Share Facebook
Crohn's Disease Forum » Books, Multimedia, Research & News » Granulomas on biopsy and severity of Crohn's disease


12-27-2017, 11:20 PM   #1
Lady Organic
Forum Monitor
 
Lady Organic's Avatar
Granulomas on biopsy and severity of Crohn's disease

''Epithelioid Granulomas Associate with Increased Severity and Progression of Crohn's Disease, Based on 6-year Follow Up.''

https://www.ncbi.nlm.nih.gov/pubmed/29277619


Abstract

Epithelioid granulomas are characteristics of a subset of patients with Crohn's disease (CD), but their significance, with regard to disease progression and severity, is unclear. We investigated the relationship between granulomas and CD severity over a 6-year time period in a large cohort of patients.


METHODS:

We performed a retrospective study of patients with CD seen at the Inflammatory Bowel Disease Center at the University of Pittsburgh; data were collected from 2009 through 2014 and patients were assigned to groups with and without histologic evidence of granuloma. Demographic, clinical (including disease activity, quality of life, medication use, and healthcare utilization), and laboratory data were used in association and survival analyses. Differences between groups were evaluated using the Mann-Whitney U-test for continuous variables.


RESULTS:

Of 1466 patients with CD, granulomas were identified in 187 (12.8%). In the subset of patients who underwent surgery, 21.0% had granulomas. The presence of granuloma was associated with increased serum levels of c-reactive protein (odds ratio [OR], 2.9; 95% CI, 2.078-4.208; P<.0001), younger mean age at diagnosis (23.611.3 years in patients with granulomas vs 27.913.3 years in patients without; P=.0005), higher rates of stricturing or penetrating disease phenotype, higher rates of steroid and narcotic use, and higher healthcare utilization. Among patients that underwent surgery, the presence of granulomas was associated with need for repeat surgery during the 6-year observation period (OR, 2.5; 95% CI, 1.54-4.02; P=.0002). Infliximab use was associated with detection of granuloma in a significantly lower proportion of surgical specimens compared to patients who had not been treated with a biologic agent (OR=0.22; 95 CI, 0.05-0.97; P=.03).


CONCLUSION:

Epithelioid granulomas develop in less than 13% of patients with CD, and are associated with a more aggressive disease phenotype. Patients who have undergone surgery for CD and have granulomas are at increased risk for repeat surgery within 6 years.
__________________
''UC-like Crohn's'' since 2001:
on: 25mg 6-MP (purinethol)+ B12 shots
minor hands/wrists chronic arthritis since 01/2013

Diet: ''IBD-AID'' : http://www.nutritionj.com/content/13/1/5+ organic food only
suppl Curcuminoid extract, Inulin,psyllium, apple pectin, Vitamin D

past meds:
pred 50mg, 5-ASA, cortifoam, Imuran (failed) Purinethol (success) methotrexate (failed CD and arthritis).
Reply

Crohn's Disease Forum » Books, Multimedia, Research & News » Granulomas on biopsy and severity of Crohn's disease
Thread Tools


All times are GMT -5. The time now is 06:15 PM.
Copyright 2006-2017 Crohnsforum.com