Leopard Skin–Like Colonic Mucosa

Obayashi, Naho; Arai, Katsuhiro; Nakano, Natsuko; Mizukami, Tomoyuki; Kawai, Toshinao; Yamamoto, Shojiro; Shimizu, Hirotaka; Nunoi, Hiroyuki; Shimizu, Toshiaki; Tang, Julian; Onodera, Masafumi

doi:10.1097/mpg.0000000000000905

Cited by 7 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While epithelioid histiocytes are commonly seen in both CGD and CD, pigmented macrophages in the lamina propria are more likely to be present in patients with CGD. 7 On endoscopic evaluation of patients with CGD, Obayashi et al described the unique finding of brown spots on yellow edematous mucosa, termed “leopard sign.” 8 Other histologic features commonly seen in biopsies of these patients include microgranulomas, tissue eosinophilia, and chronic and/or acute inflammation. 4,7…”

Section: Discussionmentioning

confidence: 99%

“…7 On endoscopic evaluation of patients with CGD, Obayashi et al described the unique finding of brown spots on yellow edematous mucosa, termed "leopard sign." 8 Other histologic features commonly seen in biopsies of these patients include microgranulomas, tissue eosinophilia, and chronic and/or acute inflammation. 4,7 The diagnosis of CGD is made through assays measuring neutrophil superoxide production, including the nitroblue tetrazolium and DHR tests.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A 9-Year-Old Male With Generalized Lymphadenopathy and Granulomatous Inflammation

Ditchek

Suryadevara

Wali

2019

Clin Pediatr (Phila)

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A 9-Year-Old Male With Generalized Lymphadenopathy and Granulomatous Inflammation

Ditchek

Suryadevara

Wali

2019

Clin Pediatr (Phila)

View full text Add to dashboard Cite

“…They are informative and has a satisfactory safety profile [ 28 ]. Some unique endoscopic findings have been reported for some monogenic IBDs, such as the leopard sign in chronic granulomatous disease (CGD) [ 29 ]. Regarding the histological findings of VEO-IBD, compared with older age at onset of IBD, apoptosis, severe chronic architectural changes, small intestinal villous blunting, and eosinophilic infiltration were more frequently found [ 30 ].…”

Section: Endoscopic and Histological Findingsmentioning

confidence: 99%

Very Early-Onset Inflammatory Bowel Disease: A Challenging Field for Pediatric Gastroenterologists

Arai

2020

Pediatr Gastroenterol Hepatol Nutr

Self Cite

View full text Add to dashboard Cite

With the increasing number of children with inflammatory bowel disease (IBD), very earlyonset IBD (VEO-IBD), defined as IBD that is diagnosed or that develops before 6 years of age, has become a field of innovation among pediatric gastroenterologists. Advances in genetic testing have enabled the diagnosis of IBD caused by gene mutations, also known as monogenic or Mendelian disorder-associated IBD (MD-IBD), with approximately 60 causative genes reported to date. The diagnosis of VEO-IBD requires endoscopic and histological evaluations. However, satisfactory small bowel imaging studies may not be feasible in this small population. Both genetic and immunological approaches are necessary for the diagnosis of MD-IBD, which can differ among countries according to the available resources. As a result of the use of targeted gene panels covered by the national health insurance and the nationwide research project investigating inborn errors of immunity, an efficient approach for the diagnosis of MD-IBD has been developed in Japan. Proper management of VEO-IBD by pediatric gastroenterologists constitutes a challenge. Some MD-IBDs can be curable by allogenic hematopoietic stem cell transplantation. With an understanding of the affected gene functions, targeted therapies are being developed. Social and psychological support systems for both children and their families should also be provided to improve their quality of life. Multidisciplinary team care would contribute to early diagnosis, proper therapeutic interventions, and improved quality of life in patients and their families.

show abstract

“…Although these endoscopic and pathological findings are nonspecific, Obayashi et al. ( 7 ) reported specific endoscopic findings in three Japanese patients with CGD-associated colitis. These findings were characterised by the appearance of brown dots distributed across the yellowish oedematous mucosa and were termed “leopard sign”.…”

Section: Introductionmentioning

confidence: 98%

“…In contrast, the histological findings resemble those of Crohn's disease, which is characterised by granuloma, cryptitis, crypt abscesses, a predominance of eosinophils, and a paucity of neutrophils (4)(5)(6). Although these endoscopic and pathological findings are nonspecific, Obayashi et al (7) reported specific endoscopic findings in three Japanese patients with CGD-associated colitis. These findings were characterised by the appearance of brown dots distributed across the yellowish oedematous mucosa and were termed "leopard sign".…”

Section: Introductionmentioning

confidence: 99%

Case Report: The leopard sign as a potential characteristic of chronic granulomatous disease-associated colitis, unrelated to colitis severity

Nishikawa,

Tomoda,

Nakamura

et al. 2023

Front. Immunol.

View full text Add to dashboard Cite

BackgroundChronic granulomatous disease (CGD) is an inborn immune disorder in which the phagocytic system cannot eradicate pathogens, and autoinflammation occurs. Approximately half of the patients have associated gastrointestinal symptoms. Although most cases with CGD-associated colitis present nonspecific histology, colonoscopy in some cases shows brownish dots over a yellowish oedematous mucosa, which is termed a “leopard sign”. However, the significance of these signs remains unclear.MethodsWe collected data from patients with CGD whose colonoscopic findings showed the leopard sign.ResultsThree patients with CGD and leopard signs were enrolled in this study. One patient underwent colonoscopy for frequent diarrhoea and weight gain failure, and another for anal fistula. The third patient was without gastrointestinal symptoms and underwent colonoscopy as a screening test before allogeneic haematopoietic cell transplantation (HCT). Endoscopic findings showed a mild leopard sign in the first case; however, non-contiguous and diffuse aphthae were observed throughout the colon. The other two cases were unremarkable except for the leopard sign. All the patients achieved remission with oral prednisolone or HCT. One patient underwent colonoscopy after HCT; results revealed improvements in endoscopy (including the leopard sign) and histological findings. However, another patient underwent colonoscopy after prednisolone treatment; this revealed no change in the leopard sign.ConclusionThe leopard sign in the colon may be a characteristic endoscopic finding of CGD, even in patients who do not develop severe gastrointestinal symptoms; however, it does not reflect the severity of CGD-associated colitis.

show abstract

Leopard Skin–Like Colonic Mucosa

Abstract: Although nonspecific endoscopic findings of CGD-associated colitis have been reported before, our observation of brownish dots spread across a yellowish edematous mucosa, termed "leopard sign," could be a unique feature of this condition.

Cited by 7 publications

References 19 publications

A 9-Year-Old Male With Generalized Lymphadenopathy and Granulomatous Inflammation

A 9-Year-Old Male With Generalized Lymphadenopathy and Granulomatous Inflammation

Very Early-Onset Inflammatory Bowel Disease: A Challenging Field for Pediatric Gastroenterologists

Case Report: The leopard sign as a potential characteristic of chronic granulomatous disease-associated colitis, unrelated to colitis severity

Contact Info

Product

Resources

About