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Bamboo joint-like appearance of the stomach: a stable endoscopic landmark for Crohn's disease regardless of anti-tumor necrosis factor alpha treatment.

Hashiguchi K, Takeshima F, Akazawa Y, Matsushima K, Minami H, Yamaguchi N, Shiozawa K, Ohnita K, Ichikawa T, Isomoto H, Nakao K - Med. Sci. Monit. (2014)

Bottom Line: Fifteen of 22 patients (68.1%) presented with BJA in the stomach, 13 of whom received follow-up esophagogastroduodenal endoscopy after anti-TNF α therapy.The mean CDAI and SES-CD scores significantly improved after anti-TNF α therapy (P<0.01).The findings indicate that BJA is frequently observed in the stomach of CD patients, regardless of whether the patient has active disease or is in remission, even after anti-TNF α therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.

ABSTRACT

Background: Bamboo joint-like appearance is a common yet easy-to-miss endoscopic finding in the stomach of patients with Crohn's disease (CD). Bamboo joint-like appearance (BJA) is characterized by swollen longitudinal folds transversed by erosive fissures or linear furrows. However, whether BJA is observed during the remission stage of CD and during the active stage is unclear. In particular, the relationship between the course of BJA and anti-tumor necrosis factor (TNF) α therapy has not been studied. We aimed to evaluate the course of BJA in CD patients treated with anti-TNF α therapy.

Material and methods: We examined 22 CD patients who underwent esophagogastroduodenal endoscopy before undergoing anti-TNF α treatment. We evaluated the changes in BJA, clinical activity using the CD activity index (CDAI), and endoscopic activity using the simple endoscopic score for CD (SES-CD) from 6 months to 1 year after anti-TNF α therapy.

Results: Fifteen of 22 patients (68.1%) presented with BJA in the stomach, 13 of whom received follow-up esophagogastroduodenal endoscopy after anti-TNF α therapy. The mean CDAI and SES-CD scores significantly improved after anti-TNF α therapy (P<0.01). Despite the marked improvements in clinical and endoscopic findings, the BJA of the stomach remained unchanged in all the patients.

Conclusions: The findings indicate that BJA is frequently observed in the stomach of CD patients, regardless of whether the patient has active disease or is in remission, even after anti-TNF α therapy. Thus, BJA may be a stable endoscopic landmark in CD.

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Related in: MedlinePlus

Changes in simple endoscopic score for CD (SES-CD) after anti-tumor necrosis factor (TNF) α therapy. The median SES-CD score significantly decreased from 15±2.7 to 8±1.6 (P=0.001) after anti-TNF α therapy.
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f3-medscimonit-20-1918: Changes in simple endoscopic score for CD (SES-CD) after anti-tumor necrosis factor (TNF) α therapy. The median SES-CD score significantly decreased from 15±2.7 to 8±1.6 (P=0.001) after anti-TNF α therapy.

Mentions: The median CDAI score significantly decreased from 186±19.1 to 82.4±13.3 (P=0.0002) after anti-TNF α therapy (Figure 2). Twelve cases (92.3%) achieved and maintained remission (CDAI score <150). The median SES-CD score also improved significantly, from 15±2.7 to 8±1.6 (P=0.001, Figure 3). Mucosal healing in the intestine and colon was observed in 7 cases (53.8%); 5 had been treated with adalimumab and 2 had been treated with infliximab. Only 1 case had moderate disease activity, whereas the other 6 cases had mild disease activity. Two of the 7 cases had received previous anti-TNF α therapy.


Bamboo joint-like appearance of the stomach: a stable endoscopic landmark for Crohn's disease regardless of anti-tumor necrosis factor alpha treatment.

Hashiguchi K, Takeshima F, Akazawa Y, Matsushima K, Minami H, Yamaguchi N, Shiozawa K, Ohnita K, Ichikawa T, Isomoto H, Nakao K - Med. Sci. Monit. (2014)

Changes in simple endoscopic score for CD (SES-CD) after anti-tumor necrosis factor (TNF) α therapy. The median SES-CD score significantly decreased from 15±2.7 to 8±1.6 (P=0.001) after anti-TNF α therapy.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4206479&req=5

f3-medscimonit-20-1918: Changes in simple endoscopic score for CD (SES-CD) after anti-tumor necrosis factor (TNF) α therapy. The median SES-CD score significantly decreased from 15±2.7 to 8±1.6 (P=0.001) after anti-TNF α therapy.
Mentions: The median CDAI score significantly decreased from 186±19.1 to 82.4±13.3 (P=0.0002) after anti-TNF α therapy (Figure 2). Twelve cases (92.3%) achieved and maintained remission (CDAI score <150). The median SES-CD score also improved significantly, from 15±2.7 to 8±1.6 (P=0.001, Figure 3). Mucosal healing in the intestine and colon was observed in 7 cases (53.8%); 5 had been treated with adalimumab and 2 had been treated with infliximab. Only 1 case had moderate disease activity, whereas the other 6 cases had mild disease activity. Two of the 7 cases had received previous anti-TNF α therapy.

Bottom Line: Fifteen of 22 patients (68.1%) presented with BJA in the stomach, 13 of whom received follow-up esophagogastroduodenal endoscopy after anti-TNF α therapy.The mean CDAI and SES-CD scores significantly improved after anti-TNF α therapy (P<0.01).The findings indicate that BJA is frequently observed in the stomach of CD patients, regardless of whether the patient has active disease or is in remission, even after anti-TNF α therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.

ABSTRACT

Background: Bamboo joint-like appearance is a common yet easy-to-miss endoscopic finding in the stomach of patients with Crohn's disease (CD). Bamboo joint-like appearance (BJA) is characterized by swollen longitudinal folds transversed by erosive fissures or linear furrows. However, whether BJA is observed during the remission stage of CD and during the active stage is unclear. In particular, the relationship between the course of BJA and anti-tumor necrosis factor (TNF) α therapy has not been studied. We aimed to evaluate the course of BJA in CD patients treated with anti-TNF α therapy.

Material and methods: We examined 22 CD patients who underwent esophagogastroduodenal endoscopy before undergoing anti-TNF α treatment. We evaluated the changes in BJA, clinical activity using the CD activity index (CDAI), and endoscopic activity using the simple endoscopic score for CD (SES-CD) from 6 months to 1 year after anti-TNF α therapy.

Results: Fifteen of 22 patients (68.1%) presented with BJA in the stomach, 13 of whom received follow-up esophagogastroduodenal endoscopy after anti-TNF α therapy. The mean CDAI and SES-CD scores significantly improved after anti-TNF α therapy (P<0.01). Despite the marked improvements in clinical and endoscopic findings, the BJA of the stomach remained unchanged in all the patients.

Conclusions: The findings indicate that BJA is frequently observed in the stomach of CD patients, regardless of whether the patient has active disease or is in remission, even after anti-TNF α therapy. Thus, BJA may be a stable endoscopic landmark in CD.

Show MeSH
Related in: MedlinePlus