Acute interstitial nephritis in patients with inflammatory bowel disease treated with vedolizumab: a systematic review.

BACKGROUND: Acute interstitial nephritis (AIN) is a complication of drugs that may cause permanent kidney injury. AIN has been reported in patients with inflammatory bowel disease (IBD) treated with the integrin inhibitor vedolizumab. Through systematic review of existing literature, we aimed to identify and describe cases of AIN in patients with IBD treated with vedolizumab. METHODS: We searched Medline, Embase, Cochrane, and Web of Science Core Collection between 1 January 2009 and 25 April 2023. The search yielded 1473 publications. Titles and abstracts were screened by two independent reviewers. Seventy publications were reviewed in full-text. Eight met the inclusion criteria. Clinical characteristics of AIN cases were extracted. Case causality assessment was performed according to two international adverse drug reaction probability assessment scales. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Nine biopsy-confirmed cases of AIN were reported in six patients with ulcerative colitis and three with Crohn's disease. Mean age at AIN onset was 36 years (range = 19-58) and the majority of patients were females (n = 6/9). Time from vedolizumab treatment initiation to AIN onset spanned from hours to 12 months. Common symptoms were fever and malaise. Creatinine levels were elevated in all patients. Five patients sustained permanent kidney injury. CONCLUSION: Our findings suggest that vedolizumab, although rarely, could cause AIN in patients with IBD. Awareness of laboratory findings and symptoms consistent with AIN, along with monitoring of the kidney function, could be warranted in patients with IBD treated with vedolizumab.

Identifying predictors of low health-related quality of life among patients with inflammatory bowel disease: comparison between Crohn's disease and ulcerative colitis with disease duration.

AIM: To identify predictors of low health-related quality of life among patients with inflammatory bowel disease and make a comparison between Crohn's disease and ulcerative colitis with disease duration. BACKGROUND: Studies have shown that patients with inflammatory bowel disease rate their health-related quality of life lower, as compared with a general population. DESIGN: Survey. METHODS: In this study, 197 patients in remission were included and divided into a Crohn's disease group and an ulcerative colitis group. Each group was also divided into separate groups whether the patients had short disease duration or long disease duration. Generic instruments, combined with disease-specific questionnaires, were used for measuring health-related quality of life. RESULTS: The analysis showed a non-significant effect for diagnosis, but a significant effect for disease duration showing that the patients with short disease duration had lower scores of health-related quality of life compared with patients with long disease duration. A significant interaction between diagnosis and disease duration was also revealed. CONCLUSION: Patients with longer disease duration experienced a better health-related quality of life than patients with short disease duration. Patients with Crohn's disease and short disease duration have the lowest health-related quality of life and are in greatest need of education and support. RELEVANCE TO CLINICAL PRACTICE: It is important to identify which patients' are in the greatest need of education and support.

Crohn's disease after gastric bypass surgery.

Bariatric surgery for the treatment of severe obesity has increased dramatically in recent years in the USA and parts of Western Europe. The most commonly used technique is the Roux-en Y gastric bypass (RYGBP). Several nutritional and gastrointestinal complications after bariatric surgery have been described during the last 10 years. The authors present two patients with diarrhoea and malnutrition; one after RYGBP and the other after jejunoileal bypass surgery. These patients were subsequently diagnosed with Crohn's disease.

Further studies on the frequency of colorectal cancer in Crohn's colitis: an 11-year survey in the Northwest Stockholm County.

BACKGROUND: The frequency of colorectal carcinomas (CRC) evolving in patients with Crohn's colitis (CC) was assessed at the Danderyds University Hospital (DUH), one of two large hospitals in Northwest Stockholm County (NWSC). PATIENTS AND METHODS: A total of 121 patients with Crohn's disease (CD) were treated at this hospital between 1996 and 2006. All sections from colectomy specimens having CC and carcinoma were reviewed. RESULTS: Of the 121 patients with CD, 79.4% (96/121) had CC. Of the 96 patients with CC, 6.3% (n=6) developed a CRC between 1996 and 2006. DISCUSSION: Recent studies at the other large hospital in NWSC showed that during the same period (1996-2006) 7.4% (n=21) of the 282 patients with CC, developed a CRC. During this 11-year period, 7.1% (n=27) of the 378 patients with CC seen at the two hospitals that treat the vast majority of patients with CD in NWSC developed a CRC. By comparison, only 0.29% or 5,566 patients (age-adjusted) out of the 1,900,000 inhabitants in the entire Stockholm County developed a CRC during the same period. These results, obtained at a comparative time-interval in the County, substantiate several recent meta-analysis and population-based studies on the high cancer risk in patients with Crohn disease.