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Original Articles
- IBD
- Serum albumin is the strongest predictor of anti-tumor necrosis factor nonresponse in inflammatory bowel disease in resource-constrained regions lacking therapeutic drug monitoring
- Peeyush Kumar, Sudheer K. Vuyyuru, Prasenjit Das, Bhaskar Kante, Mukesh Kumar Ranjan, David Mathew Thomas, Sandeep Mundhra, Pabitra Sahu, Pratap Mouli Venigalla, Saransh Jain, Sandeep Goyal, Rithvik Golla, Shubi Virmani, Mukesh K. Singh, Karan Sachdeva, Raju Sharma, Nihar Ranjan Dash, Govind Makharia, Saurabh Kedia, Vineet Ahuja
- Intest Res 2023;21(4):460-470. Published online March 17, 2023
- DOI: https://doi.org/10.5217/ir.2022.00128
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Abstract
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Supplementary Material
PubReader
ePub - Background/Aims
Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn’s disease (CD).
Methods
Inflammatory bowel disease patients treated with anti-TNF agents (January 2005–October 2020) were ambispectively included. Data concerning clinical and biochemical predictors was retrieved from a prospectively maintained database. Immunohistochemistry for expression of oncostatin M (OSM), OSM receptor (OSM-R), and interleukin-7 receptor (IL-7R) were done on pre anti-TNF initiation mucosal biopsies.
Results
One-hundred eighty-six patients (118 CD, 68 UC: mean age, 34.1±13.7 years; median disease duration at anti-TNF initiation, 60 months; interquartile range, 28–100.5 months) were included. PNR was seen in 17% and 26.5% and SLR in 47% and 28% CD and UC patients, respectively. In CD, predictors of PNR were low albumin (P<0.001), postoperative recurrence (P=0.001) and high IL-7R expression (P<0.027) on univariate; and low albumin alone (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.03–0.28; P<0.001) on multivariate analysis respectively. Low albumin (HR, 0.31; 95% CI, 0.15–0.62; P=0.001) also predicted SLR. In UC, predictors of PNR were low albumin (P<0.001), and high C-reactive protein (P<0.001), OSM (P<0.04) and OSM-R (P=0.07) stromal expression on univariate; and low albumin alone (HR, 0.11; 95% CI, 0.03–0.39; P=0.001) on multivariate analysis respectively.
Conclusions
Low serum albumin at baseline significantly predicted PNR in UC and PNR/SLR in CD patients. Mucosal markers of PNR were high stromal OSM/OSM-R in UC and high IL-7R in CD patients. -
Citations
Citations to this article as recorded by
- Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef - Tofacitinib in Steroid-Refractory Acute Severe Ulcerative Colitis: A Retrospective Analysis
Sayan Malakar, Srikanth Kothalkar, Umair Shamsul Hoda, Uday C Ghoshal
Cureus.2023;[Epub] CrossRef
- Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
- 3,921 View
- 434 Download
- 2 Web of Science
- 2 Crossref
- Infection
- Interferon-gamma release assay has poor diagnostic accuracy in differentiating intestinal tuberculosis from Crohn’s disease in tuberculosis endemic areas
- Karan Sachdeva, Peeyush Kumar, Bhaskar Kante, Sudheer K. Vuyyuru, Srikant Mohta, Mukesh K. Ranjan, Mukesh K. Singh, Mahak Verma, Govind Makharia, Saurabh Kedia, Vineet Ahuja
- Intest Res 2023;21(2):226-234. Published online June 13, 2022
- DOI: https://doi.org/10.5217/ir.2022.00010
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Abstract
PDFPubReaderePub
- Background/Aims
Intestinal tuberculosis (ITB) and Crohn’s disease (CD) frequently present with a diagnostic dilemma because of similar presentation. Interferon-gamma release assay (IGRA) has been used in differentiating ITB from CD, but with sparse reports on its diagnostic accuracy in tuberculosis endemic regions and this study evaluated the same.
Methods
Patients with definitive diagnosis of ITB (n=59) or CD (n=49) who underwent IGRA testing (n=307) were retrospectively included at All India Institute of Medical Sciences, New Delhi (July 2014 to September 2021). CD or ITB was diagnosed as per standard criteria. IGRA was considered positive at >0.35 IU/mL. Relevant data was collected and IGRA results were compared between ITB and CD to determine its accuracy.
Results
Among 59 ITB patients (mean age, 32.6±13.1 years; median disease duration, 1 year; male, 59.3%), 24 were positive and 35 tested negative for IGRA. Among 49 CD patients (mean age, 37.8±14.0; median disease duration, 4 years; male, 61.2%), 12 were positive and 37 tested negative for IGRA. Hence, for diagnosing ITB, IGRA showed a sensitivity, specificity, positive and negative predictive values of 40.68%, 75.51%, 66.67%, and 51.39%, respectively. The area under the curve of IGRA for ITB diagnosis was 0.66 (95% confidence interval, 0.55–0.75). In a subset (n=64), tuberculin skin test (TST) showed sensitivity, specificity, positive and negative predictive values of 64.7%, 73.3%, 73.3%, and 64.71%, respectively. IGRA and TST were concordant in 38 (59.4%) patients with κ=0.17.
Conclusions
In a tuberculosis endemic region, IGRA had poor diagnostic accuracy for differentiating ITB from CD, suggesting a limited value of IGRA in this setting. -
Citations
Citations to this article as recorded by- New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024; 37(5): 392. CrossRef - Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis
Tsvetelina Velikova, Anita Aleksandrova
World Journal of Clinical Cases.2024; 12(27): 6015. CrossRef - Diagnostic yield and technical performance of the novel motorized spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn's disease: a prospective study (with video)
Partha Pal, Piyush Vishwakarma, Aniruddha Pratap Singh, Palle Manohar Reddy, Mohan Ramchandani, Rupa Banerjee, Anuradha Sekaran, Polina Vijayalaxmi, Hardik Rughwani, Pradev Inavolu, Santosh Darishetty, Pradeep Rebala, Guduru Venkat Rao, Manu Tandan, D. Na
Gastrointestinal Endoscopy.2023; 97(3): 493. CrossRef - Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef - Technical performance and diagnostic yield of motorised spiral enteroscopy compared with single-balloon enteroscopy in suspected Crohn’s disease: a randomised controlled, open-label study (the MOTOR-CD trial)
Partha Pal, Mohan Ramchandani, Rupa Banerjee, Piyush Viswakarma, Aniruddha Pratap Singh, Manohar Reddy, Hardik Rughwani, Rajendra Patel, Anuradha Sekaran, Swathi Kanaganti, Santosh Darisetty, Zaheer Nabi, Jagadish Singh, Rajesh Gupta, Sundeep Lakhtakia, R
Gut.2023; 72(10): 1866. CrossRef
- New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
- 3,865 View
- 540 Download
- 3 Web of Science
- 5 Crossref
Brief Communication
- IBD
- Correlation of fecal calprotectin and patient-reported outcome measures in patients with ulcerative colitis
- Nagesh Kamat, Sudheer K Vuyyuru, Saurabh Kedia, Pabitra Sahu, Bhaskar Kante, Peeyush Kumar, Mukesh Kumar Ranjan, Mukesh Kumar Singh, Sambuddha Kumar, Vikas Sachdev, Govind Makharia, Vineet Ahuja
- Intest Res 2022;20(2):269-273. Published online February 8, 2022
- DOI: https://doi.org/10.5217/ir.2021.00064
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PDFSupplementary MaterialPubReaderePub
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Citations
Citations to this article as recorded by- Depression and active disease are the major risk factors for fatigue and sleep disturbance in inflammatory bowel disease with consequent poor quality of life: Analysis of the interplay between psychosocial factors from the developing world
Partha Pal, Rupa Banerjee, Polina Vijayalaxmi, D. Nageshwar Reddy, Manu Tandan
Indian Journal of Gastroenterology.2024; 43(1): 226. CrossRef - Research Progress in the Study of Biomarkers for Diagnosing Ulcerative Colitis or Assessing Its Activity
琳 杨
Advances in Clinical Medicine.2024; 14(01): 1167. CrossRef - A novel serum biomarker of endoscopic mucosal healing in inflammatory bowel disease
Hyoun Woo Kang
Intestinal Research.2024; 22(1): 3. CrossRef - The prevalence and burden of Rome IV faecal incontinence in ulcerative colitis: A cross‐sectional study
Dipesh H. Vasant, Gaurav B. Nigam, Sebastian Bate, Shaheen Hamdy, Jimmy K. Limdi
Alimentary Pharmacology & Therapeutics.2023; 58(1): 26. CrossRef - Current and emerging biomarkers for ulcerative colitis
Jan K. Nowak, Rahul Kalla, Jack Satsangi
Expert Review of Molecular Diagnostics.2023; 23(12): 1107. CrossRef
- Depression and active disease are the major risk factors for fatigue and sleep disturbance in inflammatory bowel disease with consequent poor quality of life: Analysis of the interplay between psychosocial factors from the developing world
- 4,115 View
- 278 Download
- 4 Web of Science
- 5 Crossref
Original Articles
- IBD
- Efficacy and tolerability of hyperbaric oxygen therapy in small bowel stricturing Crohn’s disease: a pilot study
- Bhaskar Kante, Pabitra Sahu, Saurabh Kedia, Sudheer K. Vuyyuru, Kapil Soni, Maneesh Singhal, Raju Sharma, Govind Makharia, Vineet Ahuja
- Intest Res 2022;20(2):231-239. Published online February 8, 2022
- DOI: https://doi.org/10.5217/ir.2021.00056
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Existing therapeutic options for complicated Crohn’s disease (CD) like biologics and surgery are limited by inadequate long-term efficacy, cost, and adverse effects. Tissue hypoxia is important in CD pathogenesis and may be ameliorated with hyperbaric oxygen therapy (HBOT). We assessed the efficacy and tolerability of HBOT in small bowel stricturing CD.
Methods
This pilot study included patients of small bowel stricturing CD (from April 2019 to January 2020) who underwent HBOT. These patients were refractory to conventional medical treatment or had multiple strictures not amenable to resection. Each session of HBOT was given for 60 minutes with a pressure of 1.5–2.5 atm. Clinical, biochemical responses and Short Inflammatory Bowel Disease (SIBD) questionnaire were evaluated at 2 and 6 months, and radiological response was evaluated at 6 months.
Results
Fourteen patients (mean age, 42.9±15.7 years; male, 50%) were subjected to 168 HBOT sessions. Thirteen patients (92.7%) had strictures and 1 patient had enterocutaneous fistula in addition. Median number of HBOT sessions was 11 (range, 3–20) which were administered over a median of 4 weeks. Most patients tolerated it well except 1 who had hemotympanum. At 2 and 6 months of follow-up, 64.2% of patients had a clinical response, 50% and 64.2% of patients had clinical remission respectively. Steroid-free clinical remission was seen in 8 (57%) of patients with radiological improvement in 50%. There was a significant improvement in SIBD scores at 2-month follow-up (59.4 vs. 44.5, P=0.03).
Conclusions
HBOT can be a safe and effective therapeutic option in patients with stricturing small bowel CD refractory to conventional medical treatment. -
Citations
Citations to this article as recorded by- Hyperbaric oxygen therapy as a possible therapeutic candidate for sepsis-associated encephalopathy: A novel hypothesis
Sung Eun Lee, Eunjung Park, Ji-yun Kim, HyukHoon Kim
Medical Hypotheses.2024; 182: 111212. CrossRef - Treating paediatric Crohn’s disease is challenging but new treatments hold promise
Tina Nie
Drugs & Therapy Perspectives.2024; 40(3): 121. CrossRef - Risk of avascular necrosis in patients with inflammatory bowel disease: Insights from a nationwide cohort study and the impact of corticosteroid use
Jung Min Moon, Kyoung-Eun Kwon, Ju Won Lee, Kyung Rok Minn, Kyuwon Kim, Jeongkuk Seo, Seung Yong Shin, Sun-Young Jung, Chang Hwan Choi
Digestive and Liver Disease.2024;[Epub] CrossRef - The Future of Advanced Therapies for Pediatric Crohn’s Disease
Julie Gallagher, Joel R. Rosh, Benjamin Sahn
Pediatric Drugs.2023; 25(6): 621. CrossRef - Role of hyperbaric oxygen therapy in patients with inflammatory bowel disease
Harpreet Kaur, Gursimran Singh Kochhar, Parambir S. Dulai
Current Opinion in Gastroenterology.2023; 39(4): 263. CrossRef
- Hyperbaric oxygen therapy as a possible therapeutic candidate for sepsis-associated encephalopathy: A novel hypothesis
- 4,837 View
- 295 Download
- 5 Web of Science
- 5 Crossref
- Miscellaneous
- Addition of computed tomography chest increases the diagnosis rate in patients with suspected intestinal tuberculosis
- Saurabh Kedia, Raju Sharma, Sudheer Kumar Vuyyuru, Deepak Madhu, Pabitra Sahu, Bhaskar Kante, Prasenjit Das, Ankur Goyal, Karan Madan, Govind Makharia, Vineet Ahuja
- Intest Res 2022;20(2):184-191. Published online May 4, 2021
- DOI: https://doi.org/10.5217/ir.2020.00104
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Abstract
PDFPubReaderePub
- Background/Aims
Intestinal tuberculosis (ITB) is difficult to diagnose due to poor sensitivity of definitive diagnostic tests. ITB may be associated with concomitant pulmonary tuberculosis (PTB) which may remain undetected on chest X-ray. We assessed the role of contrast enhanced computed tomography (CECT) chest in detecting the prevalence of active PTB, and increasing the diagnostic yield in patients with suspected ITB.
Methods
Consecutive treatment naïve patients with suspected ITB (n=200) who underwent CECT chest (n=88) and had follow-up duration>1 year were recruited in this retrospective study (February 2016 to October 2018). ITB was diagnosed in the presence of caseating granuloma, positive acid fast stain or culture for Mycobacterium tuberculosis on biopsy, presence of necrotic lymph nodes (LNs) on CT enterography or positive response to anti-tubercular therapy. Evidence of active tuberculosis on CECT-chest was defined as presence of centrilobular nodules with or without consolidation/miliary nodules/thick-walled cavity/enlarged necrotic mediastinal LNs.
Results
Sixty-five of eighty-eight patients (mean age, 33.8±12.8 years; 47.7% of females) were finally diagnosed as ITB (4-caseating granuloma on biopsy, 12-necrotic LNs on CT enterography, 1-both, and 48-response to anti-tubercular therapy) and 23 were diagnosed as Crohn’s disease. Findings of active TB on CECT chest with or without necrotic abdominal LNs were demonstrated in 5 and 20 patients, respectively. No patient with Crohn’s disease had necrotic abdominal LNs or active PTB. Addition of CECT chest in the diagnostic algorithm improved the sensitivity of ITB diagnosis from 26.2% to 56.9%.
Conclusions
Addition of CECT chest significantly improves the sensitivity for definite diagnosis in a patient with suspected ITB. -
Citations
Citations to this article as recorded by- Imaging in Abdominal Tuberculosis
Anuradha Sharma, Ankur Goyal, Devasenathipathy Kandasamy, Saurabh Kedia, Vineet Ahuja, Raju Sharma
Indographics.2024; 03(02): 045. CrossRef - Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef - Risk factors identification of COVID‐19 patients with chronic obstructive pulmonary disease: A retrospective study in Punjab‐Pakistan
Muhammad Muneeb Hassan, M. H. Tahir, Muhammad Ameeq, Farrukh Jamal, John T. Mendy, Christophe Chesneau
Immunity, Inflammation and Disease.2023;[Epub] CrossRef - Strengthening Tuberculosis Services for Children and Adolescents in Low Endemic Settings
Jeffrey R. Starke, Connie Erkens, Nicole Ritz, Ian Kitai
Pathogens.2022; 11(2): 158. CrossRef - Stringent screening strategy significantly reduces reactivation rates of tuberculosis in patients with inflammatory bowel disease on anti‐TNF therapy in tuberculosis endemic region
Peeyush Kumar, Sudheer K. Vuyyuru, Bhaskar Kante, Pabitra Sahu, Sandeep Goyal, Deepak Madhu, Saransh Jain, Mukesh Kumar Ranjan, Sandeep Mundhra, Rithvik Golla, Mukesh Singh, Shubi Virmani, Anvita Gupta, Nidhi Yadav, Mani Kalaivani, Raju Sharma, Prasenjit
Alimentary Pharmacology & Therapeutics.2022; 55(11): 1431. CrossRef
- Imaging in Abdominal Tuberculosis
- 5,929 View
- 425 Download
- 4 Web of Science
- 5 Crossref
Review
- IBD
- Use of thiopurines in inflammatory bowel disease: an update
- Arshdeep Singh, Ramit Mahajan, Saurabh Kedia, Amit Kumar Dutta, Abhinav Anand, Charles N. Bernstein, Devendra Desai, C. Ganesh Pai, Govind Makharia, Harsh Vardhan Tevethia, Joyce WY Mak, Kirandeep Kaur, Kiran Peddi, Mukesh Kumar Ranjan, Perttu Arkkila, Rakesh Kochhar, Rupa Banerjee, Saroj Kant Sinha, Siew Chien Ng, Stephen Hanauer, Suhang Verma, Usha Dutta, Vandana Midha, Varun Mehta, Vineet Ahuja, Ajit Sood
- Intest Res 2022;20(1):11-30. Published online April 15, 2021
- DOI: https://doi.org/10.5217/ir.2020.00155
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Abstract
PDFPubReaderePub
- Inflammatory bowel disease (IBD), once considered a disease of the Western hemisphere, has emerged as a global disease. As the disease prevalence is on a steady rise, management of IBD has come under the spotlight. 5-Aminosalicylates, corticosteroids, immunosuppressive agents and biologics are the backbone of treatment of IBD. With the advent of biologics and small molecules, the need for surgery and hospitalization has decreased. However, economic viability and acceptability is an important determinant of local prescription patterns. Nearly one-third of the patients in West receive biologics as the first/initial therapy. The scenario is different in developing countries where biologics are used only in a small proportion of patients with IBD. Increased risk of reactivation of tuberculosis and high cost of the therapy are limitations to their use. Thiopurines hence become critical for optimal management of patients with IBD in these regions. However, approximately one-third of patients are intolerant or develop adverse effects with their use. This has led to suboptimal use of thiopurines in clinical practice. This review article discusses the clinical aspects of thiopurine use in patients with IBD with the aim of optimizing their use to full therapeutic potential.
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Citations
Citations to this article as recorded by- Medical Management of Inflammatory Bowel Disease
Shahrose Rahman, Ranish K. Patel, Elisa Boden, Vassiliki Liana Tsikitis
Surgical Clinics of North America.2024; 104(3): 657. CrossRef - Tofacitinib Versus Oral Prednisolone for Induction of Remission in Moderately Active Ulcerative Colitis [ORCHID]: A Prospective, Open-Label, Randomized, Pilot Study
Arshdeep Singh, Vandana Midha, Kirandeep Kaur, Ramit Mahajan, Dharmatma Singh, Ramandeep Kaur, Aditya Kohli, Avantika Chawla, Kriti Sood, Namita Bansal, Ajit Sood
Journal of Crohn's and Colitis.2024; 18(2): 300. CrossRef - Differential molecular mechanisms of substrate recognition by selenium methyltransferases, INMT and TPMT, in selenium detoxification and excretion
Yasunori Fukumoto, Rin Kyono, Yuka Shibukawa, Yu-ki Tanaka, Noriyuki Suzuki, Yasumitsu Ogra
Journal of Biological Chemistry.2024; 300(2): 105599. CrossRef - Factors Associated with Reaching Mid-Parental Height in Patients Diagnosed with Inflammatory Bowel Disease in Childhood and Adolescent Period
So Yoon Choi, Sujin Choi, Byung-Ho Choe, Jae Hong Park, Kwang-Hae Choi, Hae Jeong Lee, Ji Sook Park, Ji-Hyun Seo, Jae Young Kim, Hyo-Jeong Jang, Suk Jin Hong, Eun Young Kim, Yeoun Joo Lee, Ben Kang
Gut and Liver.2024; 18(1): 106. CrossRef - Tofacitinib in Acute Severe Ulcerative Colitis (TACOS): A Randomized Controlled Trial
Arshdeep Singh, Manjeet Kumar Goyal, Vandana Midha, Ramit Mahajan, Kirandeep Kaur, Yogesh Kumar Gupta, Dharmatma Singh, Namita Bansal, Ramandeep Kaur, Shivam Kalra, Omesh Goyal, Varun Mehta, Ajit Sood
American Journal of Gastroenterology.2024; 119(7): 1365. CrossRef - Effectiveness of Tofacitinib in Ulcerative Proctitis Compared to Left Sided Colitis and Pancolitis
Arshdeep Singh, Ramit Mahajan, Vandana Midha, Kirandeep Kaur, Dharmatma Singh, Ramandeep Kaur, Shreya Garg, Kirti Arora, Namita Bansal, Ajit Sood
Digestive Diseases and Sciences.2024; 69(4): 1389. CrossRef - Uphill battle: Innovation of thiopurine therapy in global inflammatory bowel disease care
Ahmed B. Bayoumy, Chris J. J. Mulder, Azhar R. Ansari, Murray L. Barclay, Tim Florin, Marianne Kiszka-Kanowitz, Luc Derijks, Vishal Sharma, Nanne K. H. de Boer
Indian Journal of Gastroenterology.2024; 43(1): 36. CrossRef - The drug-survival of low-dose thioguanine in patients with inflammatory bowel disease: a retrospective observational study
Helena Gensmyr-Singer, Mårten Werner, Pontus Karling
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Thiopurine Metabolite Shunting in Late Pregnancy Increases the Risk of Intrahepatic Cholestasis of Pregnancy in Women With Inflammatory Bowel Disease, and Can be Managed With Split Dosing
Ralley Prentice, Emma Flanagan, Emily Wright, Lani Prideaux, William Connell, Miles Sparrow, Peter De Cruz, Mark Lust, Winita Hardikar, Rimma Goldberg, Sara Vogrin, Kirsten Palmer, Alyson Ross, Megan Burns, Tessa Greeve, Sally Bell
Journal of Crohn's and Colitis.2024; 18(7): 1081. CrossRef - Optimal Treatment Approaches to Intestinal Behçet's Disease Complicated by Myelodysplastic Syndrome: The KASID and KSBD Multicenter Study
Jung-Bin Park, So Jung Han, Seung Bum Lee, Dong Hyun Kim, Jae Hee Cheon, Sung Wook Hwang, Byong Duk Ye, Suk-Kyun Yang, Soo Jung Park, Sang Hyoung Park
Yonsei Medical Journal.2024; 65(5): 265. CrossRef - Application of Drug Repurposing Approach for Therapeutic Intervention
of Inflammatory Bowel Disease
Mohammad Aadil Bhat, Iqra Usman, Suneela Dhaneshwar
Current Reviews in Clinical and Experimental Pharmacology.2024; 19(3): 234. CrossRef - Selecting first-line advanced therapy for ulcerative colitis: A clinical application of personalized medicine
Mariam S. Mukhtar, Mahmoud H. Mosli
Saudi Journal of Gastroenterology.2024; 30(3): 126. CrossRef - Clinical Significance of Prognostic Nutrition Index in Patients with Crohn’s Disease after Primary Bowel Resection
Hyeon Woo Bae, Yong Joon Lee, Min Young Park, Seung Yoon Yang, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Jae Hee Cheon, Joseph C. Carmichael, Byung Soh Min
Yonsei Medical Journal.2024; 65(7): 380. CrossRef - Differences in the risk of clinical failure between thiopurine and methotrexate in bio-naïve patients with Crohn’s disease: a Korean nationwide population-based study
Yu Kyung Jun, Eunjeong Ji, Hye Ran Yang, Yonghoon Choi, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyuk Yoon
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Low risk of malignancies with thiopurines in an Indian cohort of patients with Inflammatory bowel disease
Arshdeep Singh, Vandana Midha, Ajit Sood
Indian Journal of Gastroenterology.2024;[Epub] CrossRef - Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure
June Hwa Bae, Jung-Bin Park, Ji Eun Baek, Seung Wook Hong, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sung Wook Hwang
Gut and Liver.2024; 18(4): 667. CrossRef - Pharmacogenomic Assessment of Genes Implicated in Thiopurine Metabolism and Toxicity in a UK Cohort of Pediatric Patients With Inflammatory Bowel Disease
Tracy Coelho, Guo Cheng, Sophie Lewis, James J Ashton, Farah Barakat, Kouros C T Driscoll, Adebola E Sholeye-Bolaji, Akshay Batra, Nadeem A Afzal, Robert M Beattie, Sarah Ennis
Inflammatory Bowel Diseases.2024;[Epub] CrossRef - Reply: Predicting Adverse Events to Thiopurines in IBD: Are We a Step Closer?
Tracy Coelho, Guo Cheng, Fernando Vazquez Lopez, James J Ashton, Robert M Beattie, Sarah Ennis
Inflammatory Bowel Diseases.2024; 30(10): 1928. CrossRef - Safety and Effectiveness of Thiopurines and Small Molecules in Elderly Patients with Inflammatory Bowel Diseases
Aleksandra Strigáč, Miłosz Caban, Ewa Małecka-Wojciesko, Renata Talar-Wojnarowska
Journal of Clinical Medicine.2024; 13(16): 4678. CrossRef - Saudi consensus guidance for the diagnosis and management of inflammatory bowel disease in children and adolescents
Omar I. Saadah, Turki AlAmeel, Ahmed Al Sarkhy, Mohammed Hasosah, Abdulrahman Al-Hussaini, Majid A. Almadi, Badr Al-Bawardy, Talal A. Altuwaijri, Mohammed AlEdreesi, Shakir A. Bakkari, Othman R. Alharbi, Nahla A. Azzam, Abdulelah Almutairdi, Khalidah A. A
Saudi Journal of Gastroenterology.2024;[Epub] CrossRef - Personalization of thiopurine therapy: Current recommendations and future perspectives
Dunja Urbančič, Flaka Pasha, Alenka Šmid, Irena Mlinarič-Raščan
Acta Pharmaceutica.2024; 74(3): 355. CrossRef - Navigating the pharmacotherapeutic management of comorbid inflammatory bowel disease and primary sclerosing cholangitis
Brigid Pinnuck, Kate D. Lynch
Expert Opinion on Pharmacotherapy.2024;[Epub] CrossRef - Thiopurine therapy in inflammatory bowel disease in the pandemic era: Safe or unsafe?
Shailesh Perdalkar, Pooja Basthi Mohan, Balaji Musunuri, Siddheesh Rajpurohit, Shiran Shetty, Krishnamurthy Bhat, Cannanore Ganesh Pai
International Immunopharmacology.2023; 116: 109597. CrossRef - Effectiveness and safety of thioguanine as a maintenance therapy of inflammatory bowel disease: Systematic review, meta-analysis and meta-regression
Anuraag Jena, Pardhu B Neelam, Harshavardhan Telaprolu, Uday Kiran Mangipudi, Usha Dutta, Shaji Sebastian, Vishal Sharma
Clinics and Research in Hepatology and Gastroenterology.2023; 47(7): 102155. CrossRef - Impact of Crohn’s Disease on the Survival of Patients with Small-Bowel Adenocarcinoma in Korea: A Bicenter Cohort Study
Kyuwon Kim, Kookhwan Choi, Sung Wook Hwang, Jong Pil Im, Byong Duk Ye, Joo Sung Kim, Kyu Joo Park, Suk-Kyun Yang, Seong-Joon Koh, Sang Hyoung Park
Gut and Liver.2023; 17(4): 581. CrossRef - Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting
Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im
Intestinal Research.2023; 21(3): 353. CrossRef - The Management of Inflammatory Bowel Disease during Reproductive Years: An Updated Narrative Review
Nariman Hossein-Javaheri, Michael Youssef, Yaanu Jeyakumar, Vivian Huang, Parul Tandon
Reproductive Medicine.2023; 4(3): 180. CrossRef - Long‐term safety and effectiveness of azathioprine in the management of inflammatory bowel disease: A real‐world experience
Rohan V Yewale, Balakrishnan S Ramakrishna, Babu Vinish Doraisamy, Pandurangan Basumani, Jayanthi Venkataraman, Kayalvizhi Jayaraman, Ananthavadivelu Murali, Karunakaran Premkumar, Akkim Sathish Kumar
JGH Open.2023; 7(9): 599. CrossRef - Effectiveness and tolerability of methotrexate monotherapy in Crohn’s disease patients: a multicenter observational study
Jihye Park, Jaeyoung Chun, Soo Jung Park, Jae Jun Park, Tae Il Kim, Hyuk Yoon, Jae Hee Cheon
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef -
Oral Lingzhi or Reishi Medicinal Mushroom Ganoderma lucidum (Agaricomycetes) Spore Powder Ameliorates Murine Colitis by Inhibiting Key Kinases Phosphorylation in MAPK Pathway
Yingying Zhao, Liangchen Zhu
International Journal of Medicinal Mushrooms.2023; 25(10): 39. CrossRef - Enhancing cancer therapy: The potential of mercaptopurine-based nanomaterials for targeted drug delivery
Mehrab Pourmadadi, Arsalan Rahmani Ghohrodi, Zeinab Savari, Ehsan Talebi, Iman Ahamdi, Abbas Rahdar, Sadanand Pandey
Next Nanotechnology.2023; 2: 100018. CrossRef - Thiopurine exposure during pregnancy is not associated with anemia in infants born to mothers with IBD
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Crohn's & Colitis 360.2023;[Epub] CrossRef - Reviewing the potential of probiotics, prebiotics and synbiotics: advancements in treatment of ulcerative colitis
Apurva Jadhav, Suresh Jagtap, Suresh Vyavahare, Archana Sharbidre, Bipinraj Kunchiraman
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef - Impact of Immunosuppressive Therapy on the Performance of Latent Tuberculosis Screening Tests in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Chan Hyuk Park, Jung Ho Park, Yoon Suk Jung
Journal of Personalized Medicine.2022; 12(3): 507. CrossRef - Use of Azathioprine in Ulcerative Colitis: A Comprehensive Review
Bipadabhanjan Mallick, Sarthak Malik
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Walter Fries, Maria Giulia Demarzo, Giuseppe Navarra, Anna Viola
Drugs & Aging.2022; 39(6): 441. CrossRef - Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef - Prevention of postoperative recurrence in Crohn’s disease: the never-ending story
Jung-Bin Park, Sang Hyoung Park
Intestinal Research.2022; 20(3): 279. CrossRef - Updates on conventional therapies for inflammatory bowel diseases: 5-aminosalicylates, corticosteroids, immunomodulators, and anti-TNF-α
Jihye Park, Jae Hee Cheon
The Korean Journal of Internal Medicine.2022; 37(5): 895. CrossRef - Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef - Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef - Effectiveness and Safety of Golimumab in Patients with Ulcerative Colitis: A Multicenter, Prospective, Postmarketing Surveillance Study
Jongwook Yu, Soo Jung Park, Hyung Wook Kim, Yun Jeong Lim, Jihye Park, Jae Myung Cha, Byong Duk Ye, Tae Oh Kim, Hyun-Soo Kim, Hyun Seok Lee, Su Young Jung, Youngdoe Kim, Chang Hwan Choi
Gut and Liver.2022; 16(5): 764. CrossRef - A report on the potential of Rac1/pSTAT3 protein levels in T lymphocytes to assess the pharmacodynamic effect of thiopurine therapy in Inflammatory Bowel Disease patients
Debbie S. Deben, Rob H. Creemers, Arjan J. van Adrichem, Roosmarie Drent, Audrey H. H. Merry, Mathie P. G. Leers, Adriaan A. van Bodegraven, Dennis R. Wong
Scientific Reports.2022;[Epub] CrossRef - Low-Dose Azathioprine in Combination with Allopurinol: The Past, Present and Future of This Useful Duo
Alexander Keith Turbayne, Miles Patrick Sparrow
Digestive Diseases and Sciences.2022; 67(12): 5382. CrossRef - NUDT15Genotyping in Thiopurine Drug Therapy
Jong Kwon Lee, Rihwa Choi, Soo-Youn Lee
Laboratory Medicine Online.2022; 12(4): 217. CrossRef - Personalized medicine to implementation science: Thiopurines set for the leap
Vishal Sharma, Saurabh Kedia, Vineet Ahuja
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Jeffery M Venner, Charles N Bernstein
Gastroenterology Report.2022;[Epub] CrossRef - Treatment of inflammatory bowel diseases: focusing on 5-aminosalicylates and immunomodulators
You Sun Kim
Journal of the Korean Medical Association.2021; 64(9): 596. CrossRef - Is the Long-term Disease Course of Elderly-Onset Ulcerative Colitis Different from That of Non-Elderly-Onset Ulcerative Colitis?
Jin Wook Lee, Eun Soo Kim
Gut and Liver.2021; 15(5): 639. CrossRef - Pharmacogenetics-based personalized treatment in patients with inflammatory bowel disease: A review
Ji Young Chang, Jae Hee Cheon
Precision and Future Medicine.2021; 5(4): 151. CrossRef - Current status and future perspectives on the use of therapeutic drug monitoring of thiopurine metabolites in patients with inflammatory bowel disease
Debbie S. Deben, Dennis R. Wong, Adriaan A. van Bodegraven
Expert Opinion on Drug Metabolism & Toxicology.2021; 17(12): 1433. CrossRef
- Medical Management of Inflammatory Bowel Disease
- 9,631 View
- 649 Download
- 49 Web of Science
- 51 Crossref
Original Articles
- Inflammatory Bowel Diseases
- High mucosal cytomegalovirus DNA helps predict adverse short-term outcome in acute severe ulcerative colitis
- Saransh Jain, Divya Namdeo, Pabitra Sahu, Saurabh Kedia, Peush Sahni, Prasenjit Das, Raju Sharma, Vipin Gupta, Govind Makharia, Lalit Dar, Simon PL Travis, Vineet Ahuja
- Intest Res 2021;19(4):438-447. Published online November 6, 2020
- DOI: https://doi.org/10.5217/ir.2020.00055
-
Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Predictors of short-term outcome of intravenous (IV) steroid therapy in acute severe ulcerative colitis (ASUC) have been well described, but the impact of cytomegalovirus (CMV) infection as a predictor of outcome remains debatable. We investigated the role of quantitative CMV polymerase chain reaction (PCR) as a predictor of short-term outcome in patients with ASUC.
Methods
Consecutive patients with ASUC satisfying Truelove and Witts criteria hospitalized at All India Institute of Medical Sciences (AIIMS) from May 2016 to July 2019 were included; all received IV steroid. The primary outcome measure was steroid-failure defined as the need for rescue therapy (with ciclosporin or infliximab) or colectomy during admission. AIIMS’ index (ulcerative colitis index of severity > 6 at day 1+fecal calprotectin > 1,000 μg/g at day 3), with quantitative CMV PCR on biopsy samples obtained at initial sigmoidoscopy were correlated with the primary outcome.
Results
Thirty of 76 patients (39%) failed IV corticosteroids and 12 (16%) underwent surgery. Patients with steroid failure had a significantly higher mucosal CMV DNA than responders (3,454 copies/mg [0–2,700,000] vs. 116 copies/mg [0–27,220]; P< 0.01). On multivariable analysis, mucosal CMV DNA load > 2,000 copies/mg (odds ratio [OR], 10.2; 95% confidence interval [CI], 2.6–39.7; P< 0.01) and AIIMS’ index (OR, 39.8; 95% CI, 4.4–364.4; P< 0.01) were independent predictors of steroid-failure and need for colectomy. The combination correctly predicted outcomes in 84% of patients with ASUC.
Conclusions
High mucosal CMV DNA ( > 2,000 copies/mg) independently predicts failure of IV corticosteroids and short-term risk of colectomy and it has an additional value to the established markers of disease severity in patients with ASUC. -
Citations
Citations to this article as recorded by- Predictors of adverse outcomes of steroids in patients with severe ulcerative colitis (systematic review and meta-analyses)
A. F. Mingazov, O. I. Sushkov, B. R. Kalanov, T. A. Baranova, S. I. Achkasov
Koloproktologia.2024; 23(1): 172. CrossRef - Predicting Outcome after Acute Severe Ulcerative Colitis: A Contemporary Review and Areas for Future Research
Sudheer Kumar Vuyyuru, Olga Maria Nardone, Vipul Jairath
Journal of Clinical Medicine.2024; 13(15): 4509. CrossRef - Low prevalence of Clostridioides difficile infection in acute severe ulcerative colitis: A retrospective cohort study from northern India
Sandeep Mundhra, David Thomas, Saransh Jain, Pabitra Sahu, Sudheer Vuyyuru, Peeyush Kumar, Bhaskar Kante, Rajesh Panwar, Peush Sahni, Rama Chaudhry, Prasenjit Das, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Indian Journal of Gastroenterology.2023; 42(3): 411. CrossRef - Systematic Review: Outcome Prediction in Acute Severe Ulcerative Colitis
Julia Angkeow, Alissa Rothman, Lara Chaaban, Nicole Paul, Joanna Melia
Gastro Hep Advances.2023;[Epub] CrossRef - The role of cytomegalovirus colitis on short- and long-term outcomes for patients with ulcerative colitis
Mengmeng Zhang, Xiaoyin Bai, Huimin Zhang, Yan You, Hong Lv, Yue Li, Bei Tan, Ji Li, Hui Xu, Weiyang Zheng, Hong Yang, Jiaming Qian
Scandinavian Journal of Gastroenterology.2022; 57(3): 282. CrossRef - Cytomegalovirus in ulcerative colitis: an evidence-based approach to diagnosis and treatment
Anuraag Jena, Shubhra Mishra, Anupam Kumar Singh, Aravind Sekar, Vishal Sharma
Expert Review of Gastroenterology & Hepatology.2022; 16(2): 109. CrossRef - Prospective validation of AIIMS index as a predictor of steroid failure in patients with acute severe ulcerative colitis
Pabitra Sahu, Saransh Jain, Saurabh Kedia, Sudheer K. Vuyyuru, Peush Sahni, Raju Sharma, Rajesh Panwar, Prasenjit Das, Vipin Gupta, Govind Makharia, Simon Travis, Vineet Ahuja
Indian Journal of Gastroenterology.2022; 41(3): 273. CrossRef - Cytomegalovirus Infection in Patients with Inflammatory Bowel Disease
Jun Lee
The Korean Journal of Gastroenterology.2022; 80(2): 60. CrossRef - The Impact of Human Herpesviruses in Clinical Practice of Inflammatory Bowel Disease in the Era of COVID-19
Shuhei Hosomi, Yu Nishida, Yasuhiro Fujiwara
Microorganisms.2021; 9(9): 1870. CrossRef - Does cytomegalovirus load predict the outcome of acute severe ulcerative colitis?
You Sun Kim
Intestinal Research.2021; 19(4): 357. CrossRef
- Predictors of adverse outcomes of steroids in patients with severe ulcerative colitis (systematic review and meta-analyses)
- 5,680 View
- 210 Download
- 8 Web of Science
- 10 Crossref
- Inflammatory Bowel Diseases
- Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn’s disease
- Sanchit Sharma, Arti Gupta, Saurabh Kedia, Samagra Agarwal, Namrata Singh, Sandeep Goyal, Saransh Jain, Vipin Gupta, Pabitra Sahu, Sudheer Kumar Vuyyuru, Bhaskar Kante, Raju Sharma, Rajesh Panwar, Peush Sahni, Govind Makharia, Vineet Ahuja
- Intest Res 2021;19(3):291-300. Published online May 26, 2020
- DOI: https://doi.org/10.5217/ir.2019.09172
-
Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
Exclusive enteral nutrition (EEN), an established modality for pediatric Crohn’s disease (CD) is seldomly utilized in adults. The present study reports the outcome of EEN in adult CD patients at a tertiary care hospital in India.
Methods
This was a retrospective analysis of CD patients who received EEN as a sole modality/adjunct to other treatment. The primary and secondary outcomes changed in Crohn’s Disease Activity Index (CDAI), and clinical response (decline in CDAI > 70), respectively, at 4 and 8 weeks. Subgroup analysis evaluated response across different phenotypes, EEN formulations and prior treatment. Linear mixed effect model was created to assess the predictors of EEN response.
Results
Thirty-one CD patients received EEN over median duration of 4 weeks (range, 2–6 weeks). CDAI showed a significant improvement post EEN at 4 (baseline 290 [260–320] vs. 240 [180–280], P= 0.001) and 8 weeks (baseline 290 [260–320] vs. 186 [160–240], P= 0.001), respectively. The cumulative clinical response rates at 4 and 8 weeks were 37.3% and 80.4% respectively. The clinical response rates at 8 weeks across B1 (n = 4), B2 (n = 18) and B3 (n = 9) phenotypes were 50%, 78.8% and 100% respectively (log-rank test, P= 0.093). The response rates at 8 weeks with polymeric (n = 8) and semi-elemental diet (n = 23) were 75% and 82.6%% respectively (log-rank test, P= 0.49). Baseline CDAI (odds ratio, 1.008; 95% confidence interval, 1.002–1.017; P= 0.046) predicted response to EEN.
Conclusions
EEN was effective in inducing clinical response across different phenotypes of CD. Baseline disease activity remained the most important predictor of clinical response to EEN. -
Citations
Citations to this article as recorded by- Progress and Clinical Applications of Crohn’s Disease Exclusion Diet in Crohn’s Disease
Duo Xu, Ziheng Peng, Yong Li, Qian Hou, Yu Peng, Xiaowei Liu
Gut and Liver.2024; 18(3): 404. CrossRef - Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) (Version 4.1) – living guideline
Andreas Sturm, Raja Atreya, Dominik Bettenworth, Bernd Bokemeyer, Axel Dignass, Robert Ehehalt, Christoph-Thomas Germer, P. C. Grunert, Ulf Helwig, Karoline Horisberger, Klaus Herrlinger, Peter Kienle, Torsten Kucharzik, Jost Langhorst, Christian Maaser,
Zeitschrift für Gastroenterologie.2024; 62(08): 1229. CrossRef - Use of oral diet and nutrition support in management of stricturing and fistulizing Crohn's disease
Kush Fansiwala, Neha D. Shah, Kelly A. McNulty, Mary R. Kwaan, Berkeley N. Limketkai
Nutrition in Clinical Practice.2023; 38(6): 1282. CrossRef - Exclusive Enteral Nutrition Orchestrates Immunological Balances as Early as Week 4 in Adult Patients of Crohn’s Disease: A Pilot, Open-Lable Study
Na Diao, Xinyu Liu, Minzhi Lin, Qingfan Yang, Bingyang Li, Jian Tang, Ni Ding, Xiang Gao, Kang Chao
Nutrients.2023; 15(24): 5091. CrossRef - Exclusive enteral nutrition with oral polymeric diet helps in inducing clinical and biochemical remission in adults with active Crohn's disease
Pradeep Kakkadasam Ramaswamy
Journal of Parenteral and Enteral Nutrition.2022; 46(2): 423. CrossRef - Is the frequency of dietitian support associated with greater clinical improvements in adults with Crohn's disease undertaking exclusive enteral nutrition?
Liz Purcell, Rumbidzai Mutsekwa, Rebecca Angus, Dheeraj Shukla, Michelle Palmer
Journal of Human Nutrition and Dietetics.2022; 35(3): 435. CrossRef - Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – August 2021 – AWMF-Registernummer: 021-004
Andreas Sturm, Raja Atreya, Dominik Bettenworth, Bernd Bokemeyer, Axel Dignaß, Robert Ehehalt, Christoph Germer, Philip C. Grunert, Ulf Helwig, Klaus Herrlinger, Peter Kienle, Martin E. Kreis, Torsten Kucharzik, Jost Langhorst, Christian Maaser, Johann Oc
Zeitschrift für Gastroenterologie.2022; 60(03): 332. CrossRef - Diet and nutrition in the management of inflammatory bowel disease
Pabitra Sahu, Saurabh Kedia, Vineet Ahuja, Rakesh K. Tandon
Indian Journal of Gastroenterology.2021; 40(3): 253. CrossRef - Review of exclusive enteral therapy in adult Crohn’s disease
Nikola Mitrev, Hin Huang, Barbara Hannah, Viraj Chandana Kariyawasam
BMJ Open Gastroenterology.2021; 8(1): e000745. CrossRef - Current Use of EEN in Pre-Operative Optimisation in Crohn’s Disease
Sharafaath Shariff, Gordon Moran, Caris Grimes, Rachel Margaret Cooney
Nutrients.2021; 13(12): 4389. CrossRef - Exclusive Enteral Nutrition in Adult Crohn’s Disease: an Overview of Clinical Practice and Perceived Barriers
Roberto de Sire, Olga Maria Nardone, Anna Testa, Giulio Calabrese, Anna Caiazzo, Fabiana Castiglione
Clinical and Experimental Gastroenterology.2021; Volume 14: 493. CrossRef - Making Decisions about Dietary Therapy in Inflammatory Bowel Disease
Sydney Solomon, Eunie Park, Joseph A. Picoraro
Gastrointestinal Disorders.2020; 2(4): 353. CrossRef - EEN Yesterday and Today … CDED Today and Tomorrow
Marta Herrador-López, Rafael Martín-Masot, Víctor Manuel Navas-López
Nutrients.2020; 12(12): 3793. CrossRef
- Progress and Clinical Applications of Crohn’s Disease Exclusion Diet in Crohn’s Disease
- 6,462 View
- 295 Download
- 13 Web of Science
- 13 Crossref
- Inflammatory Bowel Diseases
- Prospective validation of CD4+CD25+FOXP3+ T-regulatory cells as an immunological marker to differentiate intestinal tuberculosis from Crohn’s disease
- Ritika Rampal, Saurabh Kedia, Mohamad Nahidul Wari, Deepak Madhu, Amit Kumar Singh, Veena Tiwari, V. Pratap Mouli, Srikant Mohta, Govind Makharia, Vineet Ahuja
- Intest Res 2021;19(2):232-238. Published online May 8, 2020
- DOI: https://doi.org/10.5217/ir.2019.09181
-
Abstract
PDFPubReaderePub
- Background/Aims
Crohn’s disease (CD) and intestinal tuberculosis (ITB) remain “difficult-to-differentiate” diseases. We have previously documented peripheral blood frequency of CD4+CD25+FOXP3+ T-regulatory cells (Treg) as a biomarker to differentiate CD and ITB. We tried to validate these results in a larger cohort of CD and ITB patients.
Methods
Seventy treatment naïve patients of CD (n = 23) and ITB (n = 47) (diagnosed by standard criteria) were recruited prospectively from October 2016 to May 2017. Patients with history of antitubercular therapy in the past were excluded. The frequency of Treg cells in peripheral blood was determined by flow cytometry, and compared between CD and ITB patients.
Results
Similar to our previous study, frequency of Treg cells in peripheral blood was significantly increased in ITB as compared to CD patients (40.9 [interquartile range, 33–50] vs. 24.9 [interquartile range, 14.4–29.6], P< 0.001). Further, the receiver operating characteristics curve also showed good diagnostic accuracy with an area under the curve (AUC) of 0.77 (95% confidence interval, 0.65–0.89) and a FOXP3+ cutoff value of > 31.3% had a sensitivity and specificity of 83% and 82.6% respectively, to differentiate ITB from CD. Even for the indeterminate cases (n = 33), Treg cell frequency had similar diagnostic accuracy with an AUC of 0.85 (95% confidence interval, 0.68–0.95) and a cutoff of 32.37% had sensitivity and specificity of 87% and 95% respectively, to differentiate ITB from CD.
Conclusions
The current findings validate that the increased frequency of CD4+CD25+FOXP3+ Treg in the peripheral blood can be used as a biomarker with high diagnostic accuracy to differentiate ITB from CD. -
Citations
Citations to this article as recorded by- New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
Himanshu Narang, Saurabh Kedia, Vineet Ahuja
Current Opinion in Infectious Diseases.2024; 37(5): 392. CrossRef - Evidence-based approach to diagnosis and management of abdominal tuberculosis
Daya Krishna Jha, Mythili Menon Pathiyil, Vishal Sharma
Indian Journal of Gastroenterology.2023; 42(1): 17. CrossRef - Gut Microbiome in Probable Intestinal Tuberculosis and Changes following Anti-Tuberculosis Treatment
Hyuk Yoon, Young Soo Park, Cheol Min Shin, Nayoung Kim, Dong Ho Lee
Yonsei Medical Journal.2022; 63(1): 34. CrossRef - Single-nucleotide polymorphisms and activities of indoleamine 2,3-dioxygenase isoforms, IDO1 and IDO2, in tuberculosis patients
Tingming Cao, Guangming Dai, Hongqian Chu, Chengcheng Kong, Huijuan Duan, Na Tian, Zhaogang Sun
Hereditas.2022;[Epub] CrossRef - Recent advances in the diagnosis of intestinal tuberculosis
Hasan Maulahela, Marcellus Simadibrata, Erni Juwita Nelwan, Nur Rahadiani, Editha Renesteen, S. W. T. Suwarti, Yunita Windi Anggraini
BMC Gastroenterology.2022;[Epub] CrossRef - Addition of computed tomography chest increases the diagnosis rate in patients with suspected intestinal tuberculosis
Saurabh Kedia, Raju Sharma, Sudheer Kumar Vuyyuru, Deepak Madhu, Pabitra Sahu, Bhaskar Kante, Prasenjit Das, Ankur Goyal, Karan Madan, Govind Makharia, Vineet Ahuja
Intestinal Research.2022; 20(2): 184. CrossRef - Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef - Intestinal tuberculosis or Crohn's disease: Illusion or delusion or allusion
Saurabh Kedia, Vineet Ahuja
JGH Open.2021; 5(2): 177. CrossRef - Deep‐learning system for real‐time differentiation between Crohn's disease, intestinal Behçet's disease, and intestinal tuberculosis
Jung Min Kim, Jun Gu Kang, Sungwon Kim, Jae Hee Cheon
Journal of Gastroenterology and Hepatology.2021; 36(8): 2141. CrossRef - Mycobacterium tuberculosis (MTB) antigen-induced upregulation of interleukin-35 expression in patients with MTB infection: In vitro blockade of the effects of interleukin-35 on T lymphocyte subsets
Hongbin Jiang, Beinian Cui, Jun Zhang
Pathogens and Disease.2021;[Epub] CrossRef
- New diagnostic strategies to distinguish Crohn's disease and gastrointestinal tuberculosis
- 5,874 View
- 131 Download
- 8 Web of Science
- 10 Crossref
- IBD
- High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India
- Ashish Agarwal, Saurabh Kedia, Saransh Jain, Vipin Gupta, Sawan Bopanna, Dawesh P Yadav, Sandeep Goyal, Venigalla Pratap Mouli, Rajan Dhingra, Govind Makharia, Vineet Ahuja
- Intest Res 2018;16(4):588-598. Published online October 10, 2018
- DOI: https://doi.org/10.5217/ir.2018.00023
-
Abstract
PDFPubReaderePub
- Background/Aims
The data on the risk of tuberculosis (TB) reactivation with infliximab (IFX) in patients with inflammatory bowel disease (IBD) from TB endemic countries, like India, is limited. The risk of TB reactivation on IFX and its predictors in patients with IBD was assessed.
Methods
This retrospective review included consecutive patients with IBD who received IFX, and were on follow-up from January 2005 to November 2017. The data was recorded on age/disease duration, indications for IFX, screening for latent tuberculosis (LTB) before IFX, response to IFX, incidence and duration when TB developed after IFX, and type of TB (pulmonary [PTB]/extra-pulmonary [EPTB]/disseminated).
Results
Of 69 patients (22 ulcerative colitis/47 Crohn’s disease; mean age, 35.6±14.5 years; 50.7% males; median follow-up duration after IFX, 19 months [interquartile range, 5.5–48.7 months]), primary non-response at 8 weeks and secondary loss of response at 26 and 52 weeks were seen in 14.5%, 6% and 15% patients respectively. Prior to IFX, all patients were screened for LTB, 8 (11.6%) developed active TB (disseminated, 62.5%; EPTB, 25%; PTB, 12.5%) after a median of 19 weeks (interquartile range, 14.0–84.5 weeks) of IFX. Of these 8 patients’ none had LTB, even when 7 of 8 were additionally screened with contrast-enhanced chest tomography. Though not statistically significant, more patients with Crohn’s disease than ulcerative colitis (14.9% vs. 4.5%, P=0.21), and those with past history of TB (25% vs. 9.8%, P=0.21), developed TB. Age, gender, disease duration, or extraintestinal manifestations could not predict TB reactivation.
Conclusions
There is an extremely high rate of TB with IFX in Indian patients with IBD. Current screening techniques are ineffective and it is difficult to predict TB after IFX. -
Citations
Citations to this article as recorded by- Risk of tuberculosis with anti-TNF therapy in Indian patients with inflammatory bowel disease despite negative screening
Suprabhat Giri, Sukanya Bhrugumalla, Akash Shukla, Sagar Gangadhar, Srujan Reddy, Sumaswi Angadi, Leela Shinde, Aditya Kale
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Manish Manrai, Atul Abhishek Jha, Saurabh Dawra, Aditya Vikram Pachisia
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Didia B CURY, Liana C B CURY, Ana C MICHELETTI, Rogério A OLIVEIRA, José J S GONÇALVES
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Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
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Maede Ghanaeipour, Nima Behnaminia, Erfan Khadem, Amirhossein Nafari
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Suprabhat Giri, Harish Darak
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Peeyush Kumar, Sudheer Kumar Vuyyuru, Saurabh Kedia, Vineet Ahuja
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Peeyush Kumar, Sudheer K. Vuyyuru, Bhaskar Kante, Saurabh Kedia, Pabitra Sahu, Mukesh Kumar Ranjan, Sandeep Mundhra, Rithvik Golla, Mukesh Kumar, Shubi Virmani, Anvita Gupta, Nidhi Yadav, Govind Makharia, Vineet Ahuja
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- 31 Web of Science
- 35 Crossref
- Miscellaneous
- A simple phenotypic classification for celiac disease
- Ajit Sood, Vandana Midha, Govind Makharia, B. K. Thelma, Shivalingappa S Halli, Varun Mehta, Ramit Mahajan, Vikram Narang, Kriti Sood, Kirandeep Kaur
- Intest Res 2018;16(2):288-292. Published online April 30, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.2.288
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Celiac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.
Methods Various variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.
Results After empirical verification, age at diagnosis was considered appropriate in between A1 (<18) and A2 (≥18). The disease presentation has been classified into 3 types–P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.
Conclusions APC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis.
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Citations
Citations to this article as recorded by- Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India
Nidhya Ganesan, S. Shrinnivi, R. Shivani, R. K. Kartikayan
Medical Journal of Dr. D.Y. Patil Vidyapeeth.2024; 17(3): 616. CrossRef - Prevalence of haplotype DQ2/DQ8 and celiac disease in children with type 1 diabetes
Agnieszka Zubkiewicz-Kucharska, Tatiana Jamer, Joanna Chrzanowska, Katarzyna Akutko, Tomasz Pytrus, Andrzej Stawarski, Anna Noczyńska
Diabetology & Metabolic Syndrome.2022;[Epub] CrossRef - Celiac crisis, a rare occurrence in adult celiac disease: A systematic review
Daniel Vasile Balaban, Alina Dima, Ciprian Jurcut, Alina Popp, Mariana Jinga
World Journal of Clinical Cases.2019; 7(3): 311. CrossRef - The spectrum of clinical and subclinical endocrinopathies in treatment-naïve patients with celiac disease
Vipin Gupta, Alka Singh, Rajesh Khadgawat, Ashish Agarwal, Asif Iqbal, Wajiha Mehtab, P.K. Chaturvedi, Vineet Ahuja, Govind K. Makharia
Indian Journal of Gastroenterology.2019; 38(6): 518. CrossRef
- Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India
- 5,750 View
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- 4 Crossref
- IBD
- Are Truelove and Witts criteria for diagnosing acute severe colitis relevant for the Indian population? A prospective study
- Saransh Jain, Saurabh Kedia, Sawan Bopanna, Dawesh P Yadav, Sandeep Goyal, Peush Sahni, Sujoy Pal, Nihar Ranjan Dash, Govind Makharia, Simon P. L. Travis, Vineet Ahuja
- Intest Res 2018;16(1):69-74. Published online January 18, 2018
- DOI: https://doi.org/10.5217/ir.2018.16.1.69
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Truelove and Witts criteria have been used to define acute severe colitis since the 1950s. However, hemoglobin (an additional criterion of the definition) levels in the general population in developing countries are lower than in the population of developed countries. We aimed to determine the relevance of Truelove and Witts criteria in the Indian population.
Methods Consecutive patients with acute severe colitis satisfying the Truelove and Witts criteria, hospitalized at a single center between April 2015 and December 2016 were included. All patients received intravenous corticosteroids and 16 required colectomy. The hemoglobin levels at admission were subsequently excluded from the classification criteria, and the effect this had on the criteria for diagnosis was determined.
Results Out of 61 patients of acute severe colitis diagnosed according to the original Truelove and Witts criteria, 12 patients (20%) had 1 additional criterion, 33 (54%) had 2 additional criteria and 16 (26%) had 3 or more additional criteria in addition to 6 or more blood stained stools on admission. On excluding hemoglobin as an additional criterion from the Truelove and Witts definition, all patients still met the criteria for acute severe colitis.
Conclusions Truelove and Witts criteria can be used to define acute severe colitis in India, despite lower mean hemoglobin in the native population.
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Citations
Citations to this article as recorded by- Early management of acute severe UC in the biologics era: development and international validation of a prognostic clinical index to predict steroid response
Alex Adams, Vipin Gupta, Waled Mohsen, Thomas P Chapman, Deloshaan Subhaharan, Pradeep Kakkadasam Ramaswamy, Sudheer Kumar, Saurabh Kedia, Colleen GC McGregor, Tim Ambrose, Bruce D George, Rebecca Palmer, Oliver Brain, Alissa Walsh, Vineet Ahuja, Simon P
Gut.2023; 72(3): 433. CrossRef - Inflammatory bowel disease: An Indian perspective
Mayank Jain, Jayanthi Venkataraman
Indian Journal of Medical Research.2021; 153(4): 421. CrossRef - High Serum Osmolality May Predict the Disease Severity in Patients with Acute Ulcerative Colitis
Abdussamed VURAL, Aslı VURAL, Selahattin VURAL, Selim TURFAN, Ahmet Cumhur DÜLGER
Online Türk Sağlık Bilimleri Dergisi.2020; 5(2): 324. CrossRef Relationship Between Vitamin D Deficiency and Disease Activity in Patients with Inflammatory Bowel Disease in Ahvaz, Iran
Esmat Rasouli, Narges Sadeghi, Abazar Parsi, Seyed Jalal Hashemi, Morteza Nayebi, Aliakbar Shayesteh
Clinical and Experimental Gastroenterology.2020; Volume 13: 419. CrossRef- A current overview of corticosteroid use in active ulcerative colitis
Marco Salice, Fernando Rizzello, Carlo Calabrese, Lucia Calandrini, Paolo Gionchetti
Expert Review of Gastroenterology & Hepatology.2019; 13(6): 557. CrossRef - Optimal management of acute severe ulcerative colitis
Saransh Jain, Vineet Ahuja, Jimmy K Limdi
Postgraduate Medical Journal.2019; 95(1119): 32. CrossRef - A challenge in diagnosis and management of ulcerative colitis in elderly patient with atypical presentation: A reported case
Panutchaya Kongon, Vorapatu Tangsirapat, Vittawat Ohmpornuwat, Kannakrit Sumtong, Vichack Chakrapan Na Ayudhya, Kobkool Chakrapan Na Ayudhya, Paiboon Sookpotarom, Paisarn Vejchapipat
International Journal of Surgery Case Reports.2019; 61: 234. CrossRef
- Early management of acute severe UC in the biologics era: development and international validation of a prognostic clinical index to predict steroid response
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- Familial aggregation of inflammatory bowel disease in patients with ulcerative colitis
- Akshita Gupta, Sawan Bopanna, Saurabh Kedia, Dawesh Prakash Yadav, Sandeep Goyal, Saransh Jain, Govind Makharia, Vineet Ahuja
- Intest Res 2017;15(3):388-394. Published online June 12, 2017
- DOI: https://doi.org/10.5217/ir.2017.15.3.388
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Familial occurrence of inflammatory bowel disease (IBD) is well documented. Reports from Western countries have shown a higher familial occurrence of ulcerative colitis (UC) in first- and second-degree relatives than that in the Asian UC population. No data are currently available from the Indian subcontinent in this regard. We present our data on the familial aggregation of UC.
Methods Records of patients with UC followed at the Inflammatory Bowel Disease Clinic at the All India Institute of Medical Sciences, New Delhi from August 2004 to January 2016 were reviewed. Details regarding the prevalence of family history and characteristics of these patients were recorded. Affected family members were contacted and disease characteristics were noted for assessment of familial aggregation.
Results Of the 2,058 UC patients included in the analysis, a positive family history of IBD was confirmed in 31 patients (1.5%), 24 (77.4%) of whom had only first-degree relatives affected. All the affected relatives had UC and none had Crohn's disease. Among first-degree relatives, siblings were found to have the highest prevalence of IBD (53.3%), followed by parents (26.7%).
Conclusions The probability of occurrence of IBD in family members of affected North Indian UC patients is lower than that reported in Western populations.
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Citations
Citations to this article as recorded by- Childhood antibiotics as a risk factor for Crohn's disease: The ENIGMA International Cohort Study
Joyce W Y Mak, Sun Yang, Annalise Stanley, Xiaoqing Lin, Mark Morrison, Jessica Y L Ching, Junkun Niu, Amy L Wilson‐O'Brien, Rui Feng, Whitney Tang, Amy L Hamilton, Leo Or, Gina L Trakman, Winnie Y Y Lin, Joseph J Y Sung, Ming Hu Chen, Yinglei Mao, Michae
JGH Open.2022; 6(6): 369. CrossRef - Does the road to primary prevention of inflammatory bowel disease start from childhood?
Saurabh Kedia, Vineet Ahuja
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Junfeng Zou, Chen Liu, Shu Jiang, Dawei Qian, Jinao Duan, Anthony R. Richardson
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Nadim H Malibary, Mohammed A Ezzat, Ahmed M Mogharbel, Khalid A Kouzaba, Abdulaziz A Alkadi, Usama H Malki, Sultan M Gharib, Faisal M Altowairqi, Omar I Saadah, Mahmoud H Mosli
Cureus.2021;[Epub] CrossRef - Inflammatory bowel disease: An Indian perspective
Mayank Jain, Jayanthi Venkataraman
Indian Journal of Medical Research.2021; 153(4): 421. CrossRef - Familial aggregation of inflammatory bowel disease in India: prevalence, risks and impact on disease behavior
Rupa Banerjee, Partha Pal, Susan Hutfless, B Girish Ganesh, D Nageshwar Reddy
Intestinal Research.2019; 17(4): 486. CrossRef - Decreased Breg/Th17 Ratio Improved the Prognosis of Patients with Ulcerative Colitis
Xue Bing, Liang Linlang, Chen Keyan
Canadian Journal of Gastroenterology and Hepatology.2018; 2018: 1. CrossRef - Is the emergence of inflammatory bowel disease a prime example of “the third epidemiological transition”?
Saurabh Kedia, Vineet Ahuja
Indian Journal of Gastroenterology.2018; 37(3): 183. CrossRef
- Childhood antibiotics as a risk factor for Crohn's disease: The ENIGMA International Cohort Study
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- Evaluation of Xpert MTB/RIF assay performance in the diagnosis of abdominal tuberculosis
- Suraj Kumar, Sawan Bopanna, Saurabh Kedia, Pratap Mouli, Rajan Dhingra, Rajesh Padhan, Mikashmi Kohli, Jigyasa Chaubey, Rohini Sharma, Prasenjit Das, S Dattagupta, Govind Makharia, SK Sharma, Vineet Ahuja
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- DOI: https://doi.org/10.5217/ir.2017.15.2.187
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> The use of genetic probes for the diagnosis of pulmonary tuberculosis (TB) has been well described. However, the role of these assays in the diagnosis of intestinal tuberculosis is unclear. We therefore assessed the diagnostic utility of the Xpert
Mycobacterium tuberculosis /rifampicin (MTB/RIF) assay, and estimated the prevalence of multidrug-resistant (MDR) TB in the Indian population.Methods Of 99 patients recruited, 37 had intestinal TB; two control groups comprised 43 with Crohn's disease (CD) and 19 with irritable bowel syndrome. Colonoscopy was performed before starting any therapy; mucosal biopsies were subjected to histopathology, acid-fast bacilli staining, Lowenstein-Jensen culture, and nucleic acid amplification testing using the Xpert MTB/RIF assay. Patients were followed up for 6 months to confirm the diagnosis and response to therapy. A composite reference standard was used for diagnosis of TB and assessment of the diagnostic utility of the Xpert MTB/RIF assay.
Results Of 37 intestinal TB patients, the Xpert MTB/RIF assay was positive in three of 37 (8.1%), but none had MDR-TB. The sensitivity, specificity, positive predictive value, and negative predictive value of the Xpert MTB/RIF assay was 8.1%, 100%, 100%, and, 64.2%, respectively.
Conclusions The Xpert MTB/RIF assay has low sensitivity but high specificity for intestinal TB, and may be helpful in endemic tuberculosis areas, when clinicians are faced with difficulty differentiating TB and CD. Based on the Xpert MTB/RIF assay, the prevalence of intestinal MDR-TB is low in the Indian population.
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Harshal S. Mandavdhare, Harjeet Singh, Vishal Sharma
EMJ Gastroenterology.2017; : 52. CrossRef
- Perfusion Computed Tomography May Help in Discriminating Gastrointestinal Tuberculosis and Crohn’s Disease
- 6,486 View
- 95 Download
- 30 Web of Science
- 33 Crossref
Systematic Review
- Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis
- Saurabh Kedia, Raju Sharma, Vishnubhatla Sreenivas, Kumble Seetharama Madhusudhan, Vishal Sharma, Sawan Bopanna, Venigalla Pratap Mouli, Rajan Dhingra, Dawesh Prakash Yadav, Govind Makharia, Vineet Ahuja
- Intest Res 2017;15(2):149-159. Published online April 27, 2017
- DOI: https://doi.org/10.5217/ir.2017.15.2.149
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Abstract
PDFPubReaderePub
Abdominal computed tomography (CT) can noninvasively image the entire gastrointestinal tract and assess extraintestinal features that are important in differentiating Crohn's disease (CD) and intestinal tuberculosis (ITB). The present meta-analysis pooled the results of all studies on the role of CT abdomen in differentiating between CD and ITB. We searched PubMed and Embase for all publications in English that analyzed the features differentiating between CD and ITB on abdominal CT. The features included comb sign, necrotic lymph nodes, asymmetric bowel wall thickening, skip lesions, fibrofatty proliferation, mural stratification, ileocaecal area, long segment, and left colonic involvements. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (DOR) were calculated for all the features. Symmetric receiver operating characteristic curve was plotted for features present in >3 studies. Heterogeneity and publication bias was assessed and sensitivity analysis was performed by excluding studies that compared features on conventional abdominal CT instead of CT enterography (CTE). We included 6 studies (4 CTE, 1 conventional abdominal CT, and 1 CTE+conventional abdominal CT) involving 417 and 195 patients with CD and ITB, respectively. Necrotic lymph nodes had the highest diagnostic accuracy (sensitivity, 23%; specificity, 100%; DOR, 30.2) for ITB diagnosis, and comb sign (sensitivity, 82%; specificity, 81%; DOR, 21.5) followed by skip lesions (sensitivity, 86%; specificity, 74%; DOR, 16.5) had the highest diagnostic accuracy for CD diagnosis. On sensitivity analysis, the diagnostic accuracy of other features excluding asymmetric bowel wall thickening remained similar. Necrotic lymph nodes and comb sign on abdominal CT had the best diagnostic accuracy in differentiating CD and ITB.
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Citations
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Himanshu Narang, Saurabh Kedia, Vineet Ahuja
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EMJ Gastroenterology.2017; : 52. CrossRef
- Differentiation of Crohn's disease, ulcerative colitis, and intestinal tuberculosis by dual-layer spectral detector CT enterography
- 8,112 View
- 137 Download
- 27 Web of Science
- 29 Crossref
Original Article
- Role of random biopsies in surveillance of dysplasia in ulcerative colitis patients with high risk of colorectal cancer
- Sawan Bopanna, Maitreyee Roy, Prasenjit Das, S Dattagupta, V Sreenivas, V Pratap Mouli, Saurabh Kedia, Rajan Dhingra, Rajesh Pradhan, N Suraj Kumar, Dawesh P Yadav, Govind Makharia, Vineet Ahuja
- Intest Res 2016;14(3):264-269. Published online June 27, 2016
- DOI: https://doi.org/10.5217/ir.2016.14.3.264
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Abstract
PDFPubReaderePub
<b>Background/Aims</b><br/> Recent data suggest that the incidence of ulcerative colitis (UC) related colorectal cancer (CRC) in India is similar to that of West. The optimum method for surveillance is still a debate. Surveillance with random biopsies has been the standard of care, but is a tedious process. We therefore undertook this study to assess the yield of random biopsy in dysplasia surveillance.
Methods Between March 2014 and July 2015, patients of UC attending the Inflammatory Bowel Disease clinic at the All India Institute of Medical Sciences with high risk factors for CRC like duration of disease >15 years and pancolitis, family history of CRC, primary sclerosing cholangitis underwent surveillance colonoscopy for dysplasia. Four quadrant random biopsies at 10 cm intervals were taken (33 biopsies). Two pathologists examined specimens for dysplasia, and the yield of dysplasia was calculated.
Results Twenty-eight patients were included. Twenty-six of these had pancolitis with a duration of disease greater than 15 years, and two patients had associated primary sclerosing cholangis. No patient had a family history of CRC. The mean age at onset of disease was 28.89±8.73 years and the duration of disease was 19.00±8.78 years. Eighteen patients (64.28%) were males. A total of 924 biopsies were taken. None of the biopsies revealed any evidence of dysplasia, and 7/924 (0.7%) were indefinite for dysplasia.
Conclusions Random biopsy for surveillance in longstanding extensive colitis has a low yield for dysplasia and does not suffice for screening. Newer techniques such as chromoendoscopy-guided biopsies need greater adoption.
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Citations
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Roberto Gabbiadini, Ferdinando D’Amico, Alessandro De Marco, Maria Terrin, Alessandra Zilli, Federica Furfaro, Mariangela Allocca, Gionata Fiorino, Silvio Danese
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Oleg V. Knyazev, Sergey G. Khomeriki, Аnna V. Kagramanova, Albina A. Lishchinskaya, Olga A. Smirnova, Karina K. Noskova, Asfold I. Parfenov
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Hyo Jun Ahn, Sang-Bum Kang
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Dong Soo Han
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