nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-207-11-247-251nogr-2215Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESСерия клинических наблюдений болезни Крона верхних отделов желудочно-кишечного трактаSeries of clinical observations of Crohn’s disease of the upper gastrointestinal tracthttps://orcid.org/0000-0002-8803-7566АлександровТ. Л.AlexandrovT. L.aleksandrov_tl@gnck.ruhttps://orcid.org/0000-0003-2013-8798БарановаТ. А.BaranovaT. A.noemail@neicon.ruhttps://orcid.org/0000-0002-1979-5224ГаляевА. В.GalyaevA. V.noemail@neicon.ruhttps://orcid.org/0000-0002-9277-3734КоролевскийЕ. С.KorolevskiyE. S.noemail@neicon.ruhttps://orcid.org/0000-0001-5848-4050ЛикутовА. А.LikutovA. A.noemail@neicon.ruhttps://orcid.org/0000-0003-1697-4670НанаеваБ. А.NanaevaB. A.noemail@neicon.ruhttps://orcid.org/0000-0002-7778-8049ПедаЕ. С.PedaE. S.noemail@neicon.ruФГБУ «НМИЦ колопроктологии имени А. Н. Рыжих» Минздрава РоссииРоссияFederal State Budgetary Institution “A. N. Ryzhih National Medical Research Center of Coloproctology” of the Ministry of Health of the Russian FederationRussian Federation202223012023011247251Copyright © Александров Т.Л., Баранова Т.А., Галяев А.В., Королевский Е.С., Ликутов А.А., Нанаева Б.А., Педа Е.С., 20232023Александров Т.Л., Баранова Т.А., Галяев А.В., Королевский Е.С., Ликутов А.А., Нанаева Б.А., Педа Е.С.Alexandrov T.L., Baranova T.A., Galyaev A.V., Korolevskiy E.S., Likutov A.A., Nanaeva B.A., Peda E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/2215

В статье представлены два клинических случая успешного лечения болезни Крона (БК) верхних отделов желудочно-кишечного тракта (ЖКТ) с применением ингибиторов фактора некроза опухоли альфа (иФНО-α). Кроме того, представлен краткий обзор литературы, по диагностике и лечению БК данной локализации. Стоит отметить, что в мировой и отечественной литературе представлено небольшое количество публикаций, посвященной данной проблеме. Отсутствие унифицированного подхода к ведению таких пациентов диктует необходимость проведения эпидемиологического исследования для определения распространенности поражения верхних отделов ЖКТ при БК, не только для выработки диагностической и лечебной тактики, но и для определения факторов риска и прогнозирования эффективности терапии у этой группы пациентов.

The article introduces two clinical cases of successful treatment of Crohn’s disease (CD) of the upper gastrointestinal tract (UGT) with TNF inhibitors. Besides that, the article presentes the review, devoted to diagnostics and treat the same injury of patients with CD. It should be mentioned, that number of publications in worldwide and national literature is quite insignificant. One fact that is more important is the unavailability of unificational approach to treatment of such group of patients. We suppose that epidemiological research is necessary to define the true prevalence of lesions of the upper gastrointestinal tract in CD, risk factors and prognosis for this patient group, and to output the diagnostic and therapeutic tactics.

болезнь КронаБКверхние отделы ЖКТпищеводдвенадцатиперстная кишкаДПКCrohn’s diseaseCDupper gastrointestinal tractesophagusduodenumReferencesCrohn’s disease. Clinical recommendations (preliminary version). Koloproktologia. 2020;19(2):8-38. doi: 10.14341/probl20135943-10.@@ Клинические рекомендации диагностике и лечению болезни Крона у взрослых (проект). Колопроктология.2020;19(2):8-38.Crohn’s disease. Clinical recommendations (preliminary version). Koloproktologia. 2020;19(2):8-38. doi: 10.14341/probl20135943-10.@@ Клинические рекомендации диагностике и лечению болезни Крона у взрослых (проект). Колопроктология.2020;19(2):8-38.Kővári B., Pai R. K. Upper Gastrointestinal Tract Involvement in Inflammatory Bowel Diseases: Histologic Clues and Pitfalls. Adv Anat Pathol. 2022 Jan 1;29(1):2-14. doi: 10.1097/PAP.0000000000000311.Kővári B., Pai R. K. Upper Gastrointestinal Tract Involvement in Inflammatory Bowel Diseases: Histologic Clues and Pitfalls. Adv Anat Pathol. 2022 Jan 1;29(1):2-14. doi: 10.1097/PAP.0000000000000311.Greuter T., Piller A., Fournier N., Safroneeva E., Straumann A., Biedermann L., Godat S., Nydegger A., Scharl M., Rogler G., Vavricka S. R., Schoepfer A. M.,; Swiss IBD Cohort Study Group. Upper Gastrointestinal Tract Involvement in Crohn’s Disease: Frequency, Risk Factors, and Disease Course. J Crohns Colitis. 2018 Nov 28;12(12):1399-1409. doi: 10.1093/ecco-jcc/jjy121.Greuter T., Piller A., Fournier N., Safroneeva E., Straumann A., Biedermann L., Godat S., Nydegger A., Scharl M., Rogler G., Vavricka S. R., Schoepfer A. M.,; Swiss IBD Cohort Study Group. Upper Gastrointestinal Tract Involvement in Crohn’s Disease: Frequency, Risk Factors, and Disease Course. J Crohns Colitis. 2018 Nov 28;12(12):1399-1409. doi: 10.1093/ecco-jcc/jjy121.Diaz L., Hernandez-Oquet R.E., Deshpande A. R., Moshiree B. Upper Gastrointestinal Involvement in Crohn Disease: Histopathologic and Endoscopic Findings. South Med J. 2015 Nov;108(11):695-700. doi: 10.14423/SMJ.0000000000000373.Diaz L., Hernandez-Oquet R.E., Deshpande A. R., Moshiree B. Upper Gastrointestinal Involvement in Crohn Disease: Histopathologic and Endoscopic Findings. South Med J. 2015 Nov;108(11):695-700. doi: 10.14423/SMJ.0000000000000373.American Society for Gastrointestinal Endoscopy Standards of Practice Committee, Shergill AK, Lightdale JR, Bruining DH, Acosta RD, Chandrasekhara V, Chathadi KV, Decker GA, Early DS, Evans JA, Fanelli RD, Fisher DA, Fonkalsrud L, Foley K, Hwang JH, Jue TL, Khashab MA, Muthusamy VR, Pasha SF, Saltzman JR, Sharaf R, Cash BD, DeWitt JM. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015 May;81(5):1101-21.e1-13. doi: 10.1016/j.gie.2014.10.030.American Society for Gastrointestinal Endoscopy Standards of Practice Committee, Shergill AK, Lightdale JR, Bruining DH, Acosta RD, Chandrasekhara V, Chathadi KV, Decker GA, Early DS, Evans JA, Fanelli RD, Fisher DA, Fonkalsrud L, Foley K, Hwang JH, Jue TL, Khashab MA, Muthusamy VR, Pasha SF, Saltzman JR, Sharaf R, Cash BD, DeWitt JM. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015 May;81(5):1101-21.e1-13. doi: 10.1016/j.gie.2014.10.030.Sakuraba A, Iwao Y, Matsuoka K, Naganuma M, Ogata H, Kanai T, Hibi T. Endoscopic and pathologic changes of the upper gastrointestinal tract in Crohn’s disease. Biomed Res Int. 2014;2014:610767. doi: 10.1155/2014/610767.Sakuraba A, Iwao Y, Matsuoka K, Naganuma M, Ogata H, Kanai T, Hibi T. Endoscopic and pathologic changes of the upper gastrointestinal tract in Crohn’s disease. Biomed Res Int. 2014;2014:610767. doi: 10.1155/2014/610767.Joana Torres, Stefanos Bonovas, Glen Doherty, Torsten Kucharzik, Javier P Gisbert, Tim Raine, Michel Adamina, Alessandro Armuzzi, Oliver Bachmann, Palle Bager, Livia Biancone, Bernd Bokemeyer, Peter Bossuyt, Johan Burisch, Paul Collins, Alaa El-Hussuna, Pierre Ellul, Cornelia Frei-Lanter, Federica Furfaro, Christian Gingert, Paolo Gionchetti, Fernando Gomollon, Marien González-Lorenzo, Hannah Gordon, Tibor Hlavaty, Pascal Juillerat, Konstantinos Katsanos, Uri Kopylov, Eduards Krustins, Theodore Lytras, Christian Maaser, Fernando Magro, John Kenneth Marshall, Pär Myrelid, Gianluca Pellino, Isadora Rosa, Joao Sabino, Edoardo Savarino, Antonino Spinelli, Laurents Stassen, Mathieu Uzzan, Stephan Vavricka, Bram Verstockt, Janindra Warusavitarne, Oded Zmora, Gionata Fiorino, on behalf of the European Crohn’s and Colitis Organisation [ECCO], ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment, Journal of Crohn’s and Colitis.2020;14(1):4-22. doi: 10.1093/ecco-jcc/jjz180.Joana Torres, Stefanos Bonovas, Glen Doherty, Torsten Kucharzik, Javier P Gisbert, Tim Raine, Michel Adamina, Alessandro Armuzzi, Oliver Bachmann, Palle Bager, Livia Biancone, Bernd Bokemeyer, Peter Bossuyt, Johan Burisch, Paul Collins, Alaa El-Hussuna, Pierre Ellul, Cornelia Frei-Lanter, Federica Furfaro, Christian Gingert, Paolo Gionchetti, Fernando Gomollon, Marien González-Lorenzo, Hannah Gordon, Tibor Hlavaty, Pascal Juillerat, Konstantinos Katsanos, Uri Kopylov, Eduards Krustins, Theodore Lytras, Christian Maaser, Fernando Magro, John Kenneth Marshall, Pär Myrelid, Gianluca Pellino, Isadora Rosa, Joao Sabino, Edoardo Savarino, Antonino Spinelli, Laurents Stassen, Mathieu Uzzan, Stephan Vavricka, Bram Verstockt, Janindra Warusavitarne, Oded Zmora, Gionata Fiorino, on behalf of the European Crohn’s and Colitis Organisation [ECCO], ECCO Guidelines on Therapeutics in Crohn’s Disease: Medical Treatment, Journal of Crohn’s and Colitis.2020;14(1):4-22. doi: 10.1093/ecco-jcc/jjz180.Lichtenstein Gary R., Loftus Edward V., Isaacs Kim L., Regueiro Miguel D., Gerson Lauren B., Sands Bruce E. ACG Clinical Guideline: Management of Crohn’s Disease in Adults, American Journal of Gastroenterology: April 2018; 113(4): 481-517. doi: 10.1038/ajg.2018.27.Lichtenstein Gary R., Loftus Edward V., Isaacs Kim L., Regueiro Miguel D., Gerson Lauren B., Sands Bruce E. ACG Clinical Guideline: Management of Crohn’s Disease in Adults, American Journal of Gastroenterology: April 2018; 113(4): 481-517. doi: 10.1038/ajg.2018.27.Kawachiya T, Hara J, Hirata N, Mashimo M, Arakawa T. Successful treatment of duodenal Crohn disease with infliximab: report of 3 cases. 2010 Dec;107(12):1933-40.Kawachiya T, Hara J, Hirata N, Mashimo M, Arakawa T. Successful treatment of duodenal Crohn disease with infliximab: report of 3 cases. 2010 Dec;107(12):1933-40.Lin K. D., Chiu G. F., Waljee A. K., et al. Effects of Anti-Helicobacter pylori Therapy on Incidence of Autoimmune Diseases, Including Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2019 Sep;17(10):1991-1999. doi: 10.1016/j.cgh.2018.12.014.Lin K. D., Chiu G. F., Waljee A. K., et al. Effects of Anti-Helicobacter pylori Therapy on Incidence of Autoimmune Diseases, Including Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2019 Sep;17(10):1991-1999. doi: 10.1016/j.cgh.2018.12.014.Xiang Z., Chen Y. P., Ye Y. F., Ma K. F., Chen S. H., Zheng L., Yang Y. D., Jin X. Helicobacter pylori and Crohn’s disease: a retrospective single-center study from China. World J Gastroenterol. 2013 Jul 28;19(28):4576-81. doi: 10.3748/wjg.v19.i28.4576.Xiang Z., Chen Y. P., Ye Y. F., Ma K. F., Chen S. H., Zheng L., Yang Y. D., Jin X. Helicobacter pylori and Crohn’s disease: a retrospective single-center study from China. World J Gastroenterol. 2013 Jul 28;19(28):4576-81. doi: 10.3748/wjg.v19.i28.4576.

The authors declare that there are no conflicts of interest present.