Nonspecific Ulcerative Colitis Research Articles

Neutrophil extracellular traps in the anti-infectious defense of human organism

Background. Neutrophil extracellular traps (NETs) are net-like structures that have been investigated in inflammatory diseases. However, the presence of NETs in infected persons without clinical symptoms has not been yet studied.Aim. To reveal NETs in healthy persons during and after the H1N1 influenza pandemic as well as to study the functional activity of NETs.Materials and methods. The study included two groups of volunteers (n = 10 in each group) aged 20–25 years. The first group of volunteers was examined in the absence of acute diseases during one month before the study and in the absence of chronic diseases in the medical history. Volunteers of the second group were in contact with patients with influenza, but did not get sick. The comparative study also included patients with acute inflammation in the abdominal cavity (appendicitis, cholecystitis, abscess; 12 patients) and 9 patients with non-specific ulcerative colitis. Neutrophils were isolated from the blood by the traditional method of Ficoll density centrifugation. The number, morphology, and functional activity of NETs were determined (by capture of Klebsiella pneumoniae). SYBR Green I-based fluorescence microscopy was used to visualize and quantify NETs.Results. In healthy volunteers who were not in contact with infected patients, spontaneous NETs formation did not occur. Neutrophils of persons who were in contact with infected patients spontaneously formed NETs. In this case the number of NETs reached 8.58 ± 0.51%, and the size of NETs amounted to 39.68 ± 3.52 µm. NETs effectively captured cells of the tested microorganism, which was accompanied by retraction of network fibers and transformation of the network structure into a cloud-like one, which retained 89.38 ± 5.86 microbial cells. For comparison, the NETs in patients with acute inflammation in the abdominal cavity captured and bound 20.2 ± 1 .67 microbial cells and with non-specific ulcerative colitis – 5.53 ± 0.34 cells.Conclusion. High binding capacity of NETs is a factor contributing to effective defense of the body against the development of an infectious disease with manifested clinical symptoms.

Tubular-villous adenoma against the background of ulcerative colitis (clinical case)

A clinical case of the development of tubular-villous adenoma with moderate epithelial dysplasia (high grade) is described, taking into account the presence of foci of squamous metaplasia in the epithelium of the glands. The pathology presented in the article according to ICD-O has code 8263/2.Description of the clinical case. The patient had an initial colonoscopy in 2020 and was diagnosed with chronic ileitis and colitis with moderate and in some areas high inflammation activity, which is most characteristic of nonspecific ulcerative colitis. The patient was treated by a gastroenterologist. In December 2021, she had a follow-up colonoscopy with the histological material sampling. Endoscopic conclusion: ulcerative colitis, total lesion, exacerbation phase.Results and discussion. When the device was inserted into the rectum at a distance of 13 cm, a neoplasm was visualized, the mucosa was pale, shiny, when trying to pass the device through the narrowing of the contact-vulnerable mucosa, with instrumental palpation, the formation was displaced by a conglomerate, a polyfragmentary biopsy was taken. In the study of histological preparations of the recto-sigmoid junction, a tubular-villous adenoma with moderate epithelial dysplasia (high grade) is determined, taking into account the presence of foci of squamous metaplasia in the epithelium of the glands. According to the literature, with ulcerative colitis affecting almost the entire colon for more than 10 years, there is an increased risk of colon cancer formation (10 %), which increases by 2–5 % annually. The possibility of malignancy is present in 10–20 % of patients with ulcerative colitis for more than 20 years. Other researchers describe the identified low-grade dysplasia as progressing to high-grade dysplasia and carcinoma in 29–54 % of cases.Conclusions. The study of patients with this pathology should be carried out against the background of thorough preparation of the large intestine with modern preparations using high-tech verification methods and polyfragmental biopsy with a qualified assessment of biopsy specimens.

ЯЗВЕННЫЙ КОЛИТ И ВНУТРИПЕЧЕНОЧНЫЙ ХОЛЕСТАЗ

Background. Ulcerative colitis (UC) is an inflammatory bowel disease with unpredicted clinical course and outcomes. Histology is an important part of UC diagnosis and plays an increasing role in management of patients, since more and more histological signs with prognostic value are being identified and confirmed. Objective. To describe a clinical case of death of a UC patient with intrahepatic cholestasis. Material and methods. The article presents autopsy and pathology findings in UC. Results. A patient admitted to the hospital for unspecified acute hepatitis, nonspecific ulcerative colitis and gastrointestinal bleeding died because of ulcerative colitis complicated by sclerosing cholangitis. The course of ulcerative colitis was complicated by bleeding from ulcerated areas; by intrahepatic and extrahepatic cholestasis as well as necrosis of hepatocytes associated with sclerosing cholangitis; by the development of hepatorenal syndrome and sepsis, that resulted in fatal outcome. Conclusions. Multiple severe disturbances occurring in UC pathogenesis result in mutual aggravation syndrome involving interaction of pathophysiological processes with subsequent patient's condition deterioration as well as increased risk of complications and death.

Ulcerative colitis and pyoderma gangrenosum presentation of a case and brief literature review

Inflammatory bowel disease (IBD) is a chronic immune-mediated disorder comprised of Crohn's disease and ulcerative colitis. Ulcerative colitis affects the large intestine, while Crohn's disease can affect any part of the gastrointestinal tract (GIT). IBD is a multisystem condition that predominantly affects the gastrointestinal, musculoskeletal, ocular, and cutaneous systems. The following dermatological manifestations associated with IBDs have been identified: Specific manifestations with the same histological features of the underlying only ocurrs in Crohn Disease (CD); cutaneous disorders associated with IBD aphthous stomatitis, erythema nodosum; reactive mucocutaneous manifestations of IBDs pyoderma gangrenosum, Sweet’s syndrome, bowel-associated dermatosis-arthritis syndrome, aseptic abscess ulcers, pyodermatitis y mucocutaneous conditions secondary to treatment including injection site reactions y eczema and manifestations due to nutritional malabsorption such as stomatitis, glossitis, angular cheilitis hair and nail abnormalities. We believe dermatological examination is essential in all IBD patients, especially in candidates to biologic therapies, in whom drug-induced cutaneous reactions may assume marked clinical relevance, such as psoriasiform eruption. One of the cutaneous manifestations associated with UC is pyoderma gangrenosum (PG), which is an inflammatory neutrophilic dermatosis that clinically presents with well-defined ulcers with an erythematous border and mucopurulent or hemorrhagic exudate.We present the case of a 44-year-old female patient, who presented non-specific chronic ulcerative colitis (UC) with active intestinal symptoms, fever, diarrhea and hematochezia, 20 days later it began with pustules on the head, trunk and extremities, which evolved into an ulcer with a border erythematous and well defined whose clinical and histopathological diagnosis corresponded to pyoderma gangrenosum.

Drugs for the treatment of ulcerative colitis on the pharmaceutical market of Ukraine

The prevalence of diseases of the digestive organs at the current stage of human development is extremely high, and their universally increasing incidence rate is estimated as an epidemic. In Ukraine, mortality from diseases of the digestive organs ranks fourth in the population mortality structure (after diseases of the circulatory system, neoplasms, and accidents). Among all diseases of digestive organs in the modern world, inflammatory bowel diseases are one of the most serious and unsolved problems in modern gastroenterology and coloproctology. In terms of morbidity, non-specific ulcerative colitis (UC) and Crohn's disease (CD) are inferior to other gastroenterological diseases, although in terms of the severity of the course, the frequency of complications and mortality, they occupy one of the leading places in the structure of diseases of the gastrointestinal tract. Therefore, the goal of our work was the marketing analysis of drugs for the treatment of non-specific ulcerative colitis containing mesalazine as an active component. Obtaining data on the demand on the pharmaceutical market for medicinal products with mesalazine, determining trends in the use of dosage forms with this substance will allow predicting approaches to the development of a domestic effective medicinal product containing mesalazine. The objects of the study were medicinal products of local and systemic action, containing mesalazine in their composition. To achieve the goal, generally accepted research methods were used, which contributed to the objective assessment of the analysis of the pharmaceutical market.
 The analysis of the assortment of medicines with mesalazine presented on the domestic pharmaceutical market was carried out according to the data of the classification system of the ATС, the State Formulary of Medicines, the State Register of Medicines of Ukraine. The presence on the pharmaceutical market of Ukraine of drugs of the group A07E Intestinal antiinflammatory agents indicates that the leader in terms of assortment offers is drugs with mesalazine (5-ASA). As of February 2023, Ukraine has registration certificates for 19 medicinal products of five brands with the active ingredient mesalazine. According to the received data, no medicinal product of domestic production containing mesalazine has been registered on the pharmaceutical market of Ukraine. Several types of dosage forms with mesalazine are available on the pharmaceutical market of Ukraine (coated tablets, long-acting granules, suppositories, and rectal suspension). It should be noted the absence of combined medicines with mesalazine. Also, there is no such medicinal form as enteric-dissolving hard gelatin capsules on the pharmaceutical market of Ukraine.
 Taking into account the obtained data, approaches to the introduction into production of a domestic medicinal product for the treatment of non-specific ulcerative colitis containing mesalazine and medicinal plant raw materials are in demand for pharmaceutical development.

ONSET OF NONSPECIFIC ULCERATIVE COLITIS POST COVID-19 (CASE STUDY).

The patient suffered from a mild form of COVID-19 and was treated on an outpatient basis. According to the family doctor's prescription, she took Azithromycin 500 mg a day per os for 6 days, and then Ceftriaxone 1.0 g twice a day i.m. for another 6 days. Diarrhea appeared on the 10th day of treatment up to 10-15 times a day, a month later - blood admixtures in the stool appeared. The result was negative. Data from colonoscopy and histological examination of the intestinal mucosa and the clinical picture showed nonspecific ulcerative colitis, moderately severe. The patient started treatment with Salofalk first at a dose of 2 mg and then 4 mg per day. Due to the insufficient clinical effect, the patient was additionally prescribed Budenofalk in a daily dose of 9 mg with a positive clinical effect.

Воспалительные заболевания кишечника и гельминтозы

Inflammatory bowel disease (IBD), including nonspecific ulcerative colitis and Crohn's disease, are chronic recurrent immunemediated conditions. The prevalence of this pathology among residents of developed countries has increased significantly in recent decades. However, in about a third of the world's countries, mainly in developing countries with poor sanitary and hygienic conditions, these diseases are practically absent. According to hygienic theory, modern, overly hygienic environmental conditions negatively affect the human immune system. This predisposes genetically susceptible individuals to developing inflammatory diseases such as IBD. According to modern recommendations, immunosuppressive drugs such as azathioprine, 6-mercaptopurine and methotrexate are used to treat this pathology. However, scientists are looking for new ways to solve this problem. One of the promising directions in this area is the study of the action of helminth-derived immunosuppressive molecules. The hygienic hypothesis suggests an inverse association between parasitic infections and the incidence of IBD. Epidemiological, experimental and clinical evidence support the idea that helminths may contribute to reducing the number of inflammatory bowel diseases. Data have been accumulated on the importance of regulatory pathways, such as regulatory T-cells, by which helminths induce such protection. The study of the mechanisms of influence of helminths on innate and acquired immune responses may contribute to the development and introduction into therapeutic practice of new therapies for IBD. This article presents a literature review on the relationship of helminths and IBD, as well as the possibility of using helminths or helminth-derived immunosuppressive molecules in the therapy of this pathology. Key words: helminth infections, ulcerative colitis, Crohn's disease

Transabdominal ultrasound in the diagnosis and dynamic follow-up of a patient with nonspecific ulcerative colitis (case report)

A clinical case demonstrates the potential of transabdominal ultrasound of the large intestine in diagnosis and follow-up in a patient with ulcerative colitis. It is shown that transabdominal ultrasound examination performed in seroscan mode (B-mode) with the use of Doppler color mapping allows to monitor the degree of resolution of inflammation in the mucosa of the large bowel, as well as to evaluate the effectiveness of conservative approach.

Association between morphological manifestations of inflammatory bowel disease and biochemical markers of inflammation

Aim. To determine morphological and morphometric changes in the structure of the mucous membrane of the large intestine and their relationship with the content of short-chain volatile fatty acids and fecal calprotectin in patients with inflammatory bowel disease. Materials and methods. We examined 68 patients with inflammatory bowel disease, including 30 women and 38 men aged 20–66 years, 55 patients were with ulcerative colitis and 13 patients – with Crohn’s disease. Histological examination focused on changes in the mucous membrane of the large intestine. Determination of short-chain volatile fatty acids in feces was performed using gas chromatography. Calprotectin content was measured in fecal samples by enzyme-linked immunosorbent assay. Results. Significant correlations were found between epithelial disruption and changes in crypt architecture, infiltration density, and histological activity. The higher degree of inflammation in patients with severe course was combined with a lower level of tissue nonspecific protection, which was detected by the number of goblet cells, eosinophilic and neutrophilic leukocytes. There was a decrease in the fecal concentration of butyric acid in patients with nonspecific ulcerative colitis and Crohn’s disease compared with controls, but a more significant decrease was observed in patients with severe nonspecific ulcerative colitis. The data have confirmed the association between inflammatory bowel disease and the content of short-chain volatile fatty acids, fecal calprotectin in coprofiltrate, which was evidenced by the presence of correlations between low content of short-chain volatile fatty acids and eosinophilic infiltration (r = -0.412; fecal calprotectin levels and disease severity (r = 0.589; P = 0.001), atrophy (r = 0.458; Р < 0.05), infiltration density (r = 0.434; Р < 0.05). Conclusions. All patients with inflammatory bowel disease are characterized by a specific histological picture, which reflected the different degrees of inflammation. Morphometric parameters more accurately show significant atrophic changes in the mucous membrane of the large intestine. The data have confirmed the association between inflammatory bowel disease and the content of short-chain volatile fatty acids and calprotectin in coprofiltrate.

Autoimmune hepatitis with superimposition of primary sclerosing cholangitis on non-specific chronic ulcerative colitis

Autoimmune hepatitis with superimposition of primary sclerosing cholangitis on non-specific chronic ulcerative colitis

Diagnostic approach to chronic bowel diseases in children

Diagnosing inflammatory bowel diseases in children and differentiating them from functional disorders is complicated based on clinical assessment, laboratory data, and radiological, endoscopic, and histological signs. Therefore, in paediatrics, substantial attention has been given to standard invasive evaluation methods. Recently, research efforts have been directed towards using faecal calprotectin as a sensitive non-invasive stool test.
 The aim of the research was to study the diagnostic value of faecal calprotectin in pediatric chronic inflammatory bowel diseases. The paper discusses faecal calprotectin's diagnostic and monitoring role in 35 children aged 3 to 17 years with ulcerative colitis, non-specific non-ulcerative colitis, and irritable bowel syndrome. The concentration of the faecal calprotectin level was examined by ELISA using monoclonal antibodies.
 Results. The study shows that in patients with non-specific ulcerative and non-ulcerative colitis, the faecal calprotectin level exceeds the normal ranges 2-5 times, corresponding to clinical and morphological manifestations of the diseases and the level of inflammatory markers. However, this biological marker does not exceed the average values in children with irritable bowel syndrome.
 Conclusions. The faecal calprotectin test allows us to differentiate organic and functional intestinal diseases, monitor chronic inflammatory bowel disease activity dynamics, and estimate treatment effectiveness. Applying the faecal calprotectin test within the framework of primary medical care can decrease the number of referrals for invasive endoscopic, laboratory, and radiologic examinations in pediatric patients with inflammatory bowel diseases

Comparative assessment of genetic polymorphism of Toll-like 2 and 6 receptors predisposing for non-specific ulcerative colitis and irritable bowel syndrome in Russians from Chelyabinsk Region

Ulcerative colitis and irritable bowel syndrome are multifactorial disorders with genetic predisposition. Recent studies suggest that the mucosal immune activation, increased intestinal permeability, and altered host-microbiota interactions may modulate innate immune response, thus contributing to immunopathogenesis of these diseases. Toll-like receptors (TLR) are considered to play the main role in genetic susceptibility to the conditions. The mechanisms for regulating activity of Toll-like receptors are represented by single-nucleotide gene polymorphisms (SNPs), thus producing allelotypes with different biological effects. Among all known TLRs, TLR2 is the most actively studied. The TLR2 gene is located on the long arm of the chromosome 4 and contains the genetic variant leading to the substitution of arginine for glutamine (Arg753Gln) in TLR2 protein. Meanwhile, the most studied SNP of TLR6 is located at the C745T position causing Pro249Ser amino acid substitution in the protein. The present work aimed for analysis of distribution of alleles, genotypes and haplotype combinations of the TLR2 and TLR6 SNPs, and their associations with predisposal for ulcerative colitis and irritable bowel syndrome in Russians from Chelyabinsk Region. The following methods were used in the study: isolation of DNA samples from whole blood, genotyping of the studied gene polymorphisms using PCR with electrophoretic detection. The frequencies of two-locus haplotypes formed by SNPs TLR2 TLR6 were calculated with Arlequin ver 3.5 software. Comparison of two populational samples for predisposition to UC and IBS was carried out using standard immunogenetic criteria. Significance of differences was set at p 0.05. Results: Analysis of the data showed the association of specific alleles and genotypes, but not TLR2 TLR6 haplotypes, with predisposition to the studied diseases. The Arg753Gln gene polymorphism of TLR2 was shown to be significant for a predisposition to ulcerative colitis, and SNP Pro249Ser TLR6 is associated with susceptibility to irritable bowel syndrome in Russians from the Chelyabinsk Region.

Comorbid infections in patients with spondyloarthritis who received modern antirheumatic therapy (preliminary data)

Actuality. Data on the prevalence of comorbid infections (CI) in patients with spondyloarthritis (SpA) are few. Risk factors for CI has not been sufficiently studied.Objective. To evaluate the frequency of comorbid infections in patients with spondyloarthritis treated with biological drugs in the form of monotherapy or in combination with DMARD and/or GC.Subjects and methods. The study included 93 patients (55 men, 38 women; average age – 37.0±11.5 years). In 59 patients, AS was diagnosed, in 32 – PsA, in 2 – undifferentiated SpA and SpA associated with nonspecific ulcerative colitis. All patients received biological drugs in combination with DMARD and/or GC or without them. The patients were interviewed by a research doctor with fi lling out a unified questionnaire. Additional information was obtained from medical records.Results. The leading place in the structure of CI was occupied by respiratory tract infections and ENT organs, the 2nd place belonged to herpes viral infections, the 3rd to mycotic infection. Serious CI (SCI) were also represented mainly by injections of respiratory tract infections and ENT organs. A tendency to an increase in the frequency of pneumonia, tuberculosis, acute bronchitis, skin infections, genital organs and mycoses against the background of SpA compared to the period preceding the development of the disease (no significant differences were found) was revealed. 69% of patients noted a more severe course of previously observed CI. 47 patients reported the temporary cancellation of therapy due to the development of CI. 49% of patients have documented exacerbation of SpA. The number of cases of SCI against the background of SpA doubled (p=0.03). There was a positive correlation between the intake of GC and the development of mycoses (r=0.216; p=0.04); between the duration of taking GC and the development of eye infections (r=0.385; p=0.01); between the duration of taking methotrexate and the development of tonsillitis (r=0.25; p=0.03); between taking interleukin 12/23 inhibitors and the development of tonsillitis (r=0.261; p=0.01); between the duration of taking tumor necrosis factor α inhibitors (iTNF-α) and the development of otitis (r=0.287; p=0.01); between the number of consistently used iTNF-α and the development of otitis (r=0.273; p=0.02).Conclusion. The data obtained indicate the relevance of the problem of CI in SpA. Further studies are needed on a larger cohort of patients with an assessment of the effect of therapy on the incidence of CI and the search for risk factors for CI.

Morphological features of the intestinal mucosa in ulcerative colitis in various forms of the disease

Background. Chronic inflammatory bowel disease (CIBD) is one of the most complex nosological groups in gastroenterology, due to the constant increase in their prevalence, shifting the onset to an earlier age, increasing the frequency of severe complicated forms. The most common representative of CIBD is nonspecific ulcerative colitis (UC). At the heart of UC is a diffuse ulcerative-inflammatory lesion of the colon. The leading role in the diagnosis of UC belongs to the comparison of the results of endoscopic and morphological methods of research. The morphological method of colonobiopsy examination in UC is the gold standard of diagnosis and makes it possible to determine the signs of disease activity even in endoscopic remission. In contrast to descriptive histology, pathological anatomy, quantitative morphology complements and clarifies the data of studies conducted by conventional morphological methods from the standpoint of generalized approaches. The purpose of quantitative morphology is the maximum objectification of the study of qualitative and quantitative manifestations of pathological processes, nosological units, their pathogenesis, morphogenesis, as well as the exclusion of measurement errors and, as far as possible, the subjectivity of the researcher. The purpose of the study: to conduct a comparative histological examination of biopsies of the mucous membrane of the colon in patients with UC of different severity of the disease. Materials and methods. Histological examination of intestinal biopsy specimens was performed in 55 patients with ulcerative colitis. Patients were divided according to the severity of the disease. Group I (n=11)— mild form, group II (n=39)— moderate form and group III (n=5)— patients with severe UC. Results. In 63.6% with a mild severity of UC edema was not observed, the condition of the epithelium was unchanged, the architecture is not disturbed. Crypt abscesses were detected in 54.6% of cases, atrophic changes— in 90.9%. Inflammatory infiltrate consisted mainly of neutrophils ((176.0±8.22) per 1 mm2 stroma) and mononuclear cells ((232.4±22.83) per 1 mm2 stroma), which indicates the activation of regenerative functions of the mucous membrane. From morphometric measurements the highest indicator was the height of the crypt epithelium (38.3±1.49) μm. With an moderate degree of UC in 33.3% of cases there was a violation of the integrity of the epithelium, atrophic changes were diagnosed in 23.1% of cases, violations of crypt architecture— in 17.9%, the presence of crypt abscesses— 48.8%, edema— 64.1%. Morphometric measurement of intestinal mucosal biopsies with moderate severity of UC showed the highest crypt depth (452.6±8.12) μm, crypt epithelial height (42.3±0.33) μm and the number of goblet cells (26.6±1.43). The height of the crypt epithelium was positively correlated with the number of goblet cells (r=0.30; p <0.05). Erosions, general epithelial disorders, crypt abscesses, and atrophic changes were observed in the majority of patients with severe UC in 40%. In severe UC, the smallest crypt depth (426.1±22.37) μm, crypt epithelial height (36.0±2.57)μm, the number of goblet cells (10.5±1.04) and the largest epithelial thickness were observed (51.5±2.81) μm. Conclusions. The presence of crypt abscesses was mainly observed in the group of mild and moderate forms of the disease. Mucosal edema was more common in the group with moderate severity disease. Increased numbers of eosinophils and neutrophils were observed in the group with severety disease.

Violation of Water-Electric Exchange in Patients with Nospecific Ulcerative Colitis Before Total Colectomy

Abstract: Inflammatory diseases of the colon - ulcerative colitis and Crohn's disease are an urgent surgical problem. The paper presents an analysis of surgical interventions for ulcerative colitis and Crohn's disease over the past 12 years based on the materials of the First Republican Clinical Hospital in Izhevsk. Indications for one-stage and multi-stage radical operations for nonspecific ulcerative colitis and Crohn's disease have been developed. The indications for emergency, urgent and planned indications for inflammatory diseases of the large intestine have been clarified. Performing radical multi-stage operations for ulcerative colitis and Crohn's disease can reduce mortality, improve treatment outcomes, prognosis and quality of life. Keywords: inflammatory diseases of the colon, ulcerative colitis, Crohn's disease.

Клинический случай острого иридоциклита на фоне неспецифического язвенного колита

Conducting adequate therapy for iridocyclitis (uveitis) remains an urgent problem in patients with ulcerative colitis (UC) due to the development of this complication in almost every fifth of them. Purpose. To present a clinical case of acute iridocyclitis (AI) in a patient with UC after suffering an acute respiratory disease (ARI) accompanied by a recurrence of Herpes labialis. Material and methods. Examination of a patient at the stage of remission of UC, who applied on the 5th day of the disease with a clinic of acute iridocyclitis and Herpes labialis after acute respiratory infections, suggested an etiological or trigger role of the herpes simplex virus in the development of inflammation in the choroid. Results. Conducting complex therapy with the inclusion of the drug valaciclovir led to the relief of clinical symptoms of OI already on the 16th day of the disease and increased visual acuity. Conclusion. Supplementing the treatment of acute iridocyclitis, which developed against the background of a relapse of a latent herpes infection in a patient with chronic UC in remission, with an antiherpetic drug is etiopathogenetically substantiated to achieve good visual results. Key words: acute iridocyclitis, nonspecific ulcerative colitis, herpes infection

ВНЕКИШЕЧНЫЕ ПРОЯВЛЕНИЯ БОЛЕЗНИ КРОНА И ХРОНИЧЕСКОГО НЕСПЕЦИФИЧЕСКОГО ЯЗВЕННОГО КОЛИТА В ПОЛОСТИ РТА

Subject. The review allows us to consider the issues of etiopathogenesis, the prevalence of Crohn disease and ulcerative colitis, as well as their manifestations on the oral mucosa.
 The aim is to conduct a systematic analysis of modern indigenous and foreign literary sources to determine some features of etiopathogenesis, prevalence and manifestations in the oral cavity of Crohn disease and chronic non-specific ulcerative colitis.
 Methodology. The search for research works on the etiology and pathogenesis of Crohn disease, ulcerative colitis was carried out using the following databases: PubMed, Web of Science, elibrary.ru , Scopus in the period from 2010 to 2021, as well as the review includes some significant publications concerning the manifestations in the oral cavity of CD and NCUC for the period from 2014 to 2021. The following keywords were used: chronic ulcerative colitis, Crohn disease, caries, periodontal disease, oral mucosa, aphthae, dysbiosis.
 Results. Among the main dental diseases, pathology of hard tissues, inflammatory diseases of periodontal tissues, pathology of the oral mucosa against the background of pronounced dysbiosis most often prevails. During a comprehensive examination of these patients, it is very important to analyze not only the features of the manifestations of Crohn disease and ulcerative colitis, but also to evaluate their manifestations on the hard tissues of the teeth, the oral mucosa and periodontal tissues.
 Conclusions. Thus, the analysis of the literature data obtained is of particular relevance for identifying some features of the state of dental status in CD and NCUC in the Republic of Bashkortostan and the basis for the development of algorithms for diagnostic features of the management of this category of persons.

PYODERMA GANGRENOSUM AS THE ONLY MANIFESTATION OF ASYMPTOMATIC NEWLY DIAGNOSED NONSPECIFIC ULCERATIVE COLITIS. CLINICAL CASE.

The aim: To study the clinical case data for the feasibility of the obligatory inclusion of endoscopic methods of the gastrointestinal tract examination in patients with pyoderma gangrenosum of an unknown etiology. Clinical case: A patient under our supervision was with a not previously treated pyoderma gangrenosum of the shin skin. In the process of differential diagnostics by colonoscopic examination, nonspecific ulcerative colitis was diagnosed without clinical intestinal manifestation. A prescribed pathogenetic treatment of nonspecific ulcerative colitis led to the healing of the ulcer on the leg and induction of colitis remission. Thus, the first manifestation of asymptomatic colitis was pyoderma gangrenosum. Conclusions: Patients with pyoderma gangrenosum should be aware of the possibility of NUC, even in the absence of gastrointestinal symptoms, to get an early diagnosis and adequate treatment, to avoid disease manifestation and further complications. The inclusion of obligatory endoscopic examination of the gastrointestinal tract will increase the diagnosis of the etiology of severe skin lesions and increase the detection of asymptomatic nonspecific ulcerative colitis.

Ulcerative colitis. To the 180th anniversary of the description by Karl Rokytansky

The article describes the main historical milestones in the description and study of ulcerative colitis from the time of Hippocrates to the present day. The first description of the morphological picture of non-specific ulcerative colitis (NUC) was presented by the Viennese pathologist Karl Rokitansky in 1842. The term "ulcerative colitis" was coined by S. Wilks in 1859. A detailed description of the disease was presented in 1875 by S. Wilks and W. Maxon. In an independent nosological form, NUC was isolated in 1888 by the English doctor White. Boas in 1903. For the first time, he presented the differential diagnosis of NUC and chronic dysentery. The term "non-specific ulcerative colitis" in Russia was first introduced by A.S. Kazachenko in a report at the XIII Congress of Russian Surgeons in 1913.

P073 Diagnostic Outcome of Patients With Non-Specific Colitis.

Colitis describes inflammation in the colon and is classified into defined diseases: Inflammatory bowel disease (IBD), Microscopic colitis, Ischemic colitis and Infectious colitis. The clinical significance of non-specific colitis is unclear as there are limited analysis which report the issue. Notteghem et al. (1993) showed that of 104 patients with non-specific colitis, 52.3% had another episode of symptoms within 3 years. Of these patients 54% were diagnosed with ulcerative colitis, 33% with Crohn's disease, and 13% remained unclassified, suggesting that non-specific colitis could be undiagnosed IBD. The objective of this analysis is to determine the clinical course of non-specific colitis through colonoscopy and histologic findings. Retrospective observational study with patients underwent colonoscopies during the period from 2009 to 2019, whose biopsies were reported as non-specific colitis. 24 patients (18 women and 6 men) with non-specific colitis undergoing follow-up by the Gastroenterology outpatient clinic were included. The most frequent indications for colonoscopy were abdominal pain (43.7%), blood in stools (26.8%), diarrhea (21.6%) and anemia (7.9%). The mean age was 56.5 years. During follow-up, patients had at least 2 colonoscopies and 4 biopsies per colonic segment. In the male population ascending colon cancer was later diagnosed in 16.7%, another 16.7% were diagnosed with nonspecific chronic ulcerative colitis, 33.3% with eosinophilic colitis, and the rest of the patients were diagnosed with non-specific colitis. From the female group, 5.6% had lymphocytic colitis, 5.6% eosinophilic colitis, 5.6% collagenous colitis, 5.6% Crohn's disease, 5.6% mixed irritable bowel syndrome, and the rest of the patients (72%) had biopsy report of non-specific colitis. All patients with a histopathological diagnosis of non-specific colitis underwent a second colonoscopy with biopsy, which resulted in a definitive diagnosis of Crohn's disease in 5.6% of women and Ulcerative Colitis in 16.7% of men. This study comes to show that there is an important subgroup of patients who are underdiagnosed. We suggest that patients with non-specific colitis reported on a histopathology report must continue their follow-up by a specialized ward.