Biologic Therapy of Ulcerative Colitis: Golimumab
Fig. 44.1 Clinical response (above) and remission (below) rates for golimumab induction therapy in PURSUIT-SC Fig. 44.2 Rates of mucosal healing (Mayo 1 or 0, left panel) and inactive mucosal…
Primary Sclerosing Cholangitis
Haplotype Significance in PSC B8-TNF*2-DRB3*0101-DRB1*0301-DQA1*0501-DQB1*0201 Strong association with disease susceptibility DRB3*0101-DRB1*1301- DQA1*0103-DQB1*0603 Strong association with disease susceptibility DRB5*0101-DRB1*1501- DQA1*0102-DQB1*0602 Weak association with disease susceptibility DRB4*0103-DRB1*0401-DQA1*03-DQB1*0302 Strong association with protection against…
Autoimmune Pancreatitis and Other Organ Involvement
Diagnosis Primary basis for diagnosis Imaging evidence Collateral evidence Definitive type 1 AIP Histology Typical/indeterminate Histologically confirmed LPSP (level 1 H) Imaging Typical Any non-D level 1/level 2 Indeterminate Two…
Incidence of Cancer and Screening in Inflammatory Bowel Disease
• All patients, regardless of extent of disease at initial diagnosis, should undergo a screening colonoscopy a maximum of 8 years after onset of symptoms, with multiple biopsy obtained throughout the…
Step-Up vs. Top-Down Approach in Crohn’s Disease
Fig. 48.1 Inflammation (left panel) and fibrostenosis (right panel) The progression from early to late disease is accompanied by a change in mucosal cytokine profiles. Early CD is characterized by…
Surgical Management of Crohn’s Disease and Ulcerative Colitis
Fig. 50.1 CT image of isolated small bowel Crohn’s disease (arrows). This image clearly demonstrates the segmental nature CD and the hyper-enhancement of the mesenteric blood vessels and thickened bowel…
Environmental Factors in the Epidemiology of Inflammatory Bowel Disease
Possible causes for change over time • Before 1970 – Retrospective data – Hospital based – Cross-sectional studies – Unclear definitions – Pre-endoscopic period • After 1970 – Early endoscopic period – Defined populations – Prospective registration – GP/hospital based • After…
Extraintestinal Manifestations: Autoimmune Hepatitis
Gender Female +2 HLA DR3 or DR4 +1 AP:AST (or ALT) ratio >3 <1.5 −2 +2 Immune disease Thyroiditis, colitis, others +2 γ-Globulin or IgG level above normal >2.0 1.5–2.0…
Optimal Management of Fistulizing Crohn’s Disease
Induction Maintenance Minimal evidence Investigational No role IFX or ADA IFX or ADA CZP Spherical carbon adsorbent Steroids aAntibiotics b6-MP Tacrolimus Stem cells Aminosalicylates – bAZA Cyclosporine – – –…
Sulfasalazine and 5-Aminosalicylates for Ulcerative Colitis
Fig. 38.1 Chemical structures of sulfasalazine and 5-ASA derivatives [2, 3] Mechanism of Action Sulfasalazine has been suggested to exert its clinical effects through anti-inflammatory, immunosuppressive, and bacteriostatic mechanisms. Downregulation…
