Granulomatous vasculitis in Crohn's disease: a clinicopathologic correlate of two unusual cases

Burns, Ariel; Walsh, Noreen; Green, Peter J.

doi:10.1111/j.1600-0560.2010.01546.x

Cited by 12 publications

(8 citation statements)

References 19 publications

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“…The current understanding of this rare association stems predominantly from case reports and small case series with not more than 10 patients. Various vasculitides have been associated with IBD, especially TAK [6–8] but also GPA [9], isolated cutaneous vasculitis [10], and central nervous system vasculitis [11]. …”

mentioning

confidence: 99%

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

Khalidi

Dehghan

et al. 2016

Seminars in Arthritis and Rheumatism

121

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Background Published small case series suggest that inflammatory bowel disease [IBD; Crohn’s disease (CD) or ulcerative colitis (UC)] and vasculitis co-occur more frequently than would be expected by chance. Objectives To describe this association by an analysis of a large cohort of carefully studied patients and through a systematic literature review. Methods Patients with both IBD and vasculitis enrolled in the Vasculitis Clinical Research Consortium (VCRC) Longitudinal Studies, followed in Canadian Vasculitis research network (CanVasc) centers and/or in the University of Toronto’s IBD clinic were included in this case series. A systematic literature review of patients with IBD and vasculitis involved a PubMed search through February 2014. The main characteristics of patients with Takayasu arteritis (TAK) and IBD were compared to those in patients with TAK without IBD followed in the VCRC. Results The study identified 32 patients with IBD and vasculitis: 13 with large-vessel vasculitis [LVV; 12 with TAK, 1 with giant cell arteritis (GCA); 8 with CD, 5 with UC]; 8 with ANCA-associated vasculitis [AAV; 6 granulomatosis with polyangiitis (GPA), 2 with eosinophilic granulomatosis with polyangiitis (EGPA)]; 5 with isolated cutaneous vasculitis; and 6 with other vasculitides. Patients with LVV and AAV were mostly female (18/21). The diagnosis of IBD preceded that of vasculitis in 12/13 patients with LVV and 8/8 patients with AAV. The review of the literature identified 306 patients with IBD and vasculitis: 144 with LVV (133 TAK; 87 with IBD preceding LVV), 19 with AAV [14 GPA, 1 EGPA, 4 microscopic polyangiitis (MPA)], 66 with isolated cutaneous vasculitis, and 77 with other vasculitides. Patients with IBD and TAK were younger and had more frequent headaches, constitutional symptoms, or gastrointestinal symptoms compared to those patients in the VCRC who had TAK without IBD. Conclusions These findings highlight the risk of vasculitis, especially TAK, in patients with IBD (both CD and UC).

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confidence: 99%

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

Khalidi

Dehghan

et al. 2016

Seminars in Arthritis and Rheumatism

121

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“…There are many other medium/large vessel vasculitides such as Takayasu arteritis , Kawasaki syndrome , Behçet’s disease , Crohn’s disease , vascular collagen disease of lupus erythematosus , dermatomyositis , Sharp’s syndrome , or rheumatoid arthritis ; these disorders affect vessels in the subcutis and/or deeper soft tissues, and none is exclusively cutaneous. Arteries in deep tissues are involved, and cause vascular occlusion with subsequent ischemia.…”

Section: Medium Vessel Vasculitismentioning

confidence: 99%

Vasculitic wheel – an algorithmic approach to cutaneous vasculitides

Ratzinger

Zelger

Carlson

et al. 2015

J Deutsche Derma Gesell

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SummaryBackground: Previous classifications of vasculitides suffer from several defects. First, classifications may follow different principles including clinicopathologic findings, etiology, pathogenesis, prognosis, or therapeutic options. Second, authors fail to distinguish between vasculitis and coagulopathy. Third, vasculitides are systemic diseases. Organ-specific variations make morphologic findings difficult to compare. Fourth, subtle changes are recognized in the skin, but may be asymptomatic in other organs. Our aim was to use the skin and subcutis as a model and the clinicopathologic correlation as the basic process for classification. Methods and Results:We use an algorithmic approach with pattern analysis, which allows for consistent reporting of microscopic findings. We first differentiate between small and medium vessel vasculitis. In the second step, we differentiate the subtypes of small (capillaries versus postcapillary venules) and medium-sized (arterioles/arteries versus veins) vessels. In the final step, we differentiate, according to the predominant cell type, into leukocytoclastic and/or granulomatous vasculitis. Conclusions: Starting from leukocytoclastic vasculitis as a central reaction pattern of cutaneous small/medium vessel vasculitides, its relations or variations may be arranged around it like spokes of a wheel around the hub. This may help establish some basic order in this rather complex realm of cutaneous vasculitides, leading to a better understanding in a complicated field.

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“…The histological differential diagnosis of cutaneous CD may include sarcoidosis, foreign body reactions and atypical infections. Granulomas in cutaneous CD are more probably to localize to a perivascular location, with some authors suggesting that this may even precipitate vasculitis and ulceration . Additional features that may be seen include dermal edema, an ulcerated epidermis, and the presence of eosinophils and plasma cells in the infiltrate …”

Section: Discussionmentioning

confidence: 99%

Cutaneous Crohn's disease with superimposed psoriasis: A unique case with overlapping histology

2017

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Crohn's disease (CD) is an idiopathic, chronic inflammatory disorder of the gastrointestinal tract. We recently encountered a unique case in which a patient with longstanding CD presented with skin lesions with histopathologic features of both psoriasis and granulomatous inflammation suggestive of cutaneous CD. To our knowledge, this has not been described concomitantly in the same patient, in the same lesions. Review of the literature suggests that the intersection of these 2 histopathological reaction patterns may not be pure coincidence. Clinical-pathologic correlation of this case will be discussed, along with a review of the potential mechanisms of this unique disease presentation.

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Granulomatous vasculitis in Crohn's disease: a clinicopathologic correlate of two unusual cases

Cited by 12 publications

References 19 publications

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

Vasculitis in patients with inflammatory bowel diseases: A study of 32 patients and systematic review of the literature

Vasculitic wheel – an algorithmic approach to cutaneous vasculitides

Cutaneous Crohn's disease with superimposed psoriasis: A unique case with overlapping histology

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