• Title/Summary/Keyword: Crohn

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Steroid-induced Psychosis in Adolescent Patient with Crohn's Disease

  • Kim, Jin Woo;Kang, Ki Soo;Kang, Na Ri
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.3
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    • pp.161-164
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    • 2020
  • Crohn's disease is a chronic inflammatory disease that involves the upper and lower gastrointestinal tracts, including the oral cavity. For the conventional treatment of inflammatory bowel diseases, steroids are usually used as induction therapy, and azathioprine is used as maintenance therapy. Steroids are associated with various side effects. Under rare circumstances, they can even cause psychotic symptoms, and reports on steroid-induced psychosis in the pediatric population are few. Here, we report the first case of steroid-induced psychosis in a 16-year-old female with Crohn's disease administered with steroids as induction therapy in South Korea. She showed psychotic symptoms, including auditory hallucination, loosening of association, and idea of reference, after 2 weeks of administering prednisolone 60 mg/day. One week after steroid discontinuation, the patient gradually recovered and was treated with quetiapine. Therefore, pediatricians should be aware of serious psychiatric adverse effects when administering corticosteroids for various indications.

Depression and Risk Factors in Patients with Crohn's Disease (크론병 환자의 우울과 위험요인)

  • Cho, Ok-Hee;Yoo, Yang-Sook;Yang, Suk-Kyun
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.207-216
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    • 2012
  • Purpose: This study was conducted to determine the risk factors among patients with depression with Crohn's disease. Methods: Data were collected by questionnaire from 276 patients who were diagnosed with Crohn's disease at a tertiary hospital located in Seoul. Measurements included patients' demographic characteristics, clinical characteristics, depression level, and health-related quality of life. Data were analyzed using t-test, $X^2$-test, Wilcoxon rank sum test, and logistic regression analyses. Results: The incidence rate of depression (BDI-II${\geq}$14scores) was 31.9% (n=88). Univariate analysis revealed that being a woman, school graduation status, economic status (low), BMI(<$18.5Kg/m^2$), disease duration (${\geq}3$ years), CDAI (${\geq}150$ scores), frequency of hospital admission (${\geq}2$), extra-intestinal manifestation (arthralgia, stomatitis), administration of 5-aminosalicylic acid, and disease related quality of life (SIBDQ<50 scores) were associated with depression. Multivariate analysis revealed that economic status (low), school graduation status, and quality of life (SIBDQ<50 scores) were more likely to report high level of depression. Conclusion: Future research should consider managing depression as an essential component of comprehensive care for patients with Crohn's disease. In addition, further research is needed to develop strategies to better improve quality of life among patients with Crohn's disease who are depressed.

The oriental-western literal study of Crohn's disease (크론씨병(극한성(局限性) 장염(腸炎))에 관(關)한 한의학적(韓醫學的) 고찰(考察))

  • Choi, Chang-Woo;Son, Chang-Gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.9 no.2
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    • pp.251-268
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    • 2001
  • We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

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A Case Report on Korean Medical Treatment for Induced Remission of Pediatric Crohn's Disease (한방치료로 관해가 유도된 소아 크론병 환자의 증례 보고)

  • Lee, Hyun-Jin;Lee, Hanul;Jeong, Hae In;Cho, Yun-jae;Keum, Chang-Yul;Han, Aram;Ha, Na-yeon;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.853-862
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    • 2021
  • Objectives: This case study examined the effectiveness of Korean medical treatment for pediatric Crohn's disease. Methods: A 15-year-old female Korean patient with Crohn's disease received acupuncture, electroacupuncture, herbal medicine, moxibustion, and aromatherapy treatment for 1 month in a hospital. Results: Decreases in the Pediatric Crohn's Disease Activity Index score (from 22.5 to 7.5) and the size of two abscesses (from 39.97 mm to 33.36 mm, and from 28.14 mm to 18.71 mm) according to an abdominal CT were observed following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Conclusion: It would be worth examining the long-term effectiveness of Korean medical treatment for pediatric Crohn's disease.

Imaging Techniques and Differential Diagnosis for Inflammatory Bowel Disease (염증성 장질환의 영상기법 및 감별진단)

  • Kyoung Doo Song
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.536-549
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    • 2023
  • The two main types of inflammatory bowel disease (IBD) are Crohn's disease and ulcerative colitis. Currently, when IBD is suspected, CT enterography is widely used as an initial imaging test because it can evaluate both the bowel wall and the outside of the bowel, helping to differentiate IBD from other diseases. When IBD is suspected, it is necessary to distinguish between Crohn's disease and ulcerative colitis. In most cases this is not difficult; however, in some cases, it is difficult and such cases are called IBD-unclassified. CT findings are often non-specific for ulcerative colitis, making it difficult to differentiate it from other diseases using imaging alone. In contrast, characteristic CT findings for Crohn's disease are often helpful in diagnosis, although diseases, such as tuberculous enteritis can mimic Crohn's disease. Recently, mutations in the gene encoding a prostaglandin transporter called SLCO2A1 have been discovered as the cause of the disease in some patients with multiple ulcers and strictures, similar to Crohn's disease. Therefore, genetic testing is being used to make a differential diagnosis.

Mucosal Immunity Related to FOXP3+ Regulatory T Cells, Th17 Cells and Cytokines in Pediatric Inflammatory Bowel Disease

  • Cho, Jinhee;Kim, Sorina;Yang, Da Hee;Lee, Juyeon;Park, Kyeong Won;Go, Junyong;Hyun, Chang-Lim;Jee, Youngheun;Kang, Ki Soo
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.336.1-336.12
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    • 2018
  • Background: We aimed to investigate mucosal immunity related to forkhead box P3 ($FOXP3^+$) regulatory T (Treg) cells, T helper 17 (Th17) cells and cytokines in pediatric inflammatory bowel disease (IBD). Methods: Mucosal tissues from terminal ileum and colon and serum samples were collected from twelve children with IBD and seven control children. Immunohistochemical staining was done using anti-human FOXP3 and anti-$ROR{\gamma}t$ antibodies. Serum levels of cytokines were analyzed using a multiplex assay covering interleukin $(IL)-1{\beta}$, IL-4, IL-6, IL-10, IL-17A/F, IL-21, IL-22, IL-23, IL-25, IL-31, IL-33, interferon $(IFN)-{\gamma}$, soluble CD40L, and tumor necrosis factor-${\alpha}$. Results: $FOXP3^+$ Treg cells in the lamina propria (LP) of terminal ileum of patients with Crohn's disease were significantly (P < 0.05) higher than those in the healthy controls. $ROR{\gamma}t^+$ T cells of terminal ileum tended to be higher in Crohn's disease than those in the control. In the multiplex assay, serum concentrations (pg/mL) of IL-4 ($9.6{\pm}1.5$ vs. $12.7{\pm}3.0$), IL-21 ($14.9{\pm}1.5$ vs. $26.4{\pm}9.1$), IL-33 ($14.3{\pm}0.9$ vs. $19.1{\pm}5.3$), and $IFN-{\gamma}$ ($15.2{\pm}5.9$ vs. $50.2{\pm}42.4$) were significantly lower in Crohn's disease than those in the control group. However, serum concentration of IL-6 ($119.1{\pm}79.6$ vs. $52.9{\pm}39.1$) was higher in Crohn's disease than that in the control. Serum concentrations of IL-17A ($64.2{\pm}17.2$ vs. $28.3{\pm}10.0$) and IL-22 ($37.5{\pm}8.8$ vs. $27.2{\pm}3.7$) were significantly higher in ulcerative colitis than those in Crohn's disease. Conclusion: Mucosal immunity analysis showed increased $FOXP3^+$ T reg cells in the LP with Crohn's disease while Th17 cell polarizing and signature cytokines were decreased in the serum samples of Crohn's disease but increased in ulcerative colitis.

Network Analysis of Prescriptions for Inflammatory Bowel Disease - Preliminary Exploration of Prescriptions Using the K-HERB Database - (염증성 장질환 처방에 대한 네트워크 분석 - K-HERB 데이터베이스를 활용한 예비적 처방 탐색 -)

  • Jae-Yeon Lee;Yu-Gyeong Lee;Yeon-Hwa Lee;Seojung Ha;Bo-In Kwon
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.2
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    • pp.131-150
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    • 2024
  • Objectives : The aim of this study was to perform network analysis and analysis using the K-HERB database on inflammatory bowel disease (IBD), to verify the similarity between the derived networks and existing prescriptions, and to explore the possibility of developing new IBD prescriptions preliminarily. Methods : We conducted a comprehensive literature search on July 6, 2024, utilizing databases such as ScienceON, RISS, and OASIS. Clinical studies assessing the efficacy of herbal medicine in treating Crohn's disease and ulcerative colitis were identified and compiled into a structured database. This dataset, which included related prescriptions and herbal formulations, was subsequently analyzed using NetMiner 4 for centrality and Louvain clustering analyses. We then compared the networks derived from the K-HERB database with existing therapeutic prescriptions to assess their similarity. Results : A total of 24 prescriptions and 66 herbs were identified across the surveyed studies on IBD. Paeoniae Radix Alba(白芍藥) emerged as the most frequently utilized herb for both Crohn's disease and ulcerative colitis. Prominent herb combinations included Paeoniae Radix Alba-Angelicae Sinensis Radix (白芍藥-當歸), Angelicae Sinensis Radix-Coptidis Rhizoma (當歸-黃連), and Coptidis Rhizoma-Scutellariae Radix (黃連-黃芩) for ulcerative colitis. Centrality analysis revealed that Poria cocos (茯苓) and Paeoniae Radix Alba (白芍藥) had high centrality in the Crohn's disease, while Angelicae Sinensis Radix (當歸) and Paeoniae Radix Alba (白芍藥) had high centrality in the ulcerative colitis, indicating their prominent roles within the networks. Cohesion analysis resulted in 7 networks for Crohn's disease and 16 networks for ulcerative colitis. After excluding networks with a single herb, three networks related to Crohn's disease and two related to ulcerative colitis were examined using the K-HERB database. Among the 14 derived prescriptions for Crohn's disease and seven for ulcerative colitis, all except Oryeong-san (五苓散) were non-traditional in the context of IBD treatment. Conclusion : This preliminary study may provide a basis for the understanding and application of herbal prescriptions for IBD based on network analysis and the K-HERB database.

A Case Study of Suspected Crohn's Disease Treated with Bojanggunbi-tang (보장건비탕(補腸健脾湯)으로 증상 호전 보인 크론병 의증 1례(例))

  • Seo, Soo-Hyun;Jeong, Jae-Ook;Lee, Eun-Hyung;Choi, In-Seon;Park, Sang-Eun;Kim, Won-Il;Kim, Woo-Hwan
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.648-654
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    • 2004
  • The following case study illustrates the administration of Bojanggunbi-tang in the treatment of a man diagnosed as having Crohu's disease. The usual gastrointestinal symptoms of Crohu's disease are diarrhea, abdominal pain and weight loss, in addition to anemia and rectal bleeding. A l6-year-old man diagnosed with Crohn's disease, who was treated at our clinic, had symptoms such as diarrhea, abdominal pain, weight loss, anemia and rectal bleeding. He was treated with Bojanggunbi-tang. For the two months the symptoms were considerably reduced. The result supports the clinical efficacy of Bojanggunbi-tang for the treatment of the symptoms of suspected Crohn's disease.

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Gliotoxin Protects Trinitrobenzene Sulfonic Acid-Induced Colonic Damage through Induction of Heme Oxygenase-1

  • Oh, Jaemin;Hur, Jungmu;Kim, Yourim;Kwon, Young-Mi;Kim, Kyungsuk;Chung, Yeuntai;Choi, Minkyu
    • Toxicological Research
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    • v.20 no.4
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    • pp.293-298
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    • 2004
  • Background: Crohn's disease is characterized by a chronic relapsing inflammation of the bowel. Gliotoxin has been known to play strong immunosuppressive properties, while mechanisms for its anti-inflammatory actions are not completely understood. Here, we investigated the effects of gliotoxin in trinitrobenzene sulfonic acid (TNBS) induced mouse colitis, an animal model of Crohn's disease. Results: Gliotoxin dramatically improved clinical and histopathological symptoms in accompanied with reduced expression of TNF-$\alpha$, IL-1$\beta$, and ICAM-1 protein levels in TNBS induced colitis. Interestingly Gliotoxin induced Heme oxygenase-1 (HO-1) and the HO-1 inducer cobalt protoporphyrin IX (CoPPIX) completely mimicked the protective effects of gliotoxin in TNBS induced colitis mice. In contrast, the HO-1 inhibitor zinc protoporphyrin IX (ZnPPIX) could reverse the anti-inflammatory effects of gliotoxin and CoPPIX. Conclusions: Gliotoxin is a potential therapeutic agent targeting for the treatment of Crohn's disease by inducing HO-1.