SAN PEDRO COLLEGE
Bachelor of Science in Medical Laboratory Science
A Case Study in
Immunology, Serology and Blood Banking
CROHN'S DISEASE
August 2021
,OBJECTIVES OF THE STUDY:
This case study aims to achieve the following objectives:
● To present the patient's data provided with the given history.
● To present an accurate diagnosis and give details that would support it.
● To relate the patient’s clinical manifestations and the laboratory test results with the
diagnosis.
● To define the case and present the anatomy and physiology and the pathophysiology
of the disease.
● To recommend ways on how to prevent and manage the condition, as well as to
provide possible treatment
, CHAPTER I
Introduction
Crohn's disease belongs to the inflammatory bowel disease (IBD) group of illnesses
together with ulcerative colitis. It was named after Dr. Burrill B. Crohn and his colleagues Dr.
Leon Ginzburg and Dr. Gordon D. Oppenheimer, who initially characterized the illness in 1932
(1). Crohn’s disease causes inflammation in the digestive system which comprises the mouth,
esophagus and the gastrointestinal tract. The disease can affect any part of it, but most often,
it involves the small intestine and the colon (2). Despite the fact that there are several theories
on what causes Crohn's disease, none of them has been substantiated. Crohn's disease is
thought to be caused by a combination of variables including immune system issues, genetics,
and environmental factors (3). Other risk factors include age, infection, smoking, medication
and diet (2).
The incidence of Crohn's disease varies by geographic area and ethnicity, with northern
countries and populations of Northern European heritage having the highest incidence. In the
United States, the incidence rate is estimated to be 7 per 100,000 people. The prevalence of
Crohn’s disease in North America is estimated to be between 400,000 and 600,000 patients.
There are two peak ages of onset, with a major peak in the people aged from 10 to 29 years
old and elderly people whose ages are from 60 to 79 years old (4).
Inflammatory bowel disease (IBD) was once considered to be uncommon in Asia, but
new evidence suggests that the condition is becoming more prevalent. With a crude yearly
overall incidence of 1.37 per 100 000, a prospective research studying the incidence of IBD
in the Asia-Pacific area has proven that the incidence of Crohn’s disease is significantly lower
than in the West (5).
There are a number of common clinical presentations of Crohn’s disease that depend
on the anatomical regions affected by the inflammatory process and the type of inflammation
present. The most common presenting complaints include diarrhea, abdominal pain, weight
loss, and fatigue (4). Aside from the common signs and symptoms, Crohn’s disease has two
types of complications namely the local and systemic (2). From the word “local”, it means
that it only affects your intestine. This type of complication includes abscess, bile salt diarrhea,
fissure, fistula, malabsorption, malnutrition, small intestinal bacterial overgrowth and
strictures. Systemic on the other hand, affects your whole body and it is also medically called
as an extraintestinal complication. This includes arthritis, skin problem, bone loss, shortage
in vitamin D, eye problem, kidney and liver complication and physical development failure
(2).
Unfortunately, there is still no known cure for Crohn’s disease but treatments can
significantly reduce the symptoms and perhaps bring about long-term remission and healing
from inflammation (6). Treatment includes steroids, liquid diet, immunosuppressants and
biological medicines such as adalimumab, infliximab, vedolizumab and ustekinumab. Although
medicines are the main treatments, sometimes, surgery may be needed especially when
medications are not effective anymore (7).
Bachelor of Science in Medical Laboratory Science
A Case Study in
Immunology, Serology and Blood Banking
CROHN'S DISEASE
August 2021
,OBJECTIVES OF THE STUDY:
This case study aims to achieve the following objectives:
● To present the patient's data provided with the given history.
● To present an accurate diagnosis and give details that would support it.
● To relate the patient’s clinical manifestations and the laboratory test results with the
diagnosis.
● To define the case and present the anatomy and physiology and the pathophysiology
of the disease.
● To recommend ways on how to prevent and manage the condition, as well as to
provide possible treatment
, CHAPTER I
Introduction
Crohn's disease belongs to the inflammatory bowel disease (IBD) group of illnesses
together with ulcerative colitis. It was named after Dr. Burrill B. Crohn and his colleagues Dr.
Leon Ginzburg and Dr. Gordon D. Oppenheimer, who initially characterized the illness in 1932
(1). Crohn’s disease causes inflammation in the digestive system which comprises the mouth,
esophagus and the gastrointestinal tract. The disease can affect any part of it, but most often,
it involves the small intestine and the colon (2). Despite the fact that there are several theories
on what causes Crohn's disease, none of them has been substantiated. Crohn's disease is
thought to be caused by a combination of variables including immune system issues, genetics,
and environmental factors (3). Other risk factors include age, infection, smoking, medication
and diet (2).
The incidence of Crohn's disease varies by geographic area and ethnicity, with northern
countries and populations of Northern European heritage having the highest incidence. In the
United States, the incidence rate is estimated to be 7 per 100,000 people. The prevalence of
Crohn’s disease in North America is estimated to be between 400,000 and 600,000 patients.
There are two peak ages of onset, with a major peak in the people aged from 10 to 29 years
old and elderly people whose ages are from 60 to 79 years old (4).
Inflammatory bowel disease (IBD) was once considered to be uncommon in Asia, but
new evidence suggests that the condition is becoming more prevalent. With a crude yearly
overall incidence of 1.37 per 100 000, a prospective research studying the incidence of IBD
in the Asia-Pacific area has proven that the incidence of Crohn’s disease is significantly lower
than in the West (5).
There are a number of common clinical presentations of Crohn’s disease that depend
on the anatomical regions affected by the inflammatory process and the type of inflammation
present. The most common presenting complaints include diarrhea, abdominal pain, weight
loss, and fatigue (4). Aside from the common signs and symptoms, Crohn’s disease has two
types of complications namely the local and systemic (2). From the word “local”, it means
that it only affects your intestine. This type of complication includes abscess, bile salt diarrhea,
fissure, fistula, malabsorption, malnutrition, small intestinal bacterial overgrowth and
strictures. Systemic on the other hand, affects your whole body and it is also medically called
as an extraintestinal complication. This includes arthritis, skin problem, bone loss, shortage
in vitamin D, eye problem, kidney and liver complication and physical development failure
(2).
Unfortunately, there is still no known cure for Crohn’s disease but treatments can
significantly reduce the symptoms and perhaps bring about long-term remission and healing
from inflammation (6). Treatment includes steroids, liquid diet, immunosuppressants and
biological medicines such as adalimumab, infliximab, vedolizumab and ustekinumab. Although
medicines are the main treatments, sometimes, surgery may be needed especially when
medications are not effective anymore (7).
