Positive Coombs' Test Associated with Ulcerative Colitis

Poulsen, Lene; Freund, L; Lylloff, Kirsten; Grunnet, Niels

doi:10.1111/j.0954-6820.1988.tb15767.x

Cited by 6 publications

(1 citation statement)

References 16 publications

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“…An association between AIHA and colitis is well documented, with a prevalence of 0.2% to 1.8% in patients with ulcerative colitis. [39][40][41] As in AIHA, decreased Treg function or number is associated with development of colitis. In humans, there is an inverse correlation between active ulcerative colitis and the frequency of peripheral Tregs.…”

Section: Discussionmentioning

confidence: 99%

Distinct roles of helper T-cell subsets in a systemic autoimmune disease

Hoyer

Kuswanto

Gallo

et al. 2009

Blood

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IntroductionThe interleukin-2 knockout (IL-2-KO) mouse provides a powerful model for defining the signals involved in the development of spontaneous autoimmune disease in the absence of regulatory T cells. IL-2-KO mice on the BALB/c background develop a systemic autoimmune disease, dying by 5 weeks from complications of autoimmune hemolytic anemia (AIHA). 1 The principal immunologic defects in these mice are a deficiency of regulatory T lymphocytes (Tregs) leading to a breakdown of self-tolerance and failure of T-cell homeostasis, resulting in uncontrolled activation and proliferation of CD4 ϩ T cells. 2,3 It has been shown that AIHA progression in these animals is mediated by autoantibodies and is dependent on abnormal helper T-cell (Th) activity. 1,4,5 We used this mouse model of spontaneous, acute systemic autoimmunity to define the cytokine milieu that influences the development of autoimmune disease.A tightly controlled balance between activation and suppression normally maintains immune homeostasis. Dysregulated cytokine expression is documented in various autoimmune and inflammatory diseases, and in the expansion of autoreactive T cells. 6-10 Our understanding of the cytokine network required to induce, amplify, and control self-reactive lymphocytes continues to evolve. Autoimmune manifestations have traditionally been thought to be mediated by Th1 cells and their abundant interferon-␥ (IFN-␥) and tumor necrosis factor (TNF) production. With the more recent identification of the Th17 subset, the role of cytokines in autoimmunity is being re-evaluated. Th17 cells are potent inducers of tissue inflammation, and dysregulated expression of IL-17 appears to initiate organ-specific autoimmunity; this has been best characterized in mouse models of colitis, 11 experimental autoimmune encephalomyelitis, 12 and rheumatoid arthritis. 13 The specific roles and interactions of Th subsets during the development of autoimmunity are a topic of great interest at present. 14,15 In this study, we set out to evaluate the contributions of Th1 and Th17 cytokines in the development of inflammation and autoimmunity in the absence of Tregs using the IL-2-KO mouse model. We demonstrate a clear role for IFN-␥ in the production of autoantibodies and progression of AIHA. In the absence of IFN-␥, IL-2-KO mice show delayed AIHA but, over time, develop intestinal inflammation, whereas elimination of IL-17 has no impact on the kinetics of AIHA development. Thus, our studies reveal that different cytokines play distinct roles in various manifestations of autoimmunity in the absence of Tregs. Methods MiceMice lacking IL-2, IFN-␥, IL-17, IL-2/CD28, IL-2/CD40L, IL-2/IFN-␥, and IL-2/IL-17 were used on the BALB/c background. Mice were bred and maintained in our specific pathogen-free facility at the Animal Barrier Facility in accordance with the guidelines of the Laboratory Animal Resource Center of the University of California San Francisco. Lymphocyte isolationLymph nodes (LNs) and spleens were pressed through a nylon mesh filter, red blood ...

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Section: Discussionmentioning

confidence: 99%

Distinct roles of helper T-cell subsets in a systemic autoimmune disease

Hoyer

Kuswanto

Gallo

et al. 2009

Blood

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Extraintestinale Manifestationen bei chronischentz�ndlichen Darmerkrankungen*

Rogler

Schölmerich²

2004

coloproctology

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ZusammenfassungExtraintestinale Manifestationen von Morbus Crohn und Colitis ulcerosa finden sich bei mehr als der Hälfte aller Patienten und können belastender als die Grunderkrankung selbst sein. Extraintestinale Manifestationen müssen von Sekundärerkrankungen oder Folgen der chronisch-entzündlichen Darmerkrankungen (CED) unterschieden werden, da sie einer anderen Therapie bedürfen. Während Krankheitsfolgen wie Vitaminmangelzustände oder Osteoporose durch Vitaminsubstitution oder Calciumund Vitamin-D-Gabe spezifisch therapierbar sind, ist die Therapie extraintestinaler Manifestationen von CED wie der primär sklerosierenden Cholangitis, der sog. Typ-II-Arthritis oder granulomatöser Entzündungen der Haut, Leber oder Lunge häufig deutlich schwieriger und komplexer. Extraintestinale Symptome des Morbus Crohn und der Colitis ulcerosa können sich an nahezu jedem Organ manifestieren. Es ist wichtig, diese extraintestinalen Manifestationen der CED zu kennen, um einerseits rechtzeitig und frühzeitig Therapiemaßnahmen einleiten zu können.Andererseits können extraintestinale Symptome die Primärmanifestation eines Morbus Crohn und seltener einer Colitis ulcerosa darstellen. Sie müssen dann als solche erkannt werden, um die Betroffenen frühzeitig adäquat therapieren zu können. Schlüsselwörter: Chronisch-entzündliche Darmerkrankungen · Morbus Crohn · Colitis ulcerosa · Extraintestinale Manifestationen SummaryExtraintestinal manifestations of Crohn's disease and ulcerative colitis are found in > 50% of all patients.These extraintestinal manifestations sometimes impair the overall life quality much more than the bowel-related symptoms. Extraintestinal manifestations need to be distinguished from secondary diseases or complications of inflam-coloproctology coloproctology 2004;26:152-62

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26-j�hriger Patient mit Colitis ulcerosa und An�mie

et al. 2004

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A 26-year-old patient was admitted to the hospital because of severe anemia and exacerbation of ulcerative colitis. Laboratory tests revealed a hemolytic anemia and elevated parameters of acute phase reaction. Ten months ago an autoimmune hemolytic anemia was diagnosed. Three months before admission splenectomy was performed due to ongoing hemolytic exacerbations despite treatment with corticosteroids. Anemia is a common problem of inflammatory bowel disease. The association of autoimmune hemolytic anemia and ulcerative colitis presented in this case report is a rare complication of ulcerative colitis. The autoimmune hemolytic anemia is often refractory to corticosteroids. Immunosuppressive treatment with azathioprine induced a sustained remission in our patient, thereby a total colectomy could be avoided.

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Positive Coombs' Test Associated with Ulcerative Colitis

Cited by 6 publications

References 16 publications

Distinct roles of helper T-cell subsets in a systemic autoimmune disease

Distinct roles of helper T-cell subsets in a systemic autoimmune disease

Extraintestinale Manifestationen bei chronischentz�ndlichen Darmerkrankungen*

26-j�hriger Patient mit Colitis ulcerosa und An�mie

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