In the pediatric population, MCD typically presents from the ages of 10 to 14, with about 50% of these patients having concurrent Crohn disease.
12,18,20) Although Crohn disease typically affects the terminal ileum more often than the large bowel, cutaneous manifestations of Crohn disease appear to occur more often in patients who have involvement of the colon.
Metastatic Crohn disease presents microscopically as sterile, noncaseating granulomatous inflammation located primarily in the superficial papillary and deep reticular dermis with occasional extension into the subcuticular fat (Figures 2 through 5).
In the present comprehensive metaanalysis of 79 studies (in 75 reports) including 18 727 Crohn disease cases and 17 102 controls, we attempt to address these questions and at the same time give an updated view of this research area.
Studies of the NOD2 variants Arg702Trp, Gly908Arg, and Leu1007fsinsC, and the risk of Crohn disease and/or ulcerative colitis published before May 25, 2009, were identified through computer-based searches of PubMed, EMBASE, and Web of Science.
Initially, we found 117 potential hospital- or population-based case-control studies with Crohn disease as cases and identified 39 studies with ulcerative colitis as cases.
These approaches include specific medical therapy for Crohn disease, vasopressin infusion, infliximab, endoscopic sclerotherapy, or angiographic intervention and surgery.
Thrombophilia in Crohn disease is probably due to inappropriate hemostasis with a hypercoagulable state, thrombocytosis, hyperfibrinogenemia, hyperhomocysteinemia and increased levels of lipoproteins, which probably play a role in local microcirculatory alterations leading to CD itself.
Successful treatment of severe gastrointestinal bleeding secondary to Crohn disease with recombinant factor VIIa.
Several studies have reported the presence of MAP DNA in association with Crohn disease
, although culture confirmation remains rare in these patients (5,6).
In reviewing resection specimens of Crohn disease from the ileum, we have noted an extensive proliferation of smooth muscle obliterating the submucosa.
We reviewed 50 ileal partial resections from adult patients with indisputable diagnosis of Crohn disease examined during 1995-2000.
Additional features of Crohn disease, such as fissuring ulcers, granulomas, lymphoid aggregates, and pseudopyloric metaplasia, were also noted in most of the cases.