Differential diagnosis of the ileum diseases
Authors:
Karel Lukáš; Karel Dvořák; Aleš Novotný; Hana Hejdová; Jana Mišutková
Authors‘ workplace:
IV. interní klinika 1. LF UK a VFN, Praha
Published in:
Čas. Lék. čes. 2013; 152: 4-14
Category:
Review Article
* Předneseno dne 13. května 2012 na 6. sympoziu Gastroenterologického oddělení IV. interní kliniky 1. LF UK a VFN v Praze o idiopatických střevních zánětech na téma „Ileitida – jedná se vždy o Crohnovu nemoc?“
Overview
Inflammation of the ileum – ileitis – is classically connected with Crohn’s disease. But a wide variety of diseases is associated with inflammation of the ileum. These include inflammatory bowel disease, infections, spondyloarthropathies, vascular diseases, drug-related enteritis, infiltration (e.g. sarcoidosis, amyloidosis), postirradiation enteritis, tumors, endometriosis, celiac disease and collagenosis.
Keywords:
ileitis – inflammatory bowel disease – Crohn’s disease – ulcerative colitis – infectious enteritis
Sources
1. Kahn E, Daum F. Anatomy, Histology, Embryology, and Developmental Anomalies of the Small and Large Intestine. In: Sleisenger and Fordtrans´s Gastrointestinal and Liver Disease. Feldman M, Friedman LS, Brandt LJ. eds. Philadelphia: Saunders Elservier 2006; 2061–2091.
2. DiLauro S, Crum-Cianflone F. Ileitis: When it is Not Crohn´s Disease. Curr Gastroenterol Rep 2010; 12: 249–258.
3. Levine MS, Gyawali CP. Miscellaneous disease of the small intestine. In: Textobook of gastroenterology. Yamada T. ed. Oxford: Wiley-Blackwell 2009; 1343–1368.
4. Willliams JJ, Beck PL, Andrews CN, Hogan DB, Storr MA. Microscopic colitis – a common cause of diarrhoea in older adults. Age and Ageing 2010; 39: 162–168.
5. Bjørnbak C, Engel PJ, Nielsen PL, Munck LK. Microscopic colitis: clinical findings, topography and persistence of histopathological subgroups. Aliment Pharmacol Ther 2011; 34: 1225–1234.
6. O´Brien BH, McClymont K, Brown I. Collagenous ileitis. Am J Surg Pathol 2011; 35: 1151–1157.
7. Stenson WS, Hanauer SB, Cohen RD. Inflammatory Bowel Disease. In: Textbook of Gastroenterology. Yamada T. ed. Oxford: Wiley-Blackwell. 2009; 1386–1472.
8. Jess T, Riis L, Vind I, et al. Changes in clinical characteristics, course, and prognosis of inflammatory bowel disease during the last 5 decades: a population-based study from Copenhagen, Denmark. Inflam Bowel Dis 2007; 13: 481–489.
9. Stange EF, Travis SP, Vermeire S, et al. European evidence based consensus on the diagnosis and management of Crohn´s disease: definition and diagnosis. Gut 2006; 55(Suppl 1): il.
10. Lukáš K, Mařatka Z, Antoš F, Kulda J. Záněty střev. In: Gastro-enterologie. Praha: Univerzita Karlova v Praze, Karolinum 1999; 247–276.
11. McCready FJ, Bargen JA, Dockerty MB, Waugh JM. Involvement of the ileum in chronic ulcerative colitis. N Engl J Med 1949; 240: 119–127.
12. Abdelrazeq AS, Wilson TR, Leitch DL, Lund JN, Leveson SH. Ileitis in ulcerative colitis: is it a backwash? Dis Colon Rectum 2005; 48: 2038–2046.
13. Haskell H, Andrews CVV, Reddy SI, et al. Pathologic features and clinical significance of „backwash“ ileitis in ulcerative colitis. Am J Surg Pathol 2005; 29: 1472–1481.
14. Boonstra K, van Erpecum KJ, van Nieuwkerk KM, et al. Primary sclerosing cholangitis is associated with a distinct phenotype of inflammatory bowel disease. Inflamm Bowel Dis. 2012 Mar. doi: 10.1002/ibd.22938.
15. Loftus EV, Harewood GC, Loftus CG, et al. PSC-IBD: a unique form of inflammatory bowel disease associated with primary sclerosin cholangitis. Gut 2005; 54: 91–96.
16. Yamamoto T, Maruyama Y, Umegae S, Matsumoto K, Saniabadi AR. Mucosal inflammation in the terminal ileum of ulcerative colitis patients: Endoscopic findings and cytokine profiles. Digestive Liver Disease 2008; 40: 253–259.
17. Bell AJ, Price AB, Forbes A, Ciclitira PJ, Groves C, Nicholls RJ. Pre-pouch ileitis: a disease of the ileum in ulcerative colitis after restorative proctocolectomy. Colorectal Disease 2005; 8: 402–410.
18. Goldstein N, Dulai M. Contemporary Morphologic Definition of Backwash Ileitis in Ulcerative Colitis and Features That Distinguish It From Crohn Disease. Am J Clin Pathol 2006; 126: 365–376.
19. Abdelrazeq AS, Kandiyil N, Botterill ID, Lund JN, Reynolds JR, Holdsworth PJ, Leveson SH. Predictors for acute and chronic pouchitis following restorative proctocolectomy for ulcerative colitis. Colorectal Disease 2007; 10: 805–813.
20. Arrossi AV, Kariv Y, Bronner MP, et al. Backwash ileitis does not affect poch outcome in patients with ulcerative colitis with restorative proctocolectomy. Clin Gastroenterol Hepatol 2011; 9: 981–988.
21. Gustavsson S, Weiland LH, Kelly KA. Relationship of backwash ileitis to ileal pouchitis after ileal-pouch anastomosis. Dis Colon Rectum 1987; 30: 25–28.
22. Odze RD. Pathology of indeterminate colitis. J Clin Gastroeterol 2004; 38(5 Suppl 1): S36–40.
23. Gorbach SL. Neutropenic enterocolitis. Clin Infect Dis. Oct 1998; 27(4): 700–701.
24. Shanahan S. Gastrointestinal manifestations of immunological disorders. In: Textbook of gastroenterology. Yamada T. ed. Oxford: Willey-Blackwell 2009; 2612–2631.
25. Bierman HR, Amronin G. The ileocecal syndrome in the leukopathic conditions. Clin Res. 1960; 8: 134–138.
26. Alladi A, Das K, Karuna V, D´Cruz AJ. Non specific jejunoileitis – a report of 8 cases. Indian J Gastroenterol 2001; 20: 195–196.
27. Ersoy O, Haramanci O, Aydinli M, Sivri B, Bayrakta Y. Capability of Capsule Endoscopy Detecting Small Bowel Ulcers. Dig Dis Sci 2009; 54: 136–141.
28. Levine J, Schmidt MH, Burrell MI, et al. Acute jejunoileitis. A distinct entity? J Clin Gastroenterol 1992; 14: 47–51.
29. Kim HH, Kim YS, Ok KS, et al. Chronic Non-granulomatous ulcerative jejunoileitis assessed by wireless capsule endoscopy. Korean J Gastroenterol 2010; 56: 382–386.
30. Freeman M, Cho SR. Nongranulomatous ulcerative jejunoileitis. Am J Gastroenterol 1984; 79: 446–449.
31. Soergel K. Nongranulomatous chronic idiopathic enterocolitis: a primary histologically defined disease. Dig Dis Sci 2000; 45: 2085.
32. Puylaert JB, Van der Zant FM, Mutsaers JA. Infectious ileocecitiscaused by Yersinia, Campylobacter, and Salmonella: clinical, radiological and US findings. Eur Radiol 1997; 7: 3–9.
33. Prentice MB. Plague an Other Yersinia Infections. In: Harrison´s Principles of Internal Medicine. Longo DL. Ed., New York: McGraw Hill 2012; 1305–1313.
34. Laufer B, Pépin J, Mitchell A, Dubé S, Labbé AC. Fatal Clostridium difficile enteritis caused by the BI/NAP1/027 strain: a case series of ileal C. difficile infections. Clin Microbiol Infect 2009; 15(12): 1093–1099.
35. Lavallée C, Spencer MP, Steele SR. Clostridium difficile enteritis after colectomy. Am Surg 2009; 75: 1203–1206.
36. Arshad H, Ahmad Z. Histologic findings in biopsies/resection specimens from the small intestine with special emphasis on celiac disease: experience from developing country in South Asia. Ann Diagn Pathol 2012 Mar 29 [Epub ahead of print].
37. Amarapurkar DN, Patel ND, Rane PS. Diagnosis of Crohn’s disease in India where tuberculosis is widely prevalent. World J Gastroenterol. 2008; 14: 741–746.
38. Sinhasan SP, Puranik RB, Kulkarni MH. Abdominal tuberculosis may masquerade many diseases. Saudi J Gastroenterol 2011; 17(2): 110–113.
39. Majeed SK, Ghazanfar A, Ashraf J. Caecal amoeboma simulating malignant neoplasia, ileocaecal tuberculosis and Crohn’s disease. J Coll Physicians Surg Pak 2003; 13: 116–117.
40. Venkatesh PGK, Navaneethan U. Mimickers of Intestinal Tuberculosis: Could this be Crohn’s Disease? An Unsolved Enigma. Saudi J Gastroenterol 2011; 17: 95–96.
41. Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn’s disease: A diagnostic challenge. Am J Gastroenterol. 2009; 104: 1003–1012.
42. Navaneethan U, Cherian JV, Prabhu R, Venkataraman J. Distinguishing tuberculosis and Crohn’s disease in developing countries: How certain can you be of the diagnosis? Saudi J Gastroenterol. 2009; 15: 142–144.
43. Cintron JR, Del Pino A, Duarte B, Wood D. Abdominal actinomycosis. Dis Colon Rectum 1996; 39: 105–108.
44. Navaneethan U, Kakani PR, Selah CE. Actinomycosis. Surgical aspects. Am Surg 1985; 51: 262–264.
45. Beneš J. Aktinomykóza. In: Infekční lékařství. Beneš J. ed. Praha: Galén 2009; 267–268.
46. Nozawa H, Yamada Y, Muto Y, Arita S, Aisaka K. Pelvic actinomycosis presenting with a large abscess and bowel stenosis with marked response to conservative treatment: a case report. J Med Case Reports 2007; 1: 141.
47. Lee I-J, Ha HK, Park CM, et al. Abdominopelvic Actinomycosis Involving the Gastrointestinal Tract. Radiology 2001; 220: 76–80.
48. Tamer A, Gunduz Y, Karabay O, Mert A. Abdominal Actinomycosis. Acta Chir Belg 2006; 106: 351–353.
49. Bouree P, Paugam A, Petithory JC. Anisakidosis: report of 25 cases and review of the literature. Comp Immunpl Microbiol Infect 1995; 18: 75–84.
50. Marzocca G, Rocchi B, Lo Gatto M. Acute abdomen by anisakiasis and globalization. Ann Ital Chir 2009; 80: 65–68.
51. Baroco AL, Oldfield EC. Gastrointestinal cytomegalovirus disease in the immunocompromised patient. Curr Gastroenerol Rep 2008; 10: 409–416.
52. Beneš J. Cytomegalovirová infekce. In: Infekční lékařství. Beneš J. ed. Praha: Galén 2009; 183–187.
53. Rozsypal H. Histoplasmóza. In: Infekční lékařství. Beneš J. ed. Praha: Galén 2009; 317.
54. Kahi CJ, Wheat LJ, Allen SD, Sarosi GA. Gastrointestinal histoplasmosis. Am J Gastroenterol 2005; 100: 220–231.
55. Puéchal X. Whipple´s disease. Joint Bone Spine 2002; 69: 133–140.
56. D´Incá R, Pagnan A. Whipple disease. Gastrointest Endosc 2004; 60: 800–801.
57. Ung KA, Havel G, Claesson B, von Stedingk, Hanson HS,Midhagen G. Whipple´s disease can be diagnosed using paraffin-embedded specimens from the ileum obtained during ileocolonoscopy. Endoscopy 2003; 35: 632.
58. Petrillo T, Beck-Sague C, Songer J, et al. Enteritis necroticans (pigbel) in a diabetic child. N Engl J Med 2000; 342: 1250–1253.
59. Chandrasekharam VV, Mathur M, Agarwala S, Mitra DK, Bhatnagar V.A clinicopathological study of acute necrotising jejunoileitis. Pediatr Surg Int. 2002; 18: 472–476.
60. Mielants H, Veys EM, De Vos M, et al. The evolution of spondyloarthropathies in relation to gut histology. I. Clinical aspects. J Rheumatol 1995; 22: 2266–2272.
61. Lukáš K, Lukáš M, Jirásek A, Valešová M, Alušík Š. Atrophic colitis. In: Inflammatory bowel diseases-progress in basic research and clinical implications. Ed. H. Goebell, Dordrecht: Kluwer Academic Publishers 1991; 411.
62. Rimbaş M, Marinescu M, Voiosu MR, et al. NSAID-induced deleterious effects on the proximal and mid small bowel in seronegative spondyloarthropathy patients. World J Gastroenterol 2011; 17: 1030–1035.
63. Wu Q-J, Zhang F-C, Zhang X. Adamantides-Behçet disease-complicated gastroenteropathy. World J Gastroenterol 2012; 18: 609–617.
64. Zouboulis CC, Keitel W. A historical review of early descriptions of Adamantiades–Behçet‘s disease.The J Invest Dermatol 2002; 119: 201–205.
65. Köklü S, Yüksel O, Onur I, et al. Ileocolonic involvement in Behçet disease: endoscopic and histological evaluation. Digestion 2010; 8: 214–217.
66. Cheon JH, Kim ES, Shin SJ, et al. Development and validation of novel diagnostic criteria for intestinal Behçet´s disease in Korean patients with ileocolonic ulcers. Am J Gastroenterol 2009; 104: 2492–2499.
67. Ozaslan E. Ileocolonic Findings in Behçet´s Disease. Digestion 2010; 82: 258–259.
68. Sanft T, Barrett TA, Barr WG, Jones MP. Henoch-Schönlein purpura presenting as terminal ileitis: case report and review of unusual causes of ileitis. Gastroenterology & Hepatology 2006; 2: 375–378.
69. Northcott KA, Yoshida EM, Steinbrecher UP. Primary proteinlosing enteropathy in anti-double-straned DNA disease: the initial and sole clinical manifestation of occult systemic lupus erythematosus? J Clin Gastroenterol 2001; 33: 340–341.
70. Goldblatt F, Gordon TP, Waterman SA. Antibody-mediated gastrointestinal dysmotility in scleroderma. Gastroenterology 2002; 123: 2164–2150.
71. Takeuchi K, Satoh H. Measurement of small intestinal damage. Curr Protoc Toxicol 2010; 21: 21.7.
72. Nakase H. Ischemic enteritis. Nihon Rinsho 2008; 66: 1330–1334.
73. Gassas A, Zaidman I, Schechter T, Doyle J. Beyond gastrointestinal graft-versus-host disease. A lesson to learn. Pediatr Transplant 2011; 15: 139–141.
74. Melson J, Jakate S, Fung H, Arai S, Keshavarzian A. Crypt loss is a marker of clinical severity of acute gastrointestinal graft-versus-host disease. Am J Hematol 2007; 82: 881–886.
75. Brandt LJ. Intestinal Ischemia. In: Sleisenger and Fordtrans´s Gastro-intestinal and Liver Disease. Feldman M, Friedman LS, Brandt LJ. eds. Philadelphia: Saunders Elservier 2006; 2563–2585.
76. Iida M, Matsui T, Yao T, et al. Radiographic features in ischemic jejunoileitis: serial changes and comparison with pathologic findings. Gastrointest Radiol 1992; 17: 327–332.
77. Price AB. Pathology of drug–associated gastrointestinal disease. Br J Clin Pharmacol. 2003; 56: 477–482.
78. Geltner D, Sternfeld M, Becker SA, et al. Gold-induced ileitis. J Clin Gastroenterol 1986; 8: 184–186.
79. Weiss SM, Rutenberg HL, Paskin DL, Zaren HA. Gut lesions due to slow-release KCl tablets. N Engl J Med 1977; 296: 111–112.
80. Allison MC, Howatson AG, Torrance CJ, Lee FD, Russell RI. Gastrointestinal damage associated with the use of nonsteroidal antiinflammatory drugs. N Engl J Med 1992; 327: 749–754.
81. Hyson EA, Burrell M, Toffler R. Abdominal Imaging. Gastrointestinal Radiol 1977; 2: 183–212.
82. Graham DY, Opekun AR, Willingham FF, Qureshi WA. Visible small-intestinal mucosal injury in chronic NSAID users. Clin Gastroenterol Hepatol 2005; 3: 55–59.
83. Bertolini A, Ottani A, Sandrini M. Dual acting anti-inflammatory drugs; a reappraisal. Pharmacol Res. 2001; 437–450.
84. Going JJ, Canvin J, Sturrock R. Possible precursor of diaphragm disease in the small intestine. Lancet 1993; 341: 638–639.
85. Lang J, Price AB, Levi AJ, Burke M, Gumpel JM, Bjarnason I. Diaphragm disease: pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs. J Clin Pathol. 1988; 41: 516–526.
86. Rothenberg ME. Eosinophilic gastrointestinal disorders. J Allergy Clin Immunol 2004; 113: 11–28.
87. Shahzad G, Moise D, Lipka S, Rizvon K, Mustacchia PJ. Eosinophilic enterocolitis diagnosed by means of upper endoscopy and colonoscopy with random biopsies treated with budenoside: a case report and review of the literature. ISRN Gastroenterol 2011: 608901.
88. Shanahan S. Gastrointestinal manifestations of immunological disorders. In: Textbook of gastroenterology. Yamada T. ed. Oxford: Willey-Blackwell 2009; 2612–2631.
89. Clouse RE, Alpers DH, Hockenbery DM, DeSchryver-Kecskemeti K. Pericrypt eosinophilic enterocolitis and chronic diarrhea. Gastroenterology 1992; 103: 168–176.
90. Royston DJ, Warren BF. In: Anorectal and Colonic Diseases. Givel JC ed. Heidelberg: Springer 2010: 81–116.
91. Kala Z, Válek V, Kysela P. Amyloidosis of the small intestine. Eur J Radiol 2007; 63: 105–109.
92. Ebert EC, Kierson M, Hagspiel KD. Gastrointestinal and hepatic manifestations of sarcoidosis. Am J Gastroenterol 2008; 103: 3184–3192.
93. Philpott H, Gow P, Crowley P, Nandurkar S, Douglass J, Gib-son PR. Systemic mastocytosis: a gastroenterological perspective. Frontline Gastroenterol 2012; 3: 5–9.
94. Söderholm JD. Mast Cells and Mastocytosis. Dig Dis 2009; 27(Suppl 1): 129–136.
95. Yen EF, Pardi DS. Review article: Microscopic colitis–lymphocytic, collagenous and ‚mast cell‘ colitis. Aliment Pharmacol Ther 2011; 34: 21–32.
96. Cho LC, Antoine JE. Radiation Injury to the Gastrointestinal Tract. In: Sleisenger and Fordtrans´s Gastrointestinal and Liver Disease. Feldman M, Friedman LS, Brandt LJ. eds. Philadelphia: Saunders Elservier 2006; 813–826, 2061–2091.
97. Remes SM, Tuominen VJ, Helin H, Isola J, Arola J. Grading of neuroendocrine tumors with ki-67 requires high-quality assessment practices. Am J Surg Pathol 2012; 36: 1359–1363.
98. Matsukuma S, Okada K, Takeo H, Sato K. Histopathological study of colo-ileal carcinoma. Oncol Lett 2012; 3: 689–693.
99. Mouaqit O, Hasnai H, Chbani L et al. Adult intussusceptions caused by a lipoma in the jejunum: report of a case and review of the literature. World J Emerg Surg 2012; 7: 28.
100. Asfaw SH, Kundu N, Liu X, Abdel-Aziz H, Samotowka MA, Loor MM. Heterotopic pancreas as a lead point for ileoileal intussusception. Am Surg 2012; 78: 187–189.
101. Başsorgun CI, Ozbudak IH, Erdoğan G, Elpek GO, Erdoğan O,Gelen T. Familial adenomatous polyposis associated with gastrointestinal stromal tumor. Turk J Gastroenterol 2012; 23: 262–266.
102. De Ceglie A, Bilardi C, Blanchi S, Picasso M, Di Muzio M, Trimarchi A, Conio M. Acute small bowel obstruction caused by endometriosis: a case report and review of the literature. World J Gastroenterol 2008; 14: 3430–3434.
103. Ventruba P. Endometrióza. In: Gynekologie. Citterbart K. ed. Praha: Galén 2001; 121–126.
104. Freeman HJ. Pearls and pitfalls in the diagnosis of adult celiac disease. Can J Gastroenterol. 2008; 22: 273–280.
105. Dickey W, Hughes DF. Histology of the terminal ileum in coeliac disease. Scand J Gastroenterol 2004; 39: 665–667.
106. Arshad H, Ahmad Z. Histologic findings in biopsies/resection specimens from the small intestine with special emphasis on celiac disease: experience from developing country in South Asia. Ann Diagn Pathol 2012 Mar 29. [Epub ahead of print].
107. Soyer P, Boudiaf M, Dray X, et al. CT Enteroclysis Features of Uncomplicated Celiac Disease. Radiology 2009; 253: 416–424.
108. Han SH, Lee OY, Eun CS, et al. A case of protein-losing enteropathy associated with small bowel villous atrophy. Korean J Gastroenterol 2007; 49: 31–36.
109. Mensink PBF. Small bowel endoscopy. Best Practice Res Clin Gastroenterol. 2012; 26: 207–208.
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