Stricturing form of Crohn’s disease with damage to the upper gastrointestinal tract with extraintestinal manifestations
https://doi.org/10.31146/1682-8658-ecg-235-3-334-342
Abstract
Crohn’s disease (CD) remains one of the most mysterious and serious problems of modern gastroenterology and proctology. Despite the fact that almost 100 years have passed since the first description of this pathology, known scientific achievements have not been able to fully reveal the etiological and pathogenetic mechanisms of the disease. The diversity of clinical manifestations of the disease, caused by multilevel damage to the gastrointestinal tract, as well as the addition of systemic (extraintestinal) manifestations, significantly complicate the recognition of the disease, often leading to diagnostic errors and a fairly long period of diagnosis verification. The most difficult and late to recognize is CD with localization of the process in the upper gastrointestinal tract. Also complex is the low-symptom version of CD, manifested for a long time by one or two slightly expressed clinical signs, not always related to the intestine, or associated mainly with extraintestinal manifestations. This article presents an interesting case from clinical practice of observing a patient with a stricturing form of CD with damage to the upper gastrointestinal tract with extraintestinal manifestations.
About the Authors
E. V. Treneva
Samara State Medical University
Russian Federation
Russian Federation
S. V. Bulgakova
Samara State Medical University
Russian Federation
Russian Federation
K. A. Dyadchenko
Samara State Medical University
Russian Federation
Russian Federation
D. P. Kurmaev
Samara State Medical University
Russian Federation
Russian Federation
S. A. Nesterenko
Samara State Medical University
Russian Federation
Russian Federation
References
1. Knyazev O.V., Shkurko T.V., Fadeeva N.A., Bakulin I.G., Bordin D.S. Epidemiology of chronic inflammatory bowel diseases. Yesterday, today, tomorrow. Experimental and clinical gastroenterology. 2017; 3(139): 4-12. (In Russ.)@@ Князев О.В., Шкурко Т.В., Фадеева Н.А., Бакулин И.Г., Бордин Д.С. Эпидемиология хронических воспалительных заболеваний кишечника. Вчера, сегодня, завтра. Экспериментальная и клиническая гастроэнтерология. 2017; 3(139): 4-12.
2. Gomollón F., Dignass A., Annese V., Tilg H., Van Assche G., O Lindsay J., et al. ECCO. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn’s Disease 2016: Part 1: Diagnosis and Medical Management. J. Crohns Colitis. 2017; 11(1): 3-25. doi: 10.1093/ecco-jcc/jjw168.
3. Mak W.Y., Zhao M., Ng S.C., Burisch J. et al. The epidemiology of inflammatory bowel disease: East meets West. Journal of Gastroenterology and Hepatology. 2020; 35(3): 380-389. doi: 10.1111/jgh.14872.
4. Styazhkina S.N., Kanbekova O.G., Lozina A.S. Etiological and pathogenetic aspects of Crohn’s disease and ulcerative colitis. Avitsenna. 2018; 18: 36-38. (In Russ.)@@ Стяжкина С.Н., Канбекова О.Г., Лёзина А.С. Этиологические и патогенетические аспекты болезни Крона и язвенного колита. Авиценна. 2018; 18: 36-38.
5. Arkhipova M.V. Features of the etiology of Crohn’s disease, clinical and morphological assessment. News of the Russian Military Medical Academy. 2019; 1(S1): 18-21. (In Russ.)@@ Архипова М.В. Особенности этиологии болезни Крона, клинико-морфологическая оценка. Известия российской военно-медицинской академии. 2019; 1 (S1): 18-21.
6. Shelygin Y.A., Ivashkin V.T., Achkasov S.I., Reshetov I.V., Maev I.V., Belousova E.A.et al. Clinical guidelines. Crohn’s disease (К50), adults. Koloproktologia. 2023;22(3):10-49. (in Russ.) doi: 10.33878/2073-7556-2023-22-3-10-49.@@ Шелыгин Ю.А., Ивашкин В.Т., Ачкасов С.И., Решетов И.В., Маев И.В., Белоусова Е.А. и соавт. Клинические рекомендации. Болезнь Крона (К50), взрослые. Колопроктология. 2023;22(3):10-49. doi: 10.33878/2073-7556-2023-22-3-10-49
7. Markova A.A., Kashkina E.I., Aparkina A.V., Artyuhina L.V., Krasnikova V.I. Crohn’s disease and COVID-19: points of contact. Experimental and Clinical Gastroenterology. 2022;207(11): 242-246. (In Russ.) doi: 10.31146/1682-8658-ecg-207-11-242-246.@@ Маркова А.А., Кашкина Е.И., Апаркина А.В., Артюхина Л.В., Красникова В.И. Болезнь Крона и COVID-19: точки соприкосновения. Экспериментальная и клиническая гастроэнтерология. 2022;207(11): 242-246. doi: 10.31146/1682-8658-ecg-207-11-242-246.
8. Grinevich V.B., Kravchuk Yu.A., Ped V.I. et al. Management of patients with digestive diseases during the COVID-19 pandemic: Clinical Practice Guidelines by the Gastroenterological Scientifi c Society of Russia. Experimental and Clinical Gastroenterology. 2020; 179 (7):4-51. (In Russ.) doi: 10.31146/1682-8658-ecg-179-7-4-51.@@ Гриневич В.Б., Кравчук Ю.А., Педь В.И. и др. Ведение пациентов с заболеваниями органов пищеварения в период пандемии COVID-19. Клинические рекомендации Научного общества гастроэнтерологов России. Экспериментальная и клиническая гастроэнтерология. 2020;179(7): 4-51. doi: 10.31146/1682-8658-ecg-179-7-4-51.
9. Ye Q., Wang B., Zhang T., Xu J., Shang S. The mechanism and treatment of gastrointestinal symptoms in patients with COVID-19. Am.J. Physiol. Gastrointest. Liver. Physiol. 2020;319(2): G245-G252. doi: 10.1152/ajpgi.00148.2020.
10. Xiao F., Tang M., Zheng X., Liu Y., Li X., Shan H. Evidence for Gastrointestinal Infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-1833.e3. doi: 10.1053/j. gastro.2020.02.055.
11. Neganova O.A., Styazhkina S.N., Nikolayeva V.N., Muradova D.M. Crohn’s disease: the «bone of contention» of doctors. Alleya nauki. 2019;1(4):90-93. (In Russ.).@@ Неганова О.А., Стяжкина С.Н., Николаева В.Н., Мурадова Д.М. Болезнь Крона: «яблоко раздора» врачей. Аллея науки. 2019; 1 (4): 90-93.
12. Avalueva E.B., Bakulin I.G., Sitkin S.I., Vorobyev S.L., Belyakov I.A., Trushnikova N.A., Karpeeva Yu.S. Crohn’s disease with isolated gastric involvement as an example of a rare disease phenotype: a clinical case. Almanac of Clinical Medicine. 2019;47(6):592-602. (In Russ.). doi: 10.18786/2072-0505-2019-47-074.@@ Авалуева Е.Б., Бакулин И.Г., Ситкин С.И., Воробьев С.Л., Беляков И.А., Трушникова Н.А., Карпеева Ю.С. Болезнь Крона с изолированным поражением желудка как пример редкого фенотипа заболевания: клиническое наблюдение. Альманах клинической медицины. 2019;47(6):592-602. doi: 10.18786/2072-0505-2019-47-074.
13. Fatenkov O.V., Pirogovа Yu. Yu., Konnov P.E., Arsenyeva A.A., Orlov E.V. Pyoderma gangrenosum as a clinical debut of Crohn’s disease (clinical case). Lechaschi Vrach. 2023;9(26):82-88. (In Russ.) doi: 10.51793/OS.2023.26.9.011@@ Фатенков О.В., Пирогова Ю.Ю., Коннов П.Е., Арсеньева А.А., Орлов Е.В. Гангренозная пиодермия как клинический дебют болезни Крона (клинический случай). Лечащий Врач. 2023; 9(26): 82-88. doi: 10.51793/OS.2023.26.9.011.
14. Davydova A.Y., Repnikova R.V. Extraintestinal manifestations of Crohn’s disease: difficulties in diagnosis. Fundamental and Clinical Medicine. 2020; 5(2):119-122. (In Russ.) doi: 10.23946/2500-0764-2020-5-2-119-122.@@ Давыдова А.Я., Репникова Р.В. Внекишечные проявления болезни Крона: трудный путь к диагнозу. Фундаментальная и клиническая медицина. 2020; 5(2):119-122. doi: 10.23946/2500-0764-2020-5-2-119-122.
15. Skalinskaya M.I., Osipenko M.F., Nadeev A.P., Kulygina Yu.A., Bekker I.S. Clinical case of Crohn’s disease: a difficult path to diagnosis. Experimental and Clinical Gastroenterology. 2015; 3(115): 106-110. (In Russ.)@@ Скалинская М.И., Осипенко М.Ф., Надеев А.П., Кулыгина Ю.А., Беккер И.С. Клинический случай болезни Крона: сложный путь к диагнозу. Экспериментальная и клиническая гастроэнтерология. 2015; 3(115): 106-110.
16. Rivera E.D., Coffey J.C., Walsh D., Ehrenpreis E.D. The mesentery, systemic inflammation, and Crohn’s disease. Inflamm. Bowel Dis. 2019; 25(2): 22634. doi: 10.1093/ibd/izy201.
17. Kuna A.Т. Serological markers of inflammatory bowel disease. Biochem. Medica. 2013; 23: 28-42. doi: 10.11613/bm.2013.006.
18. Forcione D., Rosen M., Kisiel J., Sands B. Anti-Saccharomyces cerevisiae antibody (ASCA) positivity is associated with increased risk for early surgery in Crohn’s disease. Gut. 2004; 53(8): 1117-1122. doi: 10.1136/gut.2003.030734.
19. Harbord M., Annese V., Vavricka S.R., Allez M., Barreiro-de Acosta M., Boberg K.M. The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease. J. Crohns Colitis. 2016; 10(3): 239-254. doi: 10.1093/ecco-jcc/jjv213.
20. Shchukina O.B. Prognostic factors of Crohn’s disease. Almanac of Clinical Medicine. 2014. 33: 3-14. (In Russ.)@@ Щукина О.Б. Факторы прогноза болезни Крона. Альманах клинической медицины. 2014. 33: 3-14.
Review
For citations:
Treneva E.V., Bulgakova S.V., Dyadchenko K.A., Kurmaev D.P., Nesterenko S.A. Stricturing form of Crohn’s disease with damage to the upper gastrointestinal tract with extraintestinal manifestations. Experimental and Clinical Gastroenterology. 2025;(3):334-342. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-235-3-334-342
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