IBD definition:
dysregulated inappropriate response of the intestinal mucosal immune system to otherwise innocuous luminal antigens in a genetically susceptible host
2 main types IBD?
UC
CD
UC definition?
mucosal ulceration in colon
CD defintiion?
transmural inflammation in any part of GI system (usually distal ileum and R side colon)
Spread of inflammation in UC?
affects continuously - not patchy
Spread of inflammation in CD?
patchy
*patient who smoke are less likely to get? moer likely to get?
less UC
more CD
Count me in! get me a cigarette!
3 main factors for IBD pathogenesis?
luminal antigens
genetics - NOD2 mutation
environmental triggers
TH1 t-cell response seen in:
Cell-mediated granulomas (CD or celiac)
IFN gamma
IL2
TNF
TH2 t-cell response seen in:
hypersenitivity - food allergy, worm inf, UC?
IL4
IL5
IL10
Proinflammatory cytokines:
TNF IL1beta IL6 IL12 IL18 IL4 IFNgamma
Antiinflammatory cytokines:
IL10 TGFbeta IL1Ra IL13 PGE2 PGI2
see fistula in patient so you know its which disease?
CD!
Hallmark of CD
non-caseating granuloma
gold standard test for CD?
MR interography
typical look of colon mucosa with CD?
cobblestone!
Which IBD has rectal sparing?
CD!
IBD extraintestinal manifetations:
apthous stomatitis episcleritis and uveitis arthritis vascular complications (clotting) E Nodosum P gangrenosum BONE DISEASE
more inflammation cytokines with which IBD?
more with CD!
IBD peripheral arthritis:
- affects whihc joints?
- how does it affect?
- large joints
- monoarticular
- asymmetric
- no synovial destruction
- seroneg
UC and liver complication:
primary sclerosing cholangitis –
only sulfa -related toxicity?
male infertility
hemolytic anemia
agranulocytosis
Sulfa and 5ASA toxicity?
alveolitis
pancreatitis
5ASA toxicity
nephritis
