Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Incidence, prevalence and trends in IBD(CRC Press, 2018) Chandrasinghe, P.; Spinelli, A.; Warusavitarne, J.The inflammatory bowel diseases (IBD), Crohn’s disease and ulcerative colitis, are inflammatory conditions of unknown aetiology that affect the gastrointestinal tract. In Saudi Arabia, an increasing incidence of IBD has been registered, and a comparable disease progression has been recognised. Disease location is a significant factor associated with the long-term outcome in IBD. Extra-intestinal manifestations are pathologically and clinically important entities in IBD. Mortality due to IBD may be caused by complications of acute flares of the disease, long-term complication of the disease or surgical complications. Surgery is required in patients with IBD mainly for intestinal complications. The natural history of IBD is difficult to assess in today’s context, as a majority patients with symptoms will be undergoing some form of treatment. The downward trend may have been the result of more comprehensive surveillance programmes established in many high-volume IBD centres. IBDs are common chronic conditions, which place a significant burden on the individual and community.Item The Molecular classification of the clinical manifestations of Crohn's Disease.(Elsevier-W.B. Saunders, 2002) Ahamad, T.; Armuzzi, A.; Bunce, M.; Mulcahy-Hawes, K.; Marshall, S.E.; Orchard, T.R.; Crawshaw, J.; Large, O.; de Silva, A.; Cook, J.T.; Barnardo, M.; Cullen, S.; Welsh, K.I.; Jewell, D.P.BACKGROUND & AIMS: Crohn's disease is a common inflammatory disorder of the gut characterized by variation in both location and behavior. Chromosome 16 and the HLA region on chromosome 6 have been implicated in susceptibility to disease. Mutations in the NOD2/CARD15 gene, recently identified on chromosome 16, have been associated with disease overall but are found in only 25% of patients. No data regarding their contribution to specific disease subtypes exist. Here we report a detailed genotype-phenotype analysis of 244 accurately characterized patients. METHODS: A total of 244 white patients with Crohn's disease recruited from a single center in the United Kingdom were studied. All patients were rigorously phenotyped and followed-up for a median time of 16 years. By using linkage disequilibrium mapping we studied 340 polymorphisms in 24 HLA genes and 3 NOD2/CARD15 polymorphisms. RESULTS: We show that NOD2/CARD15 mutations determine ileal disease only. We confirm that alleles on specific long-range HLA haplotypes determine overall susceptibility and describe novel genetic associations with susceptibility, location, and behavior of Crohn's disease. CONCLUSIONS: The clinical pattern of Crohn's disease may be defined by specific genotypes. This study may provide the basis for a future molecular classification of disease.