Aims and objectives
Crohn’s disease (CD) is a chronic inflammatory disease of the gastro-intestinal tract that usually affects young people [1,
2,
3].
Any part of the gastro-intestinal tract can be involved and multiple intestinal segments are often affected [4].
Many medicaments are used in the therapy (corticosteroids,
5-aminosalicylate,
azathioprine,
antibiotics,
inhibition of tumor necrosis factor),
but only few patients remain in clinical remission in spite of a prolonged medical therapy [5,
6].
In general,
drugs are effective in decreasing inflammation but does not modify the long-standing fibrotic...
Methods and materials
This is a retrospective study performed at a single tertiary inflammatory bowel disease (IBD) referral center and approved by our institutional review board.
Using the hospital information system and patient databases,
we identified 160 patients with previous histological diagnosis of Crohn’s disease performed by endoscopy or surgery.
46 patients (24 men and 22 women; age range 16–78 years,
mean 36.8 years,
table 1) repeated MRE after medical therapy within 6 months,
so they were selected for the study.
In our hospital we evaluated HB index...
Results
A total of 46 patients were included in this study.
7 patients (15%) had previous intestinal (ileal-colon or ileal) resection.
Mean Harvey Bradshaw Index before therapy was 5.3; a total of 28 patients (61%) had a clinically active disease,
defined as HBI > 4 (table 1).
Concerning the use of N-butyl-hyoscine bromide,
it was administered I.V.
in all patients and no side effects were observed.
MRE before therapy showed a total number of 77 sites of disease,
affecting prevalently the distal ileum (42 lesions,
55%)....
Conclusion
In patients with Crohn’disease quantitative and periodical assessment of disease activity is crucial to plan the adequate therapy and to monitor drug effects.
In our study we have compared MaRIA score and HBI.
MRE and clinical judgment was in agreement in 72% of the patients and showed statistically significant concordance (K Cohen = 0.49).
In particular,
the MaRIA score after therapy significantly decreased in patients with clinical improvement but it did not significantly increase in impaired patients; however in impaired patients MaRIA scores were particularly...
References
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Pariente B,
Cosnes J,
Danese S et al.
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Van Assche...