Crohn disease is an inflammatory condition of the gastrointestinal tract with episodes of exacerbation and remission occurring in children, adolescents, and adults. Crohn disease diagnosis and treatment depend upon a combination of clinical, laboratory, endoscopic, histological, and imaging findings. Appropriate use of imaging provides critical information in the settings of diagnosis, assessment of acute symptoms, disease surveillance, and therapy monitoring. Four variants are discussed. The first variant discusses the initial imaging for suspected Crohn disease before established diagnosis. The second variant pertains to appropriateness of imaging modalities during suspected acute exacerbation. The third variant is a substantial discussion of recommendations related to disease surveillance and monitoring of Crohn disease. Finally, panel recommendations and discussion of perianal fistulizing disease imaging completes the document. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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http://dx.doi.org/10.1016/j.jacr.2022.02.020 | DOI Listing |
BMC Med Res Methodol
December 2024
Janssen Research & Development LLC, Global Epidemiology Organization, Raritan, NJ, USA.
Background: Autoimmune disorders have primary manifestations such as joint pain and bowel inflammation but can also have secondary manifestations such as non-infectious uveitis (NIU). A regulatory health authority raised concerns after receiving spontaneous reports for NIU following exposure to Remicade, a biologic therapy with multiple indications for which alternative therapies are available. In assessment of this clinical question, we applied validity diagnostics to support observational data causal inferences.
View Article and Find Full Text PDFDig Liver Dis
December 2024
Gastroentrology Department, Hospital Germans Trias i Pujol, 08916 Badalona, Catalonia, Spain; CIBEREHD, Madrid, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Catalonia, Spain. Electronic address:
Background: Endoscopic evaluation 6-12 months after ileocolonic resection (ICR) in Crohn's disease (CD) is advised to assess the development of postoperative recurrence (POR) but no further recommendations are available for long-term monitoring if no POR is noticed.
Methods: Prospective, open-label, study including asymptomatic patients with CD and ICR in whom no POR was observed at the last endoscopic evaluation. Patients were followed-up for two years and ileocolonoscopy was performed by means of a faecal calprotectin (FC)-based strategy.
J Clin Gastroenterol
October 2024
Department of Pathology, School of Medicine, Lebanese American University, Byblos, Lebanon.
Background: Lymphocytic esophagitis (LyE) is a rare condition that has been reported in several case studies, but its diagnostic criteria and clinical significance are inconsistent. There are no established clinical associations, except for Crohn's disease in children. Our study aimed to determine if patients with LyE have distinct demographic or clinical characteristics when compared with patients with increased intraepithelial lymphocytes (IEL) in their esophageal biopsy.
View Article and Find Full Text PDFJ Clin Gastroenterol
October 2024
Division of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Mayo Clinic, Jacksonville, FL.
Background: Video capsule retention is a complication that can have serious consequences in patients with Crohn's disease (CD). The patency capsule was developed to detect small bowel strictures. The usefulness of patency capsules in patients who do not have evidence of small bowel disease on imaging is uncertain.
View Article and Find Full Text PDFCancer Genet
December 2024
School of Life Sciences, Shanghai University, Shanghai 200444, China. Electronic address:
CD4 T cells play a pivotal role in the immune system, particularly in adaptive immunity, by orchestrating and enhancing immune responses. CD4 T cell-related immune responses exhibit diverse characteristics in different diseases. This study utilizes gene expression analysis of CD4 T cells to classify and understand complex diseases.
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