medigraphic.com
ISSN 1561-3011 (Electronic)

2014, Number 3

Next >>

Rev Cubana Invest Bioméd 2014; 33 (3)

Characterization of patients with Crohn's disease cared for at the Institute of Gastroenterology of Cuba

Hano GOM, Andrade GS, Villa JOM, González FL, Wood RL

Language: Spanish
References: 47
Page: 253-267
PDF size: 201.19 Kb.


ABSTRACT

Introduction: crohn's disease is a chronic inflammatory condition affecting any portion of the digestive tract. Its cause is still unknown.
Objective: characterize patients with Crohn's disease cared for at the Institute of Gastroenterology of Cuba from January 2011 to December 2012.
Methods: a descriptive cross-sectional study was conducted based on variables such as age at diagnosis, sex, race, province and place of residence, smoking, disease site, clinical manifestations, intestinal and extraintestinal complications, drugs used, reasons for surgical treatment and death.
Results: eighty patients with Crohn's disease were studied. Mean age at diagnosis was 35.1 ± 15 years. No differences were found between the sexes and the white race predominated. There was a larger number of patients from Havana, from urban areas, and non-smokers. The ileocolic site was the most common, followed by the ileal site. The most frequent clinical manifestations were diarrhea, abdominal pain and abdominal distension.
Conclusions: intestinal complications were relatively infrequent, with a predominance of stenosis and fistulas. Joint-related complications were the most common, followed by hepatobiliary and hematological complications. The drug therapy most commonly used was azulfidine, mesalazine and prednisone administered orally. The most frequent reasons for surgical treatment were benign stenosis and intestinal occlusion. The causes of mortality were septicemia and brain tumor, with one patient each.


REFERENCES

  1. Departamento de Medicina del Hospital Clínico, Universidad de Chile. Enfermedad inflamatoria: Fisiopatología, Epidemiologia y Diagnóstico. Medwave. 2005 Oct.[consultado: 4 de enero de 2014];5(8). Disponible en: http://www.medwave.cl/link.cgi/Medwave/Reuniones/medicina/2005/7/2527

  2. Hanauer SB, Sandborn W. Practice Parameters Committee of the American College of Gastroenterology. Management of Crohn’s disease in adults. Am J Gastroenterol. 2001;96:635-43.

  3. Bernstein C, Fried M, Krabshuis H, Cohen H, Eliakim R, Gearry R, et al. Guías Mundiales de la Organización Mundial de Gastroenterología. 2009. [consultado: 9 de marzo de 2014]. Disponible en: http://www.worldgastroenterology.org/assets/downloads/es/pdf/guidelines/21_inflam matory_bowel_disease_es.pdf.

  4. Kasper DL, Braunwald E, Fauci AS, Hanser SL, Longo DL Jameson L. Enfermedad Inflamatoria Intestinal. Harrison, Principles of Internal Medicine. Vol 16. Ed. 15ª. USA: The McGraw Hill; 2006, pp. 214-80.

  5. Figueroa C, Quera PR. Papel del sistema inmune en el desarrollo de las EII. Gastroenterol Latinoam. 2005;16(3):229-42.

  6. Editora Médica Digital. Patogenia y tratamiento de la inflamación del aparato digestivo. Dig Dis. 2009;27(4):455-64.

  7. Fava F, Danese S. Intestinal microbiota in inflammatory bowel disease: Friend of foe? World J Gastroenterol. 2011 February 7;17(5):557-66.

  8. Jostins L, Ripke S, Weersma RK. Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease. Nature. 2012;491:119-24.

  9. Gisbert JP, Gomolllon F, Mate J, Pajares JM. The role of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) in inflammatory bowel disease. Gastroenterol Hepatol. 2003;26:312-24.

  10. Satsangi J, Kennedy NA, Henderson P, Wilson DC, Nimmo ER. Exploring the hidden heritability of inflammatory bowel disease. Gut Online First (published on September 6, 2011). [consultado: 9 de marzo de 2014]. Disponible en: http://gut.bmj.com/content/early/2011/09/06/gutjnl-2011-300804.short

  11. Feldman M, Friedman SL, Brandt LJ. Sleisenger and Fordtran. Gastrointestinal and Liver Disease. Tomo 2, sección 10, capítulo 111 y 112. 9na edición. Philadelphia: Saunders, an imprint of Elseiver science, 2010. pp. 1491-2010.

  12. Leóna AJ, Garrote JA. Citocinas en la patogenia de la enfermedad inflamatoria intestinal. Barcelona. Med Clin. 2006;127:145-52.

  13. Loftus EV. New Data on the Use of Biologic Agents for Crohn’s Disease and Ulcerative Colitis. Gastroenterol Hepatol. 2010 February; 6(2_Suppl):4-16.

  14. Cabré Gelada E. Manifestaciones y complicaciones extraintestinales de la enfermedad inflamatoria intestinal. Faes Farma, Claversal. Barcelona; 2007, pp. 5-51.

  15. Brazilian Study Group of Inflammatory Bowel Diseases. Consensus guidelines for the management of inflammatory bowel disease. Arq Gastroenterol. 2010;47(3):313-25.

  16. López Blanco B, Moreno-Jiménez B, Devesa Mujica JM, Rodríguez Muñoz A. Relación entre variables sociodemográficas y clínicas y calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal. Rev Esp Enferm. 2005;97(12):887-98.

  17. Jiménez Mesa G, García Hano O. Seguimiento de 83 pacientes con enfermedad de Crohn durante 10 años en nuestro centro. Rev Cubana Cir [revista en la Internet]. 1995 Jun [citado 2013 Dic 27] ; 34(1): . Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74931995000100010&lng=es.

  18. Studd CR, Connell W, Desmond PV. Establishing a pilot population based inflammatory bowel disease registry in Australia. Journal of Gastroenterology and Hepatology. 2011;26(Suppl. 4): 594-6.

  19. Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterol. 2011;140:1785-94.

  20. Hano García OM, Jiménez Mesa G, Piñol Jiménez P. Pesquisaje de AgsHB y de anti-HVC en pacientes con enfermedad inflamatoria intestinal crónica. Rev Cubana Hig Epidemiol. 1998;36(2):127-30.

  21. Pérez F. Comportamiento de la E.I.C.I. en pacientes ingresados en el Instituto de Gastroenterología durante quince años (1980-1995). Tesis para optar por el título de especialista en Gastroenterología. Marzo 1997.

  22. Munkholm P. Crohn’s disease-occurrence, course and prognosis. An epidemiologic cohort-study. Dan Med Bull. 1997; 44:287-302.

  23. Juillerata P, Pittetb V, Bulliardb JL, Guessous I, Teodora A, Motteta C, et al. Prevalence of Inflammatory bowel disease in the Canton of Vaud (Switzerland): A population-based cohort study. Journal of Crohn & Colitis. 2007;2(2):131-41.

  24. Gearry RB, Richardson A, Frampton CM. High incidence of Crohn’s disease in Canterbury, New Zealand: results of an epidemiologic study. Inflamm Bowel Dis. 2006;12:936-43.

  25. Loftus EV, Sandborn WJ. Epidemiology of inflammatory bowel disease. Gastroenterol Clin N Am. 2002; 31:1-20.

  26. Thukkani N, Sonnemberg A. Epidemiologic characteristics of patients with inflammatory bowel disease undergoing colonoscopy. Inflammatory bowel disease. 2011 Jun;17(6):1333-7.

  27. Molodecky NA, Panaccione R, Ghosh S, Barkema HW, Kaplan G, Environmental Determinants of IBD. Clinical Review. Inflamm Bowel Dis. 2011;17(8):1992-8.

  28. Rosenfeld G, Bressler Brian. The Truth about Cigarette Smoking and the Risk of Inflammatory Bowel Disease. Am J Gastroenterol. 2012;107:1407-8.

  29. Leung Y, Kaplan GG, Rioux KP, Hubbard J, Kamhawi S, Devlin SM, et al. Assessment of variables associated with smoking cessation in Crohn’s disease. Dig Dis Sci. 2012 Apr;57(4):1026-3.

  30. Grupo Español de trabajo en EC y CU ¿Tan importante es el tabaco en la enfermedad de Crohn? Enfermedad Inflamatoria Intestinal. Al Día. 2009;8(2):112-23.

  31. Rameshshanker R. Endoscopy in IBD. World J Gastrointest Endosc. 2012 June 16;4(6):201-11.

  32. Gasche C, Scholmerich J, Brynskov J. A simple classification of Crohn’s disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflamm Bowel Dis. 2000;6:8-15.

  33. Ye DB, Kim HS, Kim YH, Kim ES, Yang SK, Kim WH et al. The clinical characteristics at diagnosis and course of Crohn’s disease: A Korean multicenter study. Inflammatory Bowel Diseases. Crohn´s and Colitis Foundation of America. Florida. 2011;17(2).

  34. Prideaux L, Kamm MA. Crohn’s disease phenotype at diagnosis is more severe in the east (China) in the west (Australia) and is managed differently. Journal of Gastroenterology and Hepatology. 2011;26(Suppl. 4):56-67.

  35. Mowat C, Cole A, Windsor AL, Ahmad T, Arnott I, Richard Driscoll, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011;60:571-607.

  36. Vermeire S, Van Assche G, Rutgeerts P. Classification of inflammatory bowel disease: the old and the new. Curr Opin Gastroenterol. 2012 Jul;28(4):321-6.

  37. Lana Soto R. Enfermedad de Crohn fistulosa perianal. Espan. Emergencias. 2006;18:36-40.

  38. Medina BE, Lugo DF, Cortina LS. Bozano GP. Enfermedad Inflamatoria Intestinal. Protocolos diagnóstico-terapéuticos de Gastroenterología, Hepatología y Nutrición. Madrid: Ergon. 2010, pp. 151-60.

  39. Vavricka SR, Brun L, Ballabeni P. Frequency and risk factors for extraintestinal manifestations in the Swiss Inflammatory Bowel Disease Cohort. Am J Gastroenterol. 2011;106:110-19.

  40. Brakenhoff L, Heijde DMV, Homes DW. IBD and arthropathies: a practical approach to its diagnosis and management. Netherland. Gut 2011;60:1426-35.

  41. Hano García OM, Ojeda Abizaid YT, González Fabián L, Sánchez Rodríguez YA. Manifestaciones hepatobiliares en pacientes con enfermedad inflamatoria crónica intestinal. Revista de Investigaciones Biomédicas [seriada en Internet]. 2012 [consultado: 9 de marzo de 2014];31(4). Disponible en: http://bvs.sld.cu/revistas/ibi/vol31_4_12/ibi09412.htm

  42. Ford AC, Kane SV, Khan KJ, Achkar JP, Talley NJ, Marshall JK, et al. Efficacy of 5- aminosalicylates in Crohn′s disease: systematic review and meta-analysis. Am J Gastroenterol. 2011;106:617-29.

  43. Jiang L, Xia B, Li J, Ye M, Yan W, Deng C, et al. Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan city, central China. Inflamm Bowel Dis. 2006;12:212-17.

  44. Mack DR. Probiotics in Inflammatory Bowel Diseases and Associated Conditions. Nutrients. 2011;3:245-64.

  45. Yokoyama K, Kobayashi K, Mukae M, MiWa S, Wasaburo MK. Surgical indications and limitations of medical therapy in patients with intestinal complications due to Crohn’s disease. Inflammatory Bowel Diseases. Crohn´s and Colitis Foundation of America. Florida. 2011;17(2).

  46. García Menocal JL. Enfermedad Inflamatoria intestinal crónica y cáncer de colon. Instituto de Gastroenterología. Tesis para optar por el título de especialista en Gastroenterología. Marzo 1997.

  47. Hovde O, Kempski-Monstad I, Cvancarova M, Solberg I, Henriksen M, Jahnsen J et al. Mortality and causes of death in Crohn´s disease: results from 20 years of follow-up in the IBSEN study. Gut. 2013;0:1-5.




2020     |     www.medigraphic.com