cortisol-succinate--sodium-salt and Crohn-Disease

We report the case of a 35-year-old man who presented with fever, diarrhea, and a left abdominal mass. Diagnostic studies confirmed Crohn disease and revealed an abdominal mass obstructing the left ureter with hydroureter and hydronephrosis. The patient was successfully treated conservatively, with corticosteroids and mesalamine, A review of the literature indicates a predominance of right ureteral involvement in Crohn disease, associated with a high incidence of ileocecal disease. Most of these patients were treated surgically, with resection of ileocecal lesion and/or ureterolysis. Ureteral obstruction as a complication of Crohn disease is discussed, with emphasis on conservative treatment.

Topics: Adult; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Crohn Disease; Humans; Hydrocortisone; Hydronephrosis; Male; Mesalamine; Nephrostomy, Percutaneous; Stents; Tomography, X-Ray Computed; Treatment Outcome; Ureteral Obstruction

The efficacy of a 5-day intensive intravenous regimen (IVR), used as treatment for severely active Crohn's disease in 49 patients, has been evaluated retrospectively. The value of such systemic therapy has not been reported before. Immediate remission was achieved in 38 (76%) patients with no significant difference between those with established disease and those seen for the first time. Patients with ileocolonic disease had the poorest response. There was no apparent change in the natural history of the Crohn's disease after IVR therapy. Nevertheless, this is a safe and effective method of achieving remission in most sick patients with severely active Crohn's disease.

Topics: Adolescent; Adult; Aged; Crohn Disease; Drug Therapy, Combination; Female; Humans; Hydrocortisone; Infusions, Parenteral; Male; Metronidazole; Middle Aged; Prednisolone; Recurrence; Retrospective Studies; Tetracycline; Time Factors

We have analyzed the results of anti-inflammatory drug treatment of 100 consecutively treated patients with Crohn's disease. The disease affected the colon in 12 patients, small bowel in 36, and both colon and small intestine in 52. Thirty-two patients had had a prior resection of Crohn's disease. According to an adaptive design, patients were treated with sulfasalazine if able to take oral drugs; with steroids if unable to take, or unresponsive to, sulfasalazine; and with added azathioprine if unresponsive to sulfasalazine and steroids and unsuitable for surgery. Drug regimens included sulfasalazine alone in 39 patients, steroids alone in seven patients, both sulfasalazine and steroids in 43 patients, and added azathioprine in 11 patients. All patients completed at least 1 year, or were regarded as treatment failures after 3 months of drug treatment. We analyzed clinical and radiographic responses. Significant improvement occurred in all categories of patients: complete or partial clinical remission was observed in 79%, and complete or partial radiographic regression was observed in 55%; 30% of patients were not reexamined radiographically and the remainder showed no improvement. Our study suggests that properly selected anti-inflammatory drug therapy has definite benefits and is indicated for patients with Crohn's disease.

Topics: Adult; Anti-Inflammatory Agents; Azathioprine; Crohn Disease; Drug Therapy, Combination; Female; Humans; Hydrocortisone; Male; Methylprednisolone; Prednisone; Prospective Studies; Radiography; Sulfasalazine