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Histopathological findings of extra-ileal manifestations at initial diagnosis of Crohn’s disease-related ileitis

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Abstract

Crohn’s disease is a chronic inflammatory disorder that can affect any part of the gastrointestinal tract. Our objective was to review the histological findings in index biopsies from the terminal ileum and other gastro-intestinal tract sites of Crohn’s disease patients prior any treatment and to compare them with the findings from patients with non-specific ileitis. A total of 111 consecutive Crohn’s disease cases (55 females, median age 27 years) with extra-ileal biopsies were retrospectively selected. Upper gastrointestinal inflammatory changes were found in 68 % of gastric biopsies, 60 % of oesophageal biopsies and 43 % of duodenal biopsies with no significant difference in frequency between paediatric and adult cases. Crohn’s colitis was more common in paediatric cases than adult cases (85 % versus 57 %). Granuloma in at least one extra-ileal site was observed in 40 %, more frequently in paediatric cases than in adults (78 vs 27 %). Compared with Crohn’s disease cases, the group of 151 non-specific ileitis cases (75 females, median age 52 years) were more likely to have normal upper and lower gastrointestinal biopsies and to show less frequent crypt architectural changes in the terminal ileum. In summary, Crohn’s disease ileitis is often associated with inflammation elsewhere in the gastrointestinal tract while non-specific ileitis was infrequently associated with inflammation elsewhere for both paediatric and adult patients. These findings support the role of systematic biopsies in multiple gastrointestinal sites to help distinguishing Crohn’s ileitis from non-specific ileitis in paediatric and adult population.

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Authors and Affiliations

  1. Envoi Specialist Pathologists, 5/38 Bishop Street, Brisbane, QLD, Australia

    Ian S. Brown, Gregory C. Miller, Mark L. Bettington & Christophe Rosty

  2. Anatomical Pathology, Pathology Queensland, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

    Ian S. Brown

  3. School of Medicine, University of Queensland, Brisbane, QLD, Australia

    Ian S. Brown, Gregory C. Miller, Mark L. Bettington & Christophe Rosty

  4. The Conjoint Gastroenterology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia

    Mark L. Bettington

  5. Department of Pathology, The University of Melbourne, Melbourne, VIC, Australia

    Christophe Rosty

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  1. Ian S. Brown
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Correspondence to Ian S. Brown.

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This study was performed in accordance with institutional ethical guidelines imposed by the local Human Research Ethics Committee.

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Brown, I.S., Miller, G.C., Bettington, M.L. et al. Histopathological findings of extra-ileal manifestations at initial diagnosis of Crohn’s disease-related ileitis. Virchows Arch 469, 515–522 (2016). https://doi.org/10.1007/s00428-016-2009-7

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  • DOI: https://doi.org/10.1007/s00428-016-2009-7

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