TY - JOUR
T1 - Genital granulomatosis in male and female patients with Crohn's disease
T2 - Clinical presentation and treatment outcomes
AU - Dederichs, Frank
AU - Iesalnieks, Igor
AU - Sladek, Malgrozata
AU - Tzivinikos, Christos
AU - Hansen, Richard
AU - Muñoz, Carmen
AU - Pavli, Paul
AU - Cavicchi, Mayran
AU - Abitbol, Vered
AU - Rahier, Jean Francois
AU - Vavricka, Stephan
AU - Katsanos, Konstantinos
AU - Domènech, Eugeni
N1 - Publisher Copyright:
© 2017 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved.
PY - 2018/2
Y1 - 2018/2
N2 - Background: Genital granulomatosis [GG] is a metastatic form of Crohn's disease [CD], characterised by granulomatous inflammation of the genital skin without contact with the gastrointestinal tract. Little is known about GG, as most publications are case reports or small series, and only sporadic in male cases. Methods and Aims: Cases of GG were retrospectively collected through the Collaborative Network For Exceptionally Rare case reports project of the European Crohn's and Colitis Organisation. Results: A total of 43 patients [9 males, 34 females] were diagnosed as having GG, mostly as oedema and/or ulcers. Histological confirmation of granulomas was obtained in 70% of the cases. CD location was colonic or ileocolonic in 97% and perianal disease was documented in 57%. There was no significant difference between males and females in CD phenotype or genital lesions. GG was the first manifestation of inflammatory bowel disease [IBD] in one-third of the patients; these patients were younger at the time of GG occurrence and they all were non-smokers. GG occurred in the absence of gastrointestinal disease activity in 30% of the cases. Ten out of 11 patients [91%] responded to systemic corticosteroid treatment, 5/9 patients responded to immunomodulators, and 9/11 patients responded to anti-tumour necrosis factor alpha [TNF-α] agents. Conclusions: GG is a rare extraintestinal manifestation of CD. It mainly occurs among women, in the setting of colonic involvement of CD, and perianal disease is often associated. Most cases are successfully managed with systemic corticosteroids or anti-TNF agents.
AB - Background: Genital granulomatosis [GG] is a metastatic form of Crohn's disease [CD], characterised by granulomatous inflammation of the genital skin without contact with the gastrointestinal tract. Little is known about GG, as most publications are case reports or small series, and only sporadic in male cases. Methods and Aims: Cases of GG were retrospectively collected through the Collaborative Network For Exceptionally Rare case reports project of the European Crohn's and Colitis Organisation. Results: A total of 43 patients [9 males, 34 females] were diagnosed as having GG, mostly as oedema and/or ulcers. Histological confirmation of granulomas was obtained in 70% of the cases. CD location was colonic or ileocolonic in 97% and perianal disease was documented in 57%. There was no significant difference between males and females in CD phenotype or genital lesions. GG was the first manifestation of inflammatory bowel disease [IBD] in one-third of the patients; these patients were younger at the time of GG occurrence and they all were non-smokers. GG occurred in the absence of gastrointestinal disease activity in 30% of the cases. Ten out of 11 patients [91%] responded to systemic corticosteroid treatment, 5/9 patients responded to immunomodulators, and 9/11 patients responded to anti-tumour necrosis factor alpha [TNF-α] agents. Conclusions: GG is a rare extraintestinal manifestation of CD. It mainly occurs among women, in the setting of colonic involvement of CD, and perianal disease is often associated. Most cases are successfully managed with systemic corticosteroids or anti-TNF agents.
KW - Crohn's disease
KW - Genital granulomatosis
KW - Penile
KW - Scrotal
KW - Vulvar
UR - http://www.scopus.com/inward/record.url?scp=85041286101&partnerID=8YFLogxK
U2 - 10.1093/ecco-jcc/jjx131
DO - 10.1093/ecco-jcc/jjx131
M3 - Article
C2 - 29029098
AN - SCOPUS:85041286101
SN - 1873-9946
VL - 12
SP - 197
EP - 203
JO - Journal of Crohn's and Colitis
JF - Journal of Crohn's and Colitis
IS - 2
M1 - jjx131
ER -