Multiple Aseptic Liver Abscesses as the Initial Manifestation of Crohn's Disease

Zakout, Raed; Fonseca, Marina; Santos, João; Marques, A.P.; Távora, Isabel; Oliveira, E S; Ferreira, Carlos Noronha; Victorino, Rui M. M.

doi:10.1007/dcr.0b013e318199db60

Cited by 17 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maintenance therapy should follow because relapse is common, as seen in over half of the patients in the literature review and in one of our two patients. Interestingly, no patients in the literature experienced relapse while on maintenance therapy of azathioprine, sulfasalazine, adalimumab, or infliximab, although the durability of this response is unknown [ 7 , 8 , 10 , 13 , 17 , 19 , 21 ]. There were no reported fatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

Bollegala

Khan

Scaffidi

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

Background. Aseptic abscesses (AA) are sterile lesions that represent an extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). Though Canada has the highest prevalence of IBD in the world, reports of IBD-associated AA are absent in Canada. This may represent a different IBD phenotype or underrecognition and underreporting. Purpose. To explore AA as a possible EIM of IBD and evaluate clinical and investigative findings among patients with IBD-associated AA. Methods. Retrospective chart and literature reviews were performed to find cases of IBD-associated AA at our institution and in the literature. Results. We identified 2 cases of IBD-associated AA in our institution. Both patients had ulcerative colitis and presented with fever, abdominal pain, and weight loss. Radiological workup and aspiration showed sterile splenic abscesses. The AA were unresponsive to antibiotics. One patient improved on corticosteroids and one underwent splenectomy. We retrieved 37 cases of IBD-associated AA from the literature. All patients showed no evidence of infection, failed to resolve with antibiotics, and, if attempted, improved on corticosteroids. Conclusions. Our cases are the first reported in Canada. They support literature which suggests AA as an EIM of IBD and may help increase recognition and reporting of this phenomenon.

show abstract

Section: Discussionmentioning

confidence: 99%

Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

Bollegala

Khan

Scaffidi

et al. 2017

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

show abstract

“…[ 38 51 60 ] Only one study was conducted in Saudi Arabia,[ 47 ] and just one article was published from the remaining Arabian Gulf Countries, from Kuwait. [ 22 ] The remaining studies were reported from Italy,[ 25 34 ] Israel,[ 27 28 ] France,[ 21 32 ] Korea,[ 55 ] Portugal,[ 53 ] Germany,[ 29 ] Turkey,[ 31 ] India,[ 39 ] China,[ 40 ] Switzerland,[ 45 ] Canada,[ 49 ] and The Netherlands. [ 43 ]…”

Section: Resultsmentioning

confidence: 99%

Hepatic Abscess in Inflammatory Bowel Disease: A Systematic Scoping Review of an Overlooked Entity

Alshammary,

Boumarah

2023

Saudi Journal of Medicine &Amp; Medical Sciences

View full text Add to dashboard Cite

Background: Liver abscess is one of the hepatobiliary manifestations of inflammatory bowel disease (IBD) that has been scarcely described in the literature. Objectives: To conduct a scoping review to provide a detailed description of the occurrence of hepatic abscess in patients with IBD and summarize the observed clinical features. Methodology: Searches were carried out using relevant keywords in Medline (via PubMed) and Web of Science from inception until June 13, 2022. Only articles that reported the occurrence of hepatic abscess in patients with IBD were included. Results: Forty-eight publications (40 case reports and 8 case series) were included, representing 73 patients with IBD who were radiologically or intraoperatively diagnosed with hepatic abscess. Patients with Crohn’s disease were more predisposed to developing hepatic abscess than patients with ulcerative colitis (79.5% vs. 20.5%, respectively). Furthermore, pyogenic liver abscess was found to be more prevalent (57.9%) compared with aseptic (38.7%) and amebic (3.2%) abscesses. No clear relation was found between death or prolonged hospital stay in terms of the clinical presentation or management plan, as mortality was reported in different age groups with different managements. Conclusion: To date, there is no consensus regarding the appropriate management of hepatic abscess as an extraintestinal manifestation of IBD. However, the condition shares several features with liver abscess diagnosed among the general population.

show abstract

“…Many liver diseases have been associated with CD including nonalcoholic liver disease [ 19 ], primary sclerosing cholangitis [ 20 ], aseptic liver abscesses [ 21 ], abnormal liver function [ 22 ], and inflammatory pseudotumors [ 23 ]. One hypothesis is that the gut-liver axis may be playing a role in the evolution of liver diseases in the setting of CD [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review

Fortinsky

Alali

Jeejeebhoy

et al. 2014

Case Reports in Gastrointestinal Medicine

View full text Add to dashboard Cite

Hepatocellular carcinoma most commonly occurs in patients with underlying liver disease or cirrhosis. We describe a case of hepatocellular carcinoma in a 34-year-old man with Crohn's disease treated with azathioprine and infliximab. The patient had no history of liver disease and a complete autoimmune and viral workup was unremarkable. Unfortunately, the patient developed widespread metastatic disease and passed away 5 months after his initial diagnosis. The mechanism of hepatocellular carcinoma in patients' with Crohn's disease is poorly understood and may include both autoimmunity and treatment-related complications. Previous case reports suggest the possibility of a concerning association between azathioprine therapy and the development of hepatocellular carcinoma in patients with Crohn's disease. Clinicians may consider early imaging in patients with Crohn's disease presenting with concerning symptomatology or abnormal liver enzymes, especially in those being treated with azathioprine alone or in combination with infliximab. Future research may help to uncover additional risk factors for this exceedingly rare diagnosis in this patient population.

show abstract

Multiple Aseptic Liver Abscesses as the Initial Manifestation of Crohn's Disease

Cited by 17 publications

References 14 publications

Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

Aseptic Abscesses and Inflammatory Bowel Disease: Two Cases and Review of Literature

Hepatic Abscess in Inflammatory Bowel Disease: A Systematic Scoping Review of an Overlooked Entity

Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review

Contact Info

Product

Resources

About