Crohn's disease-associated genetic marker is seen in medically unresponsive ulcerative colitis patients and may be associated with pouch-specific complications

Facklis, Katherine; Plevy, Scott E.; Vasiliauskas, Eric A.; Kam, Lori Y.; Taylor, Kent D.; Targan, Stephan R.; Fleshner, Phillip

doi:10.1007/bf02234133

Cited by 27 publications

(21 citation statements)

References 13 publications

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“…Types and percentage of fistula of post IPAA CLD in previously UC diagnosed patients and percentage and presentation of post IPAA CLD in previously UC diagnosed patients wihout fistula are shown at Table 5 and Table 6. ASCA IgA is not sufficient for differentiating CD and UC, though in UC patients subjected to colectomy, it may be beneficial in predicting a new diagnosis of CD (10). ASCA IgA seropositivity compared to p-ANCA (-)/ASCA (+) status may be a stronger predictive factor for final diagnosis of CLD following IPAA in UC patients (16).…”

Section: Resultsmentioning

confidence: 99%

“…Despite excellent functional results and high patient satisfaction (1,2), approximately 5-10% of patients develop Crohn's disease (CD) of the pouch (3)(4)(5)(6)(7)(8). While some authors assume the above-described situation to be CD (9), others accept this as a phenotype of UC mimicking CD (10). Therefore, they refer to the condition as Crohn's-like disease (CLD).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Rate and predictive factors of post-IPAA Crohn’s-like disease (with or without pouchitis) in patients with ulcerative colitis

Köroğlu

Çelık²

2012

Turk J Gastroenterol

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rate and predictive factors of post-IPAA Crohn’s-like disease (with or without pouchitis) in patients with ulcerative colitis

Köroğlu

Çelık²

2012

Turk J Gastroenterol

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“…Analysis of a prospective population of UC patients undergoing colectomy and IPAA revealed that very high preoperative pANCA is associated with subsequent development of chronic pouchitis, whereas the risk for those with lower levels of pANCA was similar to the risk for those who lacked this marker [46]. The clinical implications of this finding are that UC patients with proven identifiable preoperative risk factors for subsequent chronic pouchitis development (ie, primary sclerosing cholangitis, oral ulcerations, certain genotypes, and specific immune marker profiles) may need to be counseled regarding this risk, and strategies aimed at pouchitis prophylaxis may be considered in UC patients "at high risk" based on their marker expression to avoid the subsequent development of chronic pouchitis [46][47][48].…”

Section: Stratification Of Disease Subtypes and Prognosismentioning

confidence: 88%

Recent advances in the diagnosis and classification of inflammatory bowel disease

Vasiliauskas

2003

Curr Gastroenterol Rep

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The availability of an increasing number of inflammatory bowel disease (IBD)-specific serologic antibodies, the discovery of disease-susceptibility genes, the introduction of pharmacogenetic markers, and the recent application of wireless capsule enteroscopy to the evaluation of patients with IBD are providing new types of information that must be integrated with more traditional IBD paradigms. The challenge facing researchers and clinicians is to determine how to incorporate these potentially clinically relevant insights into our understanding of disease pathogenesis and to define the spectrum of potential applications to the management of patients with IBD. The ultimate diagnostic and predictive value of these tests will likely be optimized when they are applied in combination, rather than individually. As the clinical relevance of this expanding diagnostic armamentarium is defined, it is hoped that these tests will enable clinicians not only to diagnose IBD accurately but also to determine disease patterns prospectively, suggest prognoses, and allow for individualization of therapeutic regimens.

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“…The Brooke ileostomy and continent ileostomy (Kock pouch) are also options. PSC, oral ulcerations, certain genotypes, and very high preoperative pANCA levels have been associated with an increased likelihood of developing chronic pouchitis [102,103]. • CD.…”

Section: Fulminant Disease/acutely Ill or Nonrespondingmentioning

confidence: 99%

Pediatric inflammatory bowel disease

Vasiliauskas

2000

Curr Treat Options Gastro

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The combination of an unprecedented number of new therapeutic options (Fig. 1), along with new insights in how to optimize currently available therapies and advances in our understanding of disease pathogenesis, present many exciting new aspects to the management of patients with inflammatory bowel disease (IBD). Clinical management paradigms must evolve in parallel to keep pace with these advances. Traditional pediatric IBD regimens have underutilized combination therapies (Fig. 2) and immunomodulatory agents. Increased appreciation for steroid side effects is leading to a shift away from their inclusion in maintenance regimens. Immunomodulators are being introduced earlier in the course of disease for maintenance of remission and growth promotion. Recognition that the sole signs of active disease in children and adolescents may be growth and maturational delay, despite a relative lack of gastrointestinal symptoms, should prompt earlier, more aggressive interventions. When more potent, rapidly acting interventions such as infliximab, cyclosporine (CSA), or tacrolimus are considered, they should generally be co-administered with agents such as 6-mercaptopurine (6-MP) or azathioprine (AZA) for longer-term disease suppression.

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Crohn's disease-associated genetic marker is seen in medically unresponsive ulcerative colitis patients and may be associated with pouch-specific complications

Abstract: The Crohn's disease-associated tumor necrosis factor haplotype a2blc2d4e1 may define a subgroup of medically unresponsive patients with ulcerative colitis who are predisposed to a higher incidence of pouch-specific complications after ileal pouch-anal anastomosis.

Cited by 27 publications

References 13 publications

Rate and predictive factors of post-IPAA Crohn’s-like disease (with or without pouchitis) in patients with ulcerative colitis

Rate and predictive factors of post-IPAA Crohn’s-like disease (with or without pouchitis) in patients with ulcerative colitis

Recent advances in the diagnosis and classification of inflammatory bowel disease

Pediatric inflammatory bowel disease

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