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Identification of pathologic features associated with "ulcerative colitis-like" Crohn's disease.

Publication ,  Journal Article
James, SD; Wise, PE; Zuluaga-Toro, T; Schwartz, DA; Washington, MK; Shi, C
Published in: World J Gastroenterol
September 28, 2014

AIM: To identify pathologic features associated with this "ulcerative colitis (UC)-like" subgroup of Crohn's disease (CD). METHODS: Seventeen subjects diagnosed as having UC who underwent proctocolectomy (RPC) from 2003-2007 and subsequently developed CD of the ileal pouch were identified. UC was diagnosed based on pre-operative clinical, endoscopic, and pathologic studies. Eighteen patients who underwent RPC for UC within the same time period without subsequently developing CD were randomly selected and used as controls. Pathology reports and histological slides were reviewed for a wide range of gross and microscopic pathological features, as well as extent of disease. The demographics, gross description and histopathology of the resection specimens were reviewed and compared between the two groups. RESULTS: Patients with "UC-like" CD were on average 13 years younger than those with "true" UC (P < 0.01). More severe disease in the proximal involved region and active ileitis with/without architectural distortion were observed in 6 of 17 (35%) and 7 of 17 (41%) "UC-like" CD cases, respectively, but in none of the "true" UC cases (P < 0.05). Active appendicitis occurred in 8 of 16 (50%) "UC-like" CD cases but in only two (11%) "true" UC cases (P < 0.05). Conspicuous lamina propria neutrophils were more specific for "UC-like" CD (76% vs 22%, P < 0.05). In addition, prominent lymphoid aggregates tended to be more common in "UC-like" CD (P = 0.07). The "true" UC group contained a greater number of cases with severe activity (78% vs 47%). Therefore, the features more commonly seen in "UC-like" CD were not due to a more severe disease process. Crohn's granulomas and transmural inflammation in non-ulcerated areas were absent in both groups. CONCLUSION: More severe disease in the proximal involved region, terminal ileum involvement, active appendicitis, and prominent lamina propria neutrophils may be morphological factors associated with "UC-like" CD.

Duke Scholars

Published In

World J Gastroenterol

DOI

EISSN

2219-2840

Publication Date

September 28, 2014

Volume

20

Issue

36

Start / End Page

13139 / 13145

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Severity of Illness Index
  • Risk Factors
  • Retrospective Studies
  • Proctocolectomy, Restorative
  • Predictive Value of Tests
  • Neutrophils
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
James, S. D., Wise, P. E., Zuluaga-Toro, T., Schwartz, D. A., Washington, M. K., & Shi, C. (2014). Identification of pathologic features associated with "ulcerative colitis-like" Crohn's disease. World J Gastroenterol, 20(36), 13139–13145. https://doi.org/10.3748/wjg.v20.i36.13139
James, Samuel D., Paul E. Wise, Tania Zuluaga-Toro, David A. Schwartz, M Kay Washington, and Chanjuan Shi. “Identification of pathologic features associated with "ulcerative colitis-like" Crohn's disease.World J Gastroenterol 20, no. 36 (September 28, 2014): 13139–45. https://doi.org/10.3748/wjg.v20.i36.13139.
James SD, Wise PE, Zuluaga-Toro T, Schwartz DA, Washington MK, Shi C. Identification of pathologic features associated with "ulcerative colitis-like" Crohn's disease. World J Gastroenterol. 2014 Sep 28;20(36):13139–45.
James, Samuel D., et al. “Identification of pathologic features associated with "ulcerative colitis-like" Crohn's disease.World J Gastroenterol, vol. 20, no. 36, Sept. 2014, pp. 13139–45. Pubmed, doi:10.3748/wjg.v20.i36.13139.
James SD, Wise PE, Zuluaga-Toro T, Schwartz DA, Washington MK, Shi C. Identification of pathologic features associated with "ulcerative colitis-like" Crohn's disease. World J Gastroenterol. 2014 Sep 28;20(36):13139–13145.

Published In

World J Gastroenterol

DOI

EISSN

2219-2840

Publication Date

September 28, 2014

Volume

20

Issue

36

Start / End Page

13139 / 13145

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Severity of Illness Index
  • Risk Factors
  • Retrospective Studies
  • Proctocolectomy, Restorative
  • Predictive Value of Tests
  • Neutrophils
  • Middle Aged
  • Male