Document Detail


Lower extremity arterial occlusions in young patients with Crohn's colitis and premature atherosclerosis: report of six cases.
MedLine Citation:
PMID:  9068477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arterial occlusive disease (AOD) which is rarely described in patients with inflammatory bowel disease, is mainly associated with Crohn's disease (CD), and its etiology and natural course are unknown. We studied six patients (five women, one man) with CD and major lower extremity AOD who were treated at the Cleveland Clinic between 1985 and 1994. These were relatively young patients (age range 24-48 years) with steroid-dependent Crohn' colitis. On their presentation, five had acute onset of severe ischemic symptoms ("blue toe" syndrome in three) and one had rapid progression of claudication. All the patients had active CD and/or prior extensive bowel resections, and had no evidence of extraintestinal manifestation. Cardiovascular risk factors were smoking (n = 5), dyslipidemia (n = 3), family history of coronary artery disease (n = 3), premature menopause (n = 2), diabetes mellitus (n = 1). Arteriograms showed iliac artery involvement in all six patients and bilateral AOD in three. None of the patients had arteriographic or clinical signs of vasculitis. Five patients required arterial revascularizations, i.e., endovascular (n = 2), surgical (n = 2), and combined in one. Three patients had microscopic evidence of atherosclerosis. Lower extremity AOD in patients less than 50 yr of age and with CD may be partially related to premature atherosclerosis. Prospective screening for cardiovascular risk factors, subclinical disease, and hypercoagulability might be indicated in patients with active CD to prevent major arterial complications.
Authors:
P J Levy; A H Tabares; J W Olin
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  92     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-04-08     Completed Date:  1997-04-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  494-7     Citation Subset:  IM    
Affiliation:
Department of Vascular Medicine, Cleveland Clinic Foundation, Ohio, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Arterial Occlusive Diseases / etiology*,  radiography,  therapy
Arteriosclerosis / complications*
Coronary Disease / genetics
Crohn Disease / complications*,  drug therapy,  surgery
Diabetes Complications
Female
Humans
Hyperlipidemias / complications
Iliac Artery / radiography
Intermittent Claudication / etiology,  radiography,  therapy
Ischemia / etiology,  radiography,  therapy
Leg / blood supply*
Male
Menopause, Premature
Middle Aged
Prospective Studies
Risk Factors
Smoking / adverse effects
Steroids / therapeutic use
Chemical
Reg. No./Substance:
0/Steroids

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