Crohn's disease and Takayasu's arteritis: An uncommon association

Takayasu’s arteritis(TA)and Crohn’s disease(CD)are two rare autoimmune disorders;however some reports describe the presence of both diseases in the same patient.This finding has suggested the possibility that both diseases could share some common etiologic origin.We describe a case of a 13-year-old male affected by CD characterized by fever,diarrhea,weight loss,abdominal pain and elevation of inflammatory markers.Clinical and histological features from colonic specimens were consistent with CD.Treatment with steroids and azathioprine was started,however disease flared every time steroids were tapered.One year later,while still on treatment,he came back to our attention for dyspnea at rest and at night,tiredness and weakness.At physical examination a diastolic heart murmur was found as well as a left carotid artery bruit.A transthoracic echocardiography showed mild aortic valve insufficiency,left ventricular hypertrophy and a dilated ascending aorta with same findings at the aortic arch.A computed tomography scan showed abdominal aortathickening,dilated thoracic aorta and the presence of a thoracic aortic aneurysm.TA associated with CD was diagnosed and medical treatment with cyclophosphamide,steroids and aminosalicylic acid was started,with good clinical response at 6 mo follow-up.We discuss the presence of possible common causes for the two diseases and the importance of differential diagnosis in those patients characterized for intractable disease.

Heterozygous nucleotide-binding oligomerization domain-2 mutations affect monocyte maturation in Crohn's disease

瞄准：在 Crohn 的疾病(CD ) 调查单核白血球的函数病人并且相关这与联系疾病的核苷酸绑定 oligomerization domain-2 (NOD2 ) 基因变体。方法：从 47 个连续地提交的 CD 病人和 9 健康供血者的单核白血球与 interleukin (IL ) 是有教养的 -4 和 granulocyte 巨噬细胞刺激殖民地的因素(GM-CSF ) ，并且与脂肪的多糖(LPS ) 或 muramyldipeptide (MDP ) 刺激了， NOD2 的通常认为的 ligand。结果：我们发现从 CD 病人的单核白血球区分了在试管内到成熟树枝状的房间(DC ) ，由免疫显型和形态学决定了。NOD2 遗传型在所有题目被估计，并且我们观察到在 NOD2 的不成熟、刺激 LPS 的 DC 上的高 CD86 表示变异 CD 病人，作为与 wtNOD2 CD 病人和控制相比。由对比，导致到成熟， MDP 源于变异 NOD2 的题目的 DC 的 CD86 表示层次比得上正常题目的那些。在耐心房间的文化的 IL-12p70 的数量与 MDP 比在在 LPS 治疗，然而并非术后疗法以后的控制大。结论：我们的结果建议在 NOD2 基因与变化从病人获得的 DC 显示高 CD86 表示描绘的激活的显型，但是当与终端相比区别分阶段执行时，有减少的回答到 MDP。我们推测单核白血球的改变的区别可能导致在发炎和单核白血球的杀死的能力之间的不平衡，并且可能与 CD 的致病相关。