Causal Link Found Between Ibd And Psoriasis Psoriatic Arthritis
Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis, frequently co-occurs with the immune-mediated inflammatory condition, psoriasis.
New research suggests a causal effect between inflammatory bowel disease , particularly in Crohn’s disease, and both psoriasis and psoriatic arthritis , although not vice versa. Ulcerative colitis did not appear to be responsible for the causal effect. Results may allow clinicians to better manage IBD and psoriasis in clinical practice, according to a study published in JAMA Dermatology.1
About 30% of patients with psoriasis experience psoriatic arthritis, a systemic inflammatory arthritis sharing common pathogenetic and immunologic features with psoriasis, investigators stated. Furthermore, it is now recognized that psoriasis is associated with other immune-mediated inflammatory conditions in particular, IBD, including Crohn’s disease and ulcerative colitis as the main subtypes, appears to frequently co-occur with the disease.
In total, 12,882 cases of IBD, along with 21,770 controls, were identified based on up to 15 studies, with 5956 patients with Crohn’s disease and 6968 patients with ulcerative colitis . Additionally, 5621 cases of PsO and 2063 cases of PsA were obtained from the FINNGEN Consortium and compared with 252,323 controls.
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Keep An Eye Out For Side Effects
Remember that any medicine you take for lupus can have side effects. Talk with your doctors about what changes to watch for with the medicines youre taking. And tell your treatment team right away if you have any side effects.
If you have symptoms of digestive problems, tell your doctors right away. Its important to treat these problems early, before they cause serious damage to the digestive organs.
This resource is available as a PDF in English, Spanish, and Chinese . Download now to print and share.
Concurrent Monoclonal Gammopathy And Systemic Lupus Erythematosus In A Known Case Of Ulcerative Colitis: A Case Report
Tehran University of Medical Sciences, Tehran, Iran
NeuroTRACT Association, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran, Iran
Correspondence
Tehran University of Medical Sciences, Tehran, Iran
NeuroTRACT Association, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran, Iran
Correspondence
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Immunology Database And Analysis Portal
The partnership is using several new or developing technologies to analyze information from single cells and groups of cells involved in autoimmunity collecting tissue samples, including synovium from people with RA and kidney from people with lupus for molecular analysis developing computational tools to integrate different data types to characterize molecular pathways and making the data available to the broad research community for further analysis through dbGaP and ImmPort . The first datasets were released in 2018.
Researchers mining the data can seek to identify treatment targets to develop medicines for diseases of interest. The data also has potential implications for precision medicine, as AMP RA/SLE researchers identify differences in the pathways active in the tissue of different patients.
Crohns Disease Inflammatory Bowel Disease
Crohns disease and celiac disease share many common symptoms, though the underlying causes are different. In Crohns disease, the immune system could be causing disruption anywhere along the gastrointestinal tract, and more diagnostic testing is needed to establish a diagnosis compared to celiac disease. Treatment consists of diet changes and possible surgery. A substantial overlap of patients with these two conditions suggests there may be a genetic connection between the two, and research is continuing in that area.
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About Rheumatoid Arthritis And Lupus
Rheumatoid arthritis and lupus are relatively common, severe disorders. About 1.5 million people or about 0.6 percent of the U.S. adult population have rheumatoid arthritis. Estimating how many people in the U.S. have lupus is difficult because symptoms vary widely and onset is often hard to pinpoint. Both conditions are autoimmune diseases that occur when the immune system mistakenly attacks parts of the body that it is designed to protect. They represent just two of a larger number of autoimmune disorders, including multiple sclerosis, Crohns disease, ulcerative colitis, type 1 diabetes, and psoriasis. These diseases share common flaws in immune function and regulation, leading to inflammation that destroys tissues. They can last a lifetime, cause severe disability, greatly affect quality of life, and are associated with increased risk of death.
Take Medications As Prescribed
Make sure you follow your treatment plan as prescribed. If you think it needs adjusting, speak with your doctor before making any changes.
If you see multiple doctors, ask them to share medical information to coordinate your care. Ask about interactions between drugs, especially if youre taking various medications to manage multiple conditions.
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What Is Inflammatory Bowel Disease
Crohns disease and ulcerative colitis are also known as inflammatory bowel diseases. Crohns disease tends to affect the small intestine, although any part of the digestive tract may be involved. Ulcerative colitis usually causes an inflammation in all or part of the large intestine. People with inflammatory bowel disease often have diarrhea, abdominal pain, fever, and weight loss.
The causes of Crohns disease and ulcerative colitis are unknown. It is sometimes difficult to distinguish one disease from the other, and there is no cure for either condition. Medications are often prescribed to control the symptoms of IBD in some cases, surgical removal of the involved intestine may be necessary.
Treatment For Autoimmune Diseases
Just as each disease has its unique set of signs and symptoms, treatment is unique to each person and illness. Many medications can treat or manage a variety of autoimmune diseases. Each treatment is tailored to each patients needs. They depend on the severity of the disease and how well the treatment works.
The treatments for autoimmune diseases usually work towards slowing down the immune systems response. Since the immune system is working too hard at fighting the healthy cells, the doctors want to slow down the overall response. This involves using medications such as corticosteroids or certain types of immunotherapies. However, while these treatments stop your immune system from attacking the healthy cells, they also slow down your ability to fight viruses, bacteria, and other dangerous organisms. This is why you have a higher risk of getting an infection.
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Medicines To Avoid If You Have Uc
A few medicines that help AS may be risky for people with UC. Etanercept is a TNF inhibitor that treats AS but doesn’t help with UC. You may want to avoid Enbrel because there’s a chance it could cause more IBD flare-ups.
Nonsteroidal anti-inflammatory medicines like ibuprofen and naproxen are an important part of the treatment for AS. NSAIDs bring down swelling in the joints. But they’re not recommended for people with ulcerative colitis because they irritate the lining of the intestines, which could trigger UC flares and make symptoms even worse.
Nausea Vomiting Diarrhea And Constipation
Nausea, vomiting, diarrhea, and constipation can be side effects of some of the drugs commonly used to treat lupus symptoms, especially NSAIDs and steroids. People with lupus are also more susceptible to infections if they are taking immunosuppressants, and these symptoms are common side effects of GI infections.1,2
If lupus attacks the intestinal tissue itself, irritable bowel syndrome may result because the intestines stop moving food properly through the system. People with lupus rarely also develop celiac disease, an autoimmune reaction to gluten.1,2
Ulcerative colitis and Crohns disease are different forms of inflammatory bowel disease. People with lupus sometimes develop ulcerative colitis but it is rare for someone with lupus to develop Crohns disease . Bloody diarrhea and abdominal pain are common with both, but these are 2 distinct conditions.1,2
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Crohn’s Disease And Lupus
The concurrence of SLE and CD is rare. There are very few case reports of the co-existence of these two diseases while data regarding common genetic susceptibility between SLE and CD is controversial. A study did not find evidence that the Crohn’s disease-associated mutations on CARD15 contributed to SLE susceptibility. A pooled analysis of existing published and unpublished data in 1305 cases of SLE genotyped for the CARD15 risk alleles suggests that only the CARD15 IBD risk allele may have a strong effect on risk of SLE.
In total nine cases of CD and SLE and one with CD and subacute cutaneous lupus erythematosus have so far been described, all in young individuals. One of these cases was complicated with massive lower gastrointestinal bleeding, in another one rheumatoid arthritis with SLE, Sjögren’s syndrome and CD were co-existing and finally one case was of familial CD with three family members affected.
In the majority of these cases CD was the preceding diagnosis. However, in some cases CD diagnosis also followed, SLE diagnosis. Two of the eight cases were complicated by lupus nephritis, and one of them showed favorable renal response to infliximab.
The differentiation of CD from SLE gastrointestinal involvement may be difficult. In fact, cases with inflammatory bowel diseases like CD could show similar clinical signs and symptoms to SLE, and in some cases of CD might fulfill some of the classification of criteria for SLE.,
Trouble Swallowing And Gerd
Scientists estimate that between 20 percent and 70 percent of people with lupus experience esophageal motility disorder. The esophagus is the muscle that connects the throat to the stomach and its action moves food through the first parts of the digestive tract. Motility refers to the action of the muscle that moves food through the tube of the esophagus. When lupus inflames the esophagus people may have trouble swallowing or stomach acids may creep up from the stomach causing gastroesophageal reflux disease . GERD is sometimes called acid reflux and causes heartburn or gas.1,3
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Symptoms Of Autoimmune Diseases
Each disease has its own set of signs and symptoms, depending on the part of the body it primarily affects. Therefore, if you have rheumatoid arthritis, the symptoms would include pain, redness or warmth over the joints, and swelling. If you have inflammatory bowel disease, your symptoms would be related to your bowel habits and pain or discomfort in your intestines. Other diseases, such as lupus, may affect one part of your body at first, then affect other areas as the disease progresses.
How Are Lupus Gi Complications Treated
The treatments for GI complications are as wide-ranging as the symptoms themselves.
Mild heartburn caused by GERD or medications like NSAIDs can be treated with over-the-counter antacids such as Rolaids, Maalox or Tums. For more serious heartburn, your doctor may prescribe a proton-pump inhibitor, histamine-2 blocker, or promotility agent. Heartburn and acid reflux may also be improved by changing your eating habits. Eating smaller meals, avoiding laying down after eating, and cutting back on caffeine can help you avoid heartburn.4
Gastrointestinal infections may be treated with bed rest, extra fluids, and antibiotics, if necessary.
How pancreatitis is treated depends on its root cause. Pancreatic vasculitis is treated with steroids while steroid-induced pancreatitis is treated by reducing or stopping steroid use.1
Autoimmune hepatitis is treated with steroids or an immunosuppressant. However, doctors must rule out that liver inflammation is not caused by medications like steroids first.1
Peptic ulcers may be treated with over-the-counter products such as Prevacid, Prilosec, or Cytotec.
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Concomitant Diagnosis Of Ibd And Sle
Concomitant diagnosis of IBD and SLE is rare and IBD may occur either before or after SLE diagnosis . Although a chance occurrence cannot be excluded it is possible that both conditions share some genetic or immunological defects. However, data on common genetic susceptibility between SLE and CD is controversial., In addition, certain medications used for treating IBD may cause drug-induced lupus.
According to a referral center study the overall prevalence of concomitant ulcerative colitis diagnosis is 0.4% of SLE patients. The concurrence of SLE and Crohn’s disease is even more rare.
Only few cases of SLE-related to UC have been reported so far, and numbers of SLE related CD are even less including some cases with presumable co-existence of the two diseases.
The majority of those patients have excellent response to steroids combined with hydroxychloroquine or/and azathioprine. However, some patients with CD may have life-threatening gastrointestinal bleeding and some may need high dosage methylprednisolone for maintenance therapy. The prognosis of SLE-related IBD is usually good.
Growth And Development Problems For Children
You can get ulcerative colitis at any age, but its more common among 15- to 30-year-olds. A child with UC may:
- Red or discolored
Continued
Talk to your doctor right away if youre worried that you might have DVT. Its possible for a deep-vein blood clot to break loose and get stuck in a lung artery. If that happens, its an emergency called a pulmonary embolism . You could have symptoms like shortness of breath, sharp chest pain, and a cough with or without blood. Call 911 if you have these signs.
Doctors can treat DVT and pulmonary embolisms with medications, a filter through a vein that removes the clot, or surgery.
You could be more likely to get DVT or PE if you:
- Have ulcerative colitis that flares often or affects a large amount of your colon.
- Get surgery for severe ulcerative colitis.
Some studies also link certain ulcerative colitis meds, like steroids or tofacitinib, to DVT and PE.
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The Link Between Inflammatory Bowel Disease And Osteoporosis
People with IBD are often treated with medications known as glucocorticoids to reduce the inflammation caused by their disease. Over time, these drugs interfere with the development and maintenance of healthy bones. Bone loss increases with the amount and length of glucocorticoid therapy.
In addition, people with severe inflammation of the small bowel or those who have parts of the small bowel surgically removed may have difficulty absorbing calcium and vitamin D. This is an additional concern for bone health.
Association Between Ulcerative Colitis And Systemic Lupus Erythematosus: Report Of Two Cases
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- European Journal of Gastroenterology & Hepatology
- European journal of internal medicine
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- The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy
- View 2 excerpts, cites background
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Ulcerative Colitis And Lupus
The association between UC and SLE is rare. Since Brown et al. reported the first UC and SLE case in 1956, Dubois and Tuffaneli reported that the incidence of UC in 520 cases of SLE was 0.4% and in October 1975 Tsuchiya et al. reported that they had found so far 35 cases of SLE with UC reported in the literature including their own case. Our thorough search in the literature resulted in eleven additional cases from 1988 until today. Another patient from this list developed hypocomplementemic urticarial vasculitis syndrome, a year prior to the onset of ulcerative colitis. Ten years later, primary sclerosing cholangitis and the antiphospholipid syndrome developed concomitantly.
In these series, one case of patient with small bowel perforation due to concomitant non-Hodgkin-lymphoma occurred. The same list includes three cases of lupus nephritis., Among those three cases, one was with diffuse proliferative lupus nephritis and two with chronic glomerulonephritis and mild renal failure respectively. In the first case nephrotic syndrome partially improved with corticosteroid therapy combined with cessation of sulfasalazine. An additional case of severe UC, dural sinus thrombosis and lupus anticoagulant could be probably added in this list. The patient was successfully treated with osmotic agents, prophylactic anticonvulsant, and antiplatelet therapy, combined with i.v. steroids.
Coexistence Of Lupus Nephritis Ulcerative Colitis And Communicating Hydrocephalus: A Report Of A 21
Nida Saleem
Abstract
Systemic lupus erythematosus and ulcerative colitis are multisystem autoimmune disorders that rarely coexist. We report a case history of a 21-year-old male, presenting with bloody diarrhea and, later, diagnosed to have ulcerative colitis on colonic biopsy. There was clinically silent renal impairment leading to end-stage kidney disease requiring hemodialysis possibly secondary to ongoing lupus nephritis as suggested by positive lupus-specific antibodies detection. Besides this, the diagnosis of lupus associated with early communicating hydrocephalus was made on CT brain findings which clinically responded well to the initiation of immunosuppressive therapy. It is imperative to keep in mind the remote possibility of ulcerative colitis in an SLE patient with gastrointestinal manifestations. Communicating hydrocephalus is a rare neurological manifestation of SLE leading to seizures and can respond well to the initiation of steroids and immunosuppressants. Therefore, a trial of immunosuppressant medications must be given even in a patient with end-stage renal disease to halter extra renal rare lupus manifestations.
1. Introduction
2. Case
Ultrasound of the abdomen was performed in the ER which showed bilateral small echogenic kidneys with grade III renal parenchymal echogenicity as shown in Figure 1.
In order to identify the exact cause of his renal impairment, his autoimmune workup was sent, which is shown in Table 2.
3. Discussion
4. Conclusion
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Autoimmune Diseases Dont Cause Sepsis
Autoimmune diseases do not cause sepsis. But people with certain types of autoimmune diseases are at higher risk of developing infections, which can cause sepsis. As well, medications that may be used to treat some autoimmune disorders can weaken your immune system, making it easier for you to develop an infection. This includes treatments with corticosteroids , chemotherapy, and immunotherapy.
Sepsis is the bodys life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Bacterial infections are the most common cause of sepsis. Worldwide, one-third of people who develop sepsis die. Many who survive are left with life-changing effects, such as post-traumatic stress disorder , chronic pain and fatigue, organ dysfunction , and/or amputations.
Some autoimmune diseases that increase your risk of infection include:
- Inflammatory bowel disease, such as Crohns disease and ulcerative colitis
- Myasthenia gravis
- Rheumatoid arthritis
- Lupus systemic lupus erythematosus