Definition Risk Factors Differential diagnosis Epidemiology - Tends to present initially in the teens and twenties,
with another peak incidence in the fifties to seventies
- Prevalence ( Northern Europe): 27–48 per 100,000
- Higher incidence in western industrialized nations compared to other
parts of the world
- Males and females are equally affected
- Smokers are
two times more likely to develop Crohn's disease than nonsmokers.[5]
- Genetic link
Aetiology - autoimmune disease of the gastrointestinal tract
- Inflammation stimulated by an overactive Th1 cytokine response
- Th17 is of greater importance in the disease?[54]
- ATG16L1 may induce autophagy and hinder the body's ability to attack invasive bacteria
- Increasing body of evidence in
favor of the hypothesis that Crohn's disease results from an impaired
innate immunity
Clinical features Pathophysiology - Transmural pattern of inflammation
- Ulceration
is an outcome seen in highly active disease
- Usually an abrupt
transition between unaffected tissue and the ulcer.
- Mucosal inflammation, characterized by focal infiltration of neutrophils into the epithelium
- Neutrophils, along with mononuclear cells, may infiltrate the crypts, leading to inflammation (crypititis) or abscess (crypt abscess)
- Granulomas are found in 50% of cases and are
most specific for Crohn's disease
- Biopsies may also show chronic mucosal damage, as evidenced by blunting of the intestinal villi, atypical branching of the crypts, and a change in the tissue type (metaplasia)
InvestigationsManagementa) conservativeb) medical c) surgical- used when partial or a full blockage of the intestine occurs
Prognosis |
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