Application of the Vienna classification for Crohn’s disease to a single center from Brazil

Abstract

BACKGROUND: Crohn’s disease is a chronic inflammatory disorder with diversity on its clinical presentation that may be observed from the varying age of onset of symptoms to the site of occurrence of the illness. There is a need for a replicable and uniform description of the disease allowing a comparison between distinct study populations. The 1998 Vienna classification characterizes patients according to three clinical aspects: age at diagnosis, location and disease behavior. AIM: To describe Crohn’s disease in patients from a reference center of Salvador, BA, Brazil according to the Vienna classification. METHODS: Between January and October of 2005, patients (n = 47) having at least one endoscopic and radiological examination of the intestine participated in this study. RESULTS: Most of the participants had the diagnosis of the disease when they were younger than 40 years old (70.2%) while an ileocolic location (38.3%) and the penetrating form (46.8%) were the most prevalent clinical presentation. The restricted location of the ileum (L1) was more frequent in nonstricturing, nonpenetrating disease (B1) while the ileocolic disease (L3) was more associated with the penetrating behavior (B3). CONCLUSION: In this study, differently from the first description of the Vienna classification, the large number of patients presenting a complicated stage of the disease can be attributed to the fact that it was carried out at a reference center, where many patients present with the disease at an advanced stage.

Mycobacterium avium ssp. paratuberculosis vs Crohn’s Disease

“…50% of patients underwent surgical procedures and 63% were hospitalized at least once. The authors conclude that the profile of CD in evaluated patients was similar to that described in the literature, and these data were corroborated by other Brazilian authors (Faria et al, 2004;Santana et al, 2008;Torres et al, 2010).…”

Epidemiology of inflammatory bowel disease in South America: A systematic review

“…As observed in Asia, UC was more common than CD in all included studies from South America - a direct contrast to western prevalence data[5,7,8,11-28]. Previous reports from Asia, Australia, the United Kington and United States of America demonstrate a predominance of small bowel CD and rectal UC however data from Santiago, Chile and Sao Paulo, Brazil suggest a predominance of colonic CD and pancolonic UC[3,5,7,11,27]. This interesting finding may be associated with differences in genetic polymorphisms or environmental exposures however the potential for confounding due to issues with reporting also need to be considered as colonic CD and pancolonic UC are generally very symptomatic and hence more likely to be reported compared to small bowel CD or more localised UC which is prone to underreporting or misdiagnosis particularly in underprivileged regions.…”

All ileo-cecal ulcers are not Crohn’s: Changing perspectives of symptomatic ileocecal ulcers

“…First, Crohn’s disease in particular affect ileum or ileum along with colon in about 60%-70% patients[7]. However, the converse is not true, i.e ., 80% of ileo-cecal ulcers are not Crohn’s.…”

“…Due to distinct anatomy and physiology this region is affected by various diseases like ulcerative colitis, Crohn’s disease (CD), non-specific ulcers, Malignancies, Amoebiasis, Enteric fever and Tuberculosis (TB)[2-6]. CD in particular affect Ileum alone or ileo-colonic region in about 60%-70% cases[7]. But whether 60%-70% of I/C ulcers are CD needs evaluation.…”