Correlation of Presence of Granulomas With Clinical and Immunologic Variables in Crohn's Disease

Heimann, Tomas M.; Miller, F.; Martinelli, Giorgio P.; Szporn, Arnold H.; Greenstein, Adrian J.; Aufses, Arthur H.

doi:10.1001/archsurg.1988.01400250048009

Cited by 39 publications

(43 citation statements)

References 9 publications

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“…One confounding factor for this variation may be that some series include only children,23 27 others both children and adolescents,26 others both children and adults,13–18 24 25 28 29 and others only adults 10 19 20 30 31. However, from table 3, it may be deduced that in some series, the frequency of granulomas in CD was higher in adults than in children.…”

Section: Discussionmentioning

confidence: 98%

“…However, from table 3, it may be deduced that in some series, the frequency of granulomas in CD was higher in adults than in children. Another confounding factor may be differences in the quantity of tissue investigated by the various pathologists: some series include only rectal biopsies,20 21 27 28 others recto-sigmoidoscopic biopsies,26 other colonoscopic biopsies,10 12 13 23 28 and others only sections from surgical specimens 14–19 25 29 31…”

Section: Discussionmentioning

confidence: 99%

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Frequency of epithelioid granulomas in colonoscopic biopsy specimens from paediatric and adult patients with Crohn’s colitis

et al. 2007

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Aims: To test the assumption that epithelioid granulomas found in colonoscopic biopsy specimens in patients with Crohn's colitis are markers of a different clinical behaviour. Methods: Sections from colonoscopic biopsy specimens from 352 consecutive patients (119 children and 233 adults) were investigated. Results: A total of 1117 colonoscopies were performed: 293 in children (mean 2.46 per patient) and 824 in adults (mean 3.53 per patient) (p,0.05). Granulomas at initial colonoscopy were recorded in 67.2% (43/ 64) of children and 65.9% (27/41) of adults (p.0.6), and at subsequent colonoscopies in 53.8% (64/119) of children and 17.6% (41/233) of adults (p,0.05). Surgical intervention was required in 6.3% (4/64) of the children having previous granuloma, but also in 14.5% (8/55) of those without previous granuloma, the rate for operated adults being 26.8% (11/41) and 24.5% (47/192), respectively (p.0.6). Conclusions: Granulomas in entry and/or in subsequent colonoscopic biopsy specimens in patients with Crohn's colitis did not predict the need for subsequent surgical intervention. The fact that the frequency of granulomas was significantly higher in children than in adults with Crohn's colitis (despite a higher mean number of colonoscopic biopsies in adults), and that granulomas were present in colonoscopic biopsy specimens but not in the subsequent surgical specimens from 50% of the paediatric and 36% of the adult patients strengthen the conviction that granulomas in Crohn's colitis might evolve or regress at different time intervals during the course of the disease. This behaviour would reflect a particular immunological reaction, an epiphenomenon from immature tissues-as in children-when challenged by the so far elusive aetiological agent responsible for Crohn's disease.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Frequency of epithelioid granulomas in colonoscopic biopsy specimens from paediatric and adult patients with Crohn’s colitis

et al. 2007

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“…Earlier studies suggested that the presence of granulomas in the resected specimen is associated with a lower recurrence rate, at least in the colon and anus, 37,38 but this correlation was not seen with granulomas of the ileocolonic anastomosis. 39 Heimann et al 40 showed that patients with granulomas were younger, had more extensive disease, and a shorter duration of disease. Follow-up at 5 years showed a trend toward greater recurrence rate in the patients with granulomas.…”

Section: Discussionmentioning

confidence: 99%

Predictive value and clinical significance of myenteric plexitis in Crohnʼs disease

Lied

Kamm

et al. 2009

Inflammatory Bowel Diseases

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“…It is important to know that granulomas may be absent or poorly formed [1,11]. When found, ulcers are typically longitudinally oriented, separated by histologically normal edematous mucosa [1].…”

Section: Discussionmentioning

confidence: 99%

Crohn’s disease: A case report with literature review

Maiorean

Aşchie

Mitroi

et al. 2015

ARS Medica Tomitana

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Crohn's disease is an idiopathic inflammatory disorder which can affect any segment of the digestive tract. Generally considered uncommon and often underestimated, it can endanger the patient's life due to its local and systemic complications. In this article we present the case of a 67-year-old male patient who was admitted for cramping abdominal pain, nonbloody diarrhea, fever and anorexia. He described a 5-year history of similar episodes composed of the same symptoms for which he was admitted. In the past no diagnosis was confirmed and he received no treatment, due to the fact that the episodes were autolimited and the patient didn't ask for medical attention. In this case surgery was required and the diagnosis of Crohn's disease was histopathologically confirmed, thus leading to a proper choice of treatment to avoid possible complications.

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Correlation of Presence of Granulomas With Clinical and Immunologic Variables in Crohn's Disease

Cited by 39 publications

References 9 publications

Frequency of epithelioid granulomas in colonoscopic biopsy specimens from paediatric and adult patients with Crohn’s colitis

Frequency of epithelioid granulomas in colonoscopic biopsy specimens from paediatric and adult patients with Crohn’s colitis

Predictive value and clinical significance of myenteric plexitis in Crohnʼs disease

Crohn’s disease: A case report with literature review

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