disease in an 11-year old girl – Beneficial effects of exclusive enteral nutrition
This study discusses a case of an 11-year-old girl with metastatic Crohn's disease whose primary symptom was painless swelling in the labia majora. The endoscopic examination of the remaining skin lesions carried out after 3 years confirmed Crohn's disease. Initially the combined therapy with metronidazole and mesalazine gave partial recovery. Then, in accordance with the Crohn's disease treatment guidelines, the girl was subjected to an exclusive enteral nutrition with subsequently very good results. Currently, the girl is being treated with azathioprine, her general condition is good, and vulvar lesions have completely resolved.
We described the functional and morphological effect of TED in a 40-year-old female patient with SBS-IF due to Crohn's disease who underwent terminal jejunostomy after 12 months of drug exposition. Marked hypertrophy of the villi was detected by endoscopic capsule and confirmed by histological measurements. This is the first publication demonstrating an increase in intestinal absorption in an SBS-IF patient treated with TED because of a morphological adaptation of the small bowel, with hyperplasia confirmed by capsule endoscopy and histology. The capsule endoscopy, a noninvasive exploration of the gut, could be evaluated t...
CONCLUSION: The new, disease-specific, equations for predicting REE in individuals with CD give a good prediction accuracy as far as those proposed in the literature for the general population. However, the new ones performed better at the individual level. Further studies are needed to verify the reliability and usefulness of these new equations. PMID: 32010994 [PubMed - as supplied by publisher]
PMID: 31989671 [PubMed - as supplied by publisher]
Teduglutide is a glucagon-like peptide-2 (GLP-2) analogue with trophic effects on the intestinal mucosa to increase the absorptive surface area and enhance nutrient and fluid absorption of the small bowel (SB).1 It has been shown to reduce parenteral nutrition (PN) and intravenous fluid (IVF) requirements and is an important adjunct in the medical management of short bowel syndrome (SBS).1-2 Crohn ’s disease (CD) is an important etiology of SBS but use of teduglutide in this population can be challenging.
Wernicke`s encephalopathy is associated mainly with malnourishment in alcohol-dependent patients but can be caused also by cancer, Crohn's disease, gastrointestinal surgery or prolonged parenteral nutrition (PN) without adequate supplementation of vitamins. The disorder, with a significant mortality rate of up to 20%, is often associated with the underlying disease and intensifies after administration of non-supplemented PN. Thus, it seems justified to add thiamine to PN admixtures prepared for parenterally fed patients.
to M PMID: 31769051 [PubMed - as supplied by publisher]
Conclusions: Depression is associated with prolonged LOS in pediatric patients with IBD, even when controlling for gastrointestinal disease severity. Future research evaluating the efficacy of standardized depression screening and early intervention may be beneficial to improving inpatient outcomes in this population.
CONCLUSION: We present the largest published cohort investigating SMI with regard to major postoperative morbidity in surgery for CD. In multivariable analysis, SMI was the only significant risk factor for Clavien-Dindo complications grade ≥III. Lumbar SMI was reliably determined by CT and MRI alike. Because preoperative abdominal imaging with either modality is common for patients with CD, SMI could be a reliable and largely available tool to stratify the risk of postoperative complications. PMID: 31444789 [PubMed - as supplied by publisher]
Rationale: Crohn disease includes 3 phenotypes, inflammatory, stricturing, and penetrating. In cases where corticosteroids and immunosuppressive agents are not suitable treatment options, enteral nutrition (EN) can be used to reduce disease severity and enhance barrier defense with fewer potential adverse effects. Patient concerns: A 23-year-old man with abdominal pain and diarrhea presented at our hospital in 2014. The frequency of defecation was 3 or 4 times a day without mucus or blood in the stool. His body mass index was 15.8, and in laboratory tests the erythrocyte sedimentation rate was 42.4 mm/h, serum C rea...
We report the case of a 61-year-old female with Crohn's disease dependent on total parenteral nutrition who developed a central venous catheter bloodstream infection and septic arthritis, complicated further by osteomyelitis and persistent Candida glabrata fungemia. Fluconazole treatment led to persistent infection, and micafungin therapy failed with development of FKS-associated resistance. Infection responded after initiation of amphotericin B plus voriconazole. Echinocandin resistance is increasingly recognized, suggesting a role for alternative antifungal therapies. PMID: 31345844 [PubMed - in process]