IntroductionRecently, there is an increasing interest in the link between anorexia nervosa and autoimmune diseases. Studies show significant association between anorexia nervosa, diabetes mellitus, autoimmune thyroid disease and Crohn's disease [1]. The findings of significantly elevated autoantibodies (anti α-MSH, anti ACTH) and cytokines (IL-1, IL-6, IFN-γ, TNF-α) support this relationship.ObjectivesTo illustrate with a clinical case the connection between eating disorders and Crohn's disease.MethodsFourteen years-old boy with moderate depression syndrome after his grandfather's decease. Since overweight diagnosis by his pediatrician, he begins to restrict food intake with an important weight loss (19 kg in 9 months) and over exercising. Blood test reveals microcytic and hypochromic anaemia, rest of the examination shows no other disorder. Psychometric assessment EDI-3 suggests Anorexia Nervosa restricting type.ResultsTwo months after clinical stabilization, he is hospitalized due to abdominal pain. Exploration including blood test, serology, coproculture, sonography and colonoscopy reveals severe Crohn's disease.ConclusionsThis case is about a patient diagnosed of moderate depressive syndrome, who develops anorexia nervosa and Crohn's disease during his follow up. It exemplifies the link between stress, immunity and eating disorders. Recent findings suggest that immune diseases are involved in onset and maintenance of eating disorders. More studies are required in order to inference its consequences in evaluation, prognostic, treatment and identification of subgroups of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Los síndromes periódicos asociados con criopirinas (Cryopyrin Associated Periodic Syndromes, CAPS), o criopirinopatías, son enfermedades raras que hacen parte de los síndromes autoinflamatorios, caracterizados por episodios de fiebre recurrente e inflamación sin etiología autoinmunitaria, neoplásica ni infecciosa. Entre estos síndromes, los CAPS incluyen tres entidades: el síndrome autoinflamatorio familiar por frío (Familial Cold Autoinflammatory Syndrome, FCAS), el síndrome de Muckle-Wells y la enfermedad multisistémica inflamatoria de inicio neonatal (Neonatal Onset Multisystem Inflammatory Disease, NOMID), también conocida como síndrome articular, cutáneo y neurológico crónico infantil (Chronic Infantile Neurological Cutaneous and Articular (CINCA) syndrome). Se han identificado mutaciones en el gen NLRP3 como etiología de estos síndromes, con un patrón de herencia autosómico dominante en la mayoría de los casos. El diagnóstico suele hacerse por sus manifestaciones clínicas, con apoyo de la biopsia de piel, y se confirma con el estudio genético. Hasta la fecha, el tratamiento basado en el bloqueo de la IL-1β, ha mostrado una mejoría satisfactoria en la mayoría de los pacientes.
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