Refractory central nervous system vasculitis and gastrocnemius myalgia syndrome in Crohn's disease successfully treated with anti-tumor necrosis factor-alpha antibody.
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Refractory central nervous system vasculitis and gastrocnemius myalgia syndrome in Crohn's disease successfully treated with anti-tumor necrosis factor-alpha antibody. / Ullrich, Sebastian; Schinke, Susanne; Both, Markus; Knop, Karl Christian; Kirkiles-Smith, Nancy Coula; Gross, Wolfgang Ludwig; Lamprecht, Peter.
In: SEMIN ARTHRITIS RHEU, Vol. 38, No. 5, 5, 2009, p. 337-347.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Refractory central nervous system vasculitis and gastrocnemius myalgia syndrome in Crohn's disease successfully treated with anti-tumor necrosis factor-alpha antibody.
AU - Ullrich, Sebastian
AU - Schinke, Susanne
AU - Both, Markus
AU - Knop, Karl Christian
AU - Kirkiles-Smith, Nancy Coula
AU - Gross, Wolfgang Ludwig
AU - Lamprecht, Peter
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Secondary vasculitis represents a rare extraintestinal manifestation of Crohn's disease (CD). Appropriate and prompt diagnosis is often delayed by uncertainties about the relationship of the vasculitic manifestations and CD. OBJECTIVE: To describe our experience with vasculitis in CD and review the literature with respect to different manifestations and pathophysiological aspects of extraintestinal vasculitic manifestations of CD. METHODS: We report 2 new cases of CD with secondary small-vessel vasculitis. We also extensively review the literature (1960-2007) using a broad range of key words related to secondary vasculitis in CD. Relevant publications were evaluated for the number of reported patients and manifestations of vasculitis. RESULTS: Vasculitis is a rare extraintestinal manifestation of CD. Different types of vasculitis affect large-, medium-, and small-sized vessels associated with CD. Common immunologic features include intestinal inflammation as well as an infiltration of gammadelta-T-cells and/or Th1-type cells into vessel walls. The 2 new cases of secondary vasculitis in CD reported here reflect 2 major types of CD-related inflammatory vascular disorders. The first involves the central nervous system, while the second represents circumscribed Musculus gastrocnemius involvement (so-called "gastrocnemius myalgia syndrome"). Successful treatment of refractory secondary vasculitis in CD with an anti-tumor necrosis factor-alpha antibody is shown for the first time. CONCLUSION: Vasculitis secondary to CD is an uncommon finding. Therefore, it has to be carefully differentiated from other forms of primary or secondary vasculitis with intestinal involvement. Treatment with an anti- tumor necrosis factor-alpha antibody may prove a treatment option in vasculitis as an extraintestinal manifestation of CD.
AB - BACKGROUND: Secondary vasculitis represents a rare extraintestinal manifestation of Crohn's disease (CD). Appropriate and prompt diagnosis is often delayed by uncertainties about the relationship of the vasculitic manifestations and CD. OBJECTIVE: To describe our experience with vasculitis in CD and review the literature with respect to different manifestations and pathophysiological aspects of extraintestinal vasculitic manifestations of CD. METHODS: We report 2 new cases of CD with secondary small-vessel vasculitis. We also extensively review the literature (1960-2007) using a broad range of key words related to secondary vasculitis in CD. Relevant publications were evaluated for the number of reported patients and manifestations of vasculitis. RESULTS: Vasculitis is a rare extraintestinal manifestation of CD. Different types of vasculitis affect large-, medium-, and small-sized vessels associated with CD. Common immunologic features include intestinal inflammation as well as an infiltration of gammadelta-T-cells and/or Th1-type cells into vessel walls. The 2 new cases of secondary vasculitis in CD reported here reflect 2 major types of CD-related inflammatory vascular disorders. The first involves the central nervous system, while the second represents circumscribed Musculus gastrocnemius involvement (so-called "gastrocnemius myalgia syndrome"). Successful treatment of refractory secondary vasculitis in CD with an anti-tumor necrosis factor-alpha antibody is shown for the first time. CONCLUSION: Vasculitis secondary to CD is an uncommon finding. Therefore, it has to be carefully differentiated from other forms of primary or secondary vasculitis with intestinal involvement. Treatment with an anti- tumor necrosis factor-alpha antibody may prove a treatment option in vasculitis as an extraintestinal manifestation of CD.
M3 - SCORING: Zeitschriftenaufsatz
VL - 38
SP - 337
EP - 347
JO - SEMIN ARTHRITIS RHEU
JF - SEMIN ARTHRITIS RHEU
SN - 0049-0172
IS - 5
M1 - 5
ER -