Cytokine Therapies for Crohn’s Disease

Posted by e-Medical PPT Tuesday, March 13, 2012
Crohn’s Disease is a Chronic, transmural inflammatory disease of the GIT of unknown cause.Most commonly affects the small intestine and colon.
Clinical manifestations
 Abdominal pain
 Diarrhea
 Weight loss
Complications
 Intestinal obstruction
 Localized perforation with fistula formation
Medical and surgical treatments are palliative
Operative therapy can provide effective symptomatic relief

Gross Pathologic Features
Thickened grayish-pink or dull purple-red loops of bowel
“Skip areas”
“Fat wrapping”
thickened, firm, rubbery and virtually incompressible bowel wall
Internal fistulas
Thickened mesentery with enlarged LN
“Transmural inflammation”
“Cobblestone appearance”

Microscopic Features
Mucosal and submucosal edema
Chronic inflammatory infiltrate
Noncaseating granulomas

Medical therapy
Aminosalicylates (e.g., sulfasalazine, mesalamine)
Corticosteroids
Immunosuppressive agents (e.g., azathioprine, 6-mercaptopurine, and methotrexate)
Antibiotics (metronidazole, ciprofloxacin, tetracycline, ampicillin, and clindamycin)
Infliximab (anti-TNF-a antibody)
Surgery

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