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No description available.

Non-invasive markers that are clinically useful for the diagnosis and monitoring of canine chronic enteropathies are scarce. The first aim of this study was to investigate the prevalence of cobalamin deficiency on a cellular level in dogs with chronic gastrointestinal disease by measuring serum methylmalonic acid (MMA) concentrations. Hypocobalaminemia has been associated with a negative outcome in dogs with chronic enteropathies, but the prevalence of cellular cobalamin deficiency is unknown. The second aim of this study was to determine the utility of fecal and urinary concentrations of N-methylhistamine (NMH) as a marker of gastrointestinal inflammation and disease activity in dogs with chronic enteropathies. Serum MMA concentrations were measured in healthy control dogs to establish a reference interval, which was calculated to be 415-1,193 nmol/L. Measurement of MMA concentrations in 555 serum samples from dogs with varying cobalamin concentrations showed a significant increase (p<0.05) in dogs with hypocobalaminemia. In a prospective group of 56 dogs with chronic enteropathies, 36% had decreased serum cobalamin concentrations, five of which (9% of 56 dogs) had increased serum MMA concentrations. We conclude that hypocobalaminemia is commonly seen in dogs with chronic gastrointestinal disease, but does not always appear to be associated with cellular cobalamin deficiency. In 47 dogs with chronic enteropathies, fecal and urinary NMH concentrations were increased in 21% and 27%, respectively, indicating that mast cell degranulation plays a role in a subset of dogs with chronic enteropathies. However fecal and urinary NMH concentrations did not correlate with each other, or with the clinical activity index. Urinary NMH concentrations correlated significantly with serum CRP concentrations, and were also significantly associated with severity of duodenal mucosal inflammation (p=0.008). The lack of correlation with the clinical activity index suggests that degranulation of mast cells only plays a role in some dogs with chronic enteropathies. Also, these results suggest that NMH alone may not be a good marker for clinical disease activity in dogs with chronic enteropathies. Due to its linear association with serum CRP and severity of mucosal inflammation, urinary NMH concentrations may be a better marker of intestinal inflammation than fecal NMH concentrations.

Background: Chronic enteropathies (CE) predispose dogs to thromboembolic disease, but the underlying mechanisms are poorly understood. Humans with CE have decreased activity of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13), a von Willebrand factor (vWF) cleaving enzyme, and increased circulating vWF. The primary aim of this study is to assess plasma ADAMTS13 activity, vWF antigen (vWF:Ag) concentration, and vWF collagen binding activity (vWF:CBA) in dogs with CE. Hypotheses: Dogs with CE have reduced plasma ADAMTS13 activity, increased vWF:Ag, and increased vWF:CBA compared to healthy control dogs. Animals: Twenty privately-owned dogs with CE and 40 healthy dogs were recruited from a specialty hospital population. Methods: Prospective observational study. Dogs were confirmed to have CE using histopathology. ADAMTS13 activity was measured using a commercially available ELISA kit (DiapharmaⓇ) in 20 dogs with CE and 40 healthy control dogs. Plasma vWF:Ag was assessed in 20 dogs with CE and 20 healthy control dogs. Plasma vWF:CBA was assessed in 19 dogs with CE and 20 healthy control dogs. For statistical analysis, an unpaired t-test was used for normally distributed data and Wilcoxon rank sum was used for non-Gaussian distribution. Significance was set at P < 0.05. Results: Plasma ADAMTS13 activity and vWF:Ag were not significantly different compared to healthy dogs (P = 0.07, P = 0.16, respectively). Plasma vWF:CBA was significantly decreased compared to healthy dogs (P = 0.007). Conclusions and clinical relevance: Plasma ADAMTS13 activity was not significantly different in dogs with CE compared to healthy dogs and is unlikely to be the primary mechanism for hypercoagulability associated with CE. Forty-three percent of CE dogs with hypoalbuminemia had ADAMTS13 activity below reference interval. Further studies are warranted to evaluate ADAMTS13 activity in a subset of dogs with CE, including those with protein losing enteropathy and thromboembolism. / Master of Science / Background: Dogs with chronic gastrointestinal disease, or chronic enteropathies (CE), often have abnormal blood clotting which predisposes to thrombosis. The mechanisms leading to this abnormal blood clotting are poorly understood. Humans with CE also suffer from abnormal blood clotting and thrombosis. Decreased activity of a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13), a von Willebrand factor (vWF) cleaving enzyme, and increased circulating vWF have been reported as contributors to this abnormal blood clotting in people. Von Willebrand factor is a protein that allows platelets to stick together and adhere to damaged tissue to facilitate blood clot formation. The concentration of vWF can be measured using vWF antigen (vWF:Ag) and the activity of vWF can be measured using vWF collagen binding activity (vWF:CBA). Hypothesis: Dogs with CE have reduced plasma ADAMTS13 activity, increased vWF:Ag, and increased vWF:CBA compared to healthy control dogs. Animals: Twenty privately-owned dogs with CE and 40 healthy dogs were recruited from a hospital population. Methods: Prospective observational study. Plasma ADAMTS13 activity, vWF:Ag and vWF:CBA were assessed in dogs with CE and compared to healthy control dogs. Results: There was no difference in plasma ADAMTS13 activity and vWF:Ag between the two groups. The mean vWF:CBA was significantly lower in CE dogs compared to healthy dogs. Conclusions and clinical relevance: Reduced ADAMTS13 activity is unlikely to be the primary mechanism for abnormal blood clotting in dogs with CE.

INTRODUÇÃO: As doenças inflamatórias intestinais têm chamado a atenção da comunidade científica pela multiplicidade de manifestações no trato digestivo, manifestações extra-intestinais e pela sua incidência em ascensão. Existe uma grande prevalência de manifestações extra-intestinais em portadores de doença de Crohn e de retocolite ulcerativa, variando na literatura de 24 a 65%. Estas alterações podem surgir antes dos sintomas intestinais, concomitante ou ulteriormente, podendo ou não ter relação com a atividade da doença intestinal. O conhecimento destas manifestações extra-intestinais assim como seu quadro clínico, evolução e tratamento é importante, devido ao aumento da morbidade e mortalidade desencadeada por elas. OBJETIVO: Objetivou-se neste trabalho determinar a prevalência de manifestações extra-intestinais em retocolite ulcerativa e doença de Crohn, correlacionando com diagnóstico do tipo de doença inflamatória intestinal, extensão, tempo de evolução e aparecimento dos sintomas, sexo e atividade da doença. MÉTODOS: Os pacientes que participaram do estudo estão cadastrados no Ambulatório de Doenças Inflamatórias do Serviço de Cirurgia do Cólon, Reto e Ânus do Departamento de Gastroenterologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de setembro de 1984 até setembro de 2004. Os dados para a pesquisa foram colhidos retrospectivamente de mil protocolos que foram preenchidos em caráter prospectivo na primeira consulta do doente e atualizados em consultas subsequentes. Foram estudadas as manifestações articulares, dermatológicas, oftalmológicas, urológicas, hepáticas, pulmonares e vasculares. RESULTADOS: Entre os 1.000 pacientes estudados encontrou-se 468 com doença de Crohn (46,8%) e 532 com retocolite ulcerativa (53,2%). Foram encontrados 627 pacientes com pelo menos uma forma de manifestação extra-intestinal(315-59,2% com RCUI e 312-66,7% com doença de Crohn). A média de tempo de duração da doença inflamatória intestinal dos pacientes que tinham manifestações extra-intestinais foi de 10,23 anos, comparado a 7,89 anos daqueles que não possuíam, sendo estatisticamente significativo. Também foi evidenciado que as manifestações extraintestinais surgiram com maior frequencia ulteriormente aos sintomas intestinais da doença. CONCLUSÕES: Na retocolite ulcerativa a maior extensão da doença no cólon foi proporcional a incidência de manifestações extra-intestinais, enquanto na doença de Crohn, quando havia algum acometimento colônico era maior a incidência destas manifestações. Apenas as manifestações urológicas tiveram uma predisposição maior pela doença de Crohn, e nestes, no sexo masculino. As manifestações articulares e dermatológicas foram mais prevalentes no sexo feminino tanto em retocolite ulcerativa quanto na doença de Crohn. Na doença de Crohn também houve maior prevalência de manifestações hepáticas no sexo feminino. As manifestações articulares, dermatológicas e vasculares tiveram uma maior correlação com a atividade da doença intestinal em ambos os grupos. / INTRODUCTION: Intestinal inflammatory diseases have been calling the attention of the scientific community due to the multiplicity of manifestations in the digestive tract, extra-intestinal manifestations and due to its growing incidence. There\'s great prevalence of extra-intestinal manifestations in Crohn\'s disease and ulcerative rectocolitis bearers, varying in literature from 24 to 65%. These alterations may arise before the intestinal symptoms, either at the same time or after, and they may or may not be related to the activity of the intestinal disease. Knowing these extra-intestinal manifestations, as well as their clinical condition, evolution and treatment is important, due to the enhancement in morbidity and mortality aroused by them. AIM: The objective of this paper was to determine the prevalence of extra-intestinal manifestations in ulcerative rectocolitis and Crohn\'s disease, relating it with the diagnosis of the kind of intestinal inflammatory disease, extension, evolution time and the arising of the symptoms, sex and disease activity. METHODS: The patients who took part in the study are registered in the Ambulatory for Inflammatory Diseases of the Anus, Rectum and Colon Surgery Service in the Gastroenterology Service of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, from September 1984 until September 2004. The data for the research were retrospectively gotten from one thousand protocols that were filled out in a prospective character during the patient\'s first consultation, and updated during subsequent consultations. Articular, dermatological, ophthalmologic, urologic, hepatic, pulmonary and vascular manifestations were studied. RESULTS: Among the 1,000 patients studied 468 were found to have Crohn\'s disease (46.8%) and 532 had ulcerative rectocolitis (53.2%). 627 patients were found with at least one form of extra-intestinal manifestation (315-59.2% had ulcerative retocolitis and 312-66.7% had Crohn\'s disease). The average duration time of the intestinal inflammatory disease of the patients who had extra-intestinal manifestations was of 10.23 years, compared to 7.89 years of those who had no disease, being statistically significant. It was also evident that the extra-intestinal manifestations came about more frequently subsequently to intestinal symptoms of the disease. CONCLUSIONS: In ulcerative rectocolitis, the greater extension of the disease in the colon was proportional to the incidence of extra-intestinal manifestations, whereas in Crohn\'s disease, when there was some colonic assault, the incidence of these manifestations was greater. Only the urologic manifestations have greater predisposition for Crohn\'s disease and in these ones, in the masculine sex. Articular and dermatological manifestations were more prevalent in the feminine sex both for ulcerative rectocolitis and for Crohn\'s disease. In Crohn\'s disease there was also greater prevalence of hepatic manifestations in the feminine sex. Articular, dermatological and vascular manifestations had greater correlation with the intestinal disease activity in both groups.

La thèse examine les déterminants nutritionnels et environnementaux de retard de croissance aux enfants en Afrique de l'Est. Je vais examiner le retard de croissance en utilisant une analyse épidémiologique des données secondaires (e.g. données de DHS) et l'analyse des données biochimiques liés à micronutriments et l'état de l'entéropathie. Pendant l'année scolaire 2015-2016, j'ai publié trois manuscrits liés à un retard de croissance en Ethiopie, a recueilli des échantillons de selles dans le cadre d'une étude cas-témoins en Tanzanie, et a reçu un financement pour analyser ces échantillons. Les analyses de laboratoire se fera en Novembre-Décembre 2016. Cette étude en Tanzanie examinera à la fois les facteurs nutritionnels et environnementaux associés à la croissance linéaire. / The thesis examines nutritional and environmental determinants of childhood stunting in East Africa. I will examine stunting by using epidemiologic analysis of secondary data (i.e. DHS data) and the analysis of biochemical data related to micronutrient and enteropathy status. During the 2015-2016 academic year, I published three manuscripts related to stunting in Ethiopia, collected stool samples as part of a case-control study in Tanzania, and received funding to analyze these samples. Laboratory analysis will be done in November-December 2016. This research study in Tanzania will examine both the nutritional and environmental factors associated with linear growth.

Lawsonia intracellularis causes proliferative enteropathies in juvenile mammals. The porcine (PPE) and equine (EPE) diseases are worldwide. Rabbits and hamsters are naturally susceptible, the latter being a classic modeling-host for PPE. None is known for EPE, besides foals. An in vitro evaluation of antimicrobial efficacy against L. intracellularis is difficult. This study aimed to validate a laboratory animal EPE model and to investigate pharmacokinetics (PK) and efficacy of gallium maltolate (GaM) as an alternative antimicrobial therapy. Infected animals were inoculated with cell-cultured L. intracellularis and infection was verified with clinically utilized diagnostic tests. Initially, 2 groups of EPE-infected rabbits were compared to 1 uninfected group. After inoculation (PI), EPE-infected rabbits showed mild clinical signs; detectable seroconversion, fecal shedding, gross lesions in intestinal tissues (IT), and early immuno-histochemistry labeling of L. intracellularis antigen. Thus, a humane EPE-rabbit model was achieved. Subsequently, EPE-infected hamsters were compared to uninfected and PPE-infected hamsters; whereas, PPE-infected rabbits were compared to EPE-infected rabbits. EPE-hamsters did not develop infection, unlike PPE-infected controls; and PPE-rabbits did not develop IT lesions or seroconversion comparable to EPE-rabbits. Therefore rabbits were chosen as the EPE modeling-host for the GaM studies. First, GaM PK and IT concentrations of Ga and Fe were measured. Then, GaM efficacy was compared to a current EPE antimicrobial treatment. During sampling, the intra-arterial catheters in the rabbits’ ears were protected with a novel moleskin-cover, allowing repeated sampling while minimally restrained. The PK study was based on the comparison of EPE-infected and uninfected rabbits, after a single treatment with GaM, collection of serial blood samples and IT samples. The only differing PK parameter, between groups, was a decrease in the terminal phase rate constant of the EPE-rabbits, so a 48h dosing interval was chosen for the efficacy study. In the efficacy study, 3 groups of EPE-infected rabbits were treated with GaM, doxycycline and a placebo, respectively. No differences were noted between treatments, in terms of lesions and fecal shedding. GaM appears no more efficacious than doxycycline in EPE- rabbits. In conclusion, albeit GaM tolerance appeared adequate in rabbits, results do not support its use in EPE-infected animals.

Die proliferative Enteropathie, verursacht durch das gram-negative Bakterium Lawsonia intracellularis, ist weltweit bei Schweinen als Durchfallerkrankung bekannt. Neben anderen Tierarten, unter anderem Hamster, Ratten, Schafe und Hunde, konnte diese Krankheit auch bei Fohlen im Alter zwischen zwei und neun Monaten nachgewiesen werden. Die Fallberichte stammen meist aus Nordamerika. Intra vitam gibt es neben der klinischen und labordiagnostischen Untersuchung weitere Nachweismöglichkeiten. Im Kot kann mittels Polymerasekettenreaktion (PCR) die L. intracellularis-DNA, im Serum mittels Immunoperoxidase Monolayer Assay (IPMA), Immunofluoreszenz-Antikörpertest (IFAT) oder blocking enzyme-linked immunosorbent assay (ELISA) der L. intracellularis-Antikörper nachgewiesen werden. Diese vier Testsysteme sind bei Schweinen zur Herdendiagnostik etabliert. Während es diverse Studien zur Prävalenz von Antikörpern bei Schweinen in Deutschland gibt, wurde dies bei Pferden bislang nicht geklärt. Da es auch einen Fallbericht aus Deutschland gibt, wurde in der vorliegenden Arbeit untersucht, wie viele Fohlen und Stuten aus verschiedenen Beständen und mit unterschiedlichem Vorbericht bzw. Gesundheitszustand seropositiv sind. Desweiteren sollte der Verlauf der Antikörper bei Stuten und ihren Fohlen nachverfolgt werden. Die serologische Untersuchung erfolgte mit Hilfe eines ELISAs. Dabei werden die Ergebnisse als Prozentsatz der Inhibition (PI) durch L. intracellularis-Antikörper angegeben. Ein PI – Wert über 30 wird als seropositiv gewertet. Für die erste Studie wurden 56 Fohlen, die mit unterschiedlichen Vorberichten in die Medizinische Tierklinik eingeliefert worden waren, sowie 24 gesunde Fohlen eines Haflingergestütes serologisch untersucht. Die zweite Studie war eine Verlaufsuntersuchung. In einem Haflingergestüt wurde der Antikörpernachweis bei 24 (2009) bzw. 16 (2010) Mutterstuten und ihren Fohlen in zwei aufeinanderfolgenden Jahren durchgeführt. In einem Warmblutgestüt wurden sechs Stuten und ihre Fohlen vor und nach der Abfohlung bzw. nach der Geburt monatlich getestet, bis alle Fohlen seronegativ waren. Es waren 39,3 % der in die Klinik eingelieferten Fohlen seropositiv. Signifikante Unterschiede zwischen gesunden Fohlen, Fohlen mit Diarrhoe, Fohlen mit Erkrankungen des Magen-Darm-Traktes und anderen Erkrankungen wurden nicht beobachtet. Alle getesteten erwachsenen Stuten waren zu jedem Zeitpunkt seropositiv. Im Haflingergestüt hatten im ersten Jahr 29,2 % und im zweiten Jahr 25 % der Fohlen Antikörper gegen L. intracellularis. Die seropositiven Fohlen des zweiten Jahres hatten dieselben Mutterstuten wie die seropositiven Fohlen des ersten Jahres. Bei den Warmblütern hatten fünf von sechs Fohlen nach der Geburt L. intracellularis-Antikörper. Die PI – Werte sanken sowohl bei den Stuten als auch bei den Fohlen im Untersuchungszeitraum kontinuierlich ab. Ende Juli, im Alter zwischen 82 und 141 Tagen (Median 115 Tage), wurden die fünf anfangs seropositiven Fohlen zum ersten Mal seronegativ getestet. Alle Fohlen im Alter von weniger als 14 Tagen waren seropositiv. Es bestand eine negative Korrelation zwischen dem Alter der Fohlen und ihrem PI-Wert, die bei den Warmblütern signifikant war. Außerdem bestand eine signifikante, positive Korrelation zwischen dem PI – Wert der Mutterstute und dem ihres Fohlens. Die Untersuchungen zeigen, dass der Nachweis von Antikörpern im equinen Serum auch mittels eines ursprünglich für Schweineserum entwickelten ELISAs möglich ist. Prozentual haben in Mitteldeutschland ähnlich viele Fohlen positive Ergebnisse wie in Nordamerika. Beeinflusst wird der PI – Wert eines Fohlens durch die Mutterstute, deren PI – Wert und das Alter des Fohlens. Nach der Geburt sinkt die Anzahl der Antikörper bis zum Alter von drei bis vier Monaten. In diesem Alter werden auch die meisten Erkrankungen beschrieben. Man kann daraus schlussfolgern, dass das Bakterium L. intracellularis auch bei Pferden in Deutschland weit verbreitet ist. Antikörper bilden nicht nur erkrankte Fohlen aus, sondern auch gesunde Pferde und Pferde mit anderen Erkrankungen. Da Fohlen im Alter von 12 bis 20 Wochen keine Antikörper mehr haben, ist eine Impfung empfehlenswert.

INTRODUÇÃO: As doenças inflamatórias intestinais têm chamado a atenção da comunidade científica pela multiplicidade de manifestações no trato digestivo, manifestações extra-intestinais e pela sua incidência em ascensão. Existe uma grande prevalência de manifestações extra-intestinais em portadores de doença de Crohn e de retocolite ulcerativa, variando na literatura de 24 a 65%. Estas alterações podem surgir antes dos sintomas intestinais, concomitante ou ulteriormente, podendo ou não ter relação com a atividade da doença intestinal. O conhecimento destas manifestações extra-intestinais assim como seu quadro clínico, evolução e tratamento é importante, devido ao aumento da morbidade e mortalidade desencadeada por elas. OBJETIVO: Objetivou-se neste trabalho determinar a prevalência de manifestações extra-intestinais em retocolite ulcerativa e doença de Crohn, correlacionando com diagnóstico do tipo de doença inflamatória intestinal, extensão, tempo de evolução e aparecimento dos sintomas, sexo e atividade da doença. MÉTODOS: Os pacientes que participaram do estudo estão cadastrados no Ambulatório de Doenças Inflamatórias do Serviço de Cirurgia do Cólon, Reto e Ânus do Departamento de Gastroenterologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de setembro de 1984 até setembro de 2004. Os dados para a pesquisa foram colhidos retrospectivamente de mil protocolos que foram preenchidos em caráter prospectivo na primeira consulta do doente e atualizados em consultas subsequentes. Foram estudadas as manifestações articulares, dermatológicas, oftalmológicas, urológicas, hepáticas, pulmonares e vasculares. RESULTADOS: Entre os 1.000 pacientes estudados encontrou-se 468 com doença de Crohn (46,8%) e 532 com retocolite ulcerativa (53,2%). Foram encontrados 627 pacientes com pelo menos uma forma de manifestação extra-intestinal(315-59,2% com RCUI e 312-66,7% com doença de Crohn). A média de tempo de duração da doença inflamatória intestinal dos pacientes que tinham manifestações extra-intestinais foi de 10,23 anos, comparado a 7,89 anos daqueles que não possuíam, sendo estatisticamente significativo. Também foi evidenciado que as manifestações extraintestinais surgiram com maior frequencia ulteriormente aos sintomas intestinais da doença. CONCLUSÕES: Na retocolite ulcerativa a maior extensão da doença no cólon foi proporcional a incidência de manifestações extra-intestinais, enquanto na doença de Crohn, quando havia algum acometimento colônico era maior a incidência destas manifestações. Apenas as manifestações urológicas tiveram uma predisposição maior pela doença de Crohn, e nestes, no sexo masculino. As manifestações articulares e dermatológicas foram mais prevalentes no sexo feminino tanto em retocolite ulcerativa quanto na doença de Crohn. Na doença de Crohn também houve maior prevalência de manifestações hepáticas no sexo feminino. As manifestações articulares, dermatológicas e vasculares tiveram uma maior correlação com a atividade da doença intestinal em ambos os grupos. / INTRODUCTION: Intestinal inflammatory diseases have been calling the attention of the scientific community due to the multiplicity of manifestations in the digestive tract, extra-intestinal manifestations and due to its growing incidence. There\'s great prevalence of extra-intestinal manifestations in Crohn\'s disease and ulcerative rectocolitis bearers, varying in literature from 24 to 65%. These alterations may arise before the intestinal symptoms, either at the same time or after, and they may or may not be related to the activity of the intestinal disease. Knowing these extra-intestinal manifestations, as well as their clinical condition, evolution and treatment is important, due to the enhancement in morbidity and mortality aroused by them. AIM: The objective of this paper was to determine the prevalence of extra-intestinal manifestations in ulcerative rectocolitis and Crohn\'s disease, relating it with the diagnosis of the kind of intestinal inflammatory disease, extension, evolution time and the arising of the symptoms, sex and disease activity. METHODS: The patients who took part in the study are registered in the Ambulatory for Inflammatory Diseases of the Anus, Rectum and Colon Surgery Service in the Gastroenterology Service of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, from September 1984 until September 2004. The data for the research were retrospectively gotten from one thousand protocols that were filled out in a prospective character during the patient\'s first consultation, and updated during subsequent consultations. Articular, dermatological, ophthalmologic, urologic, hepatic, pulmonary and vascular manifestations were studied. RESULTS: Among the 1,000 patients studied 468 were found to have Crohn\'s disease (46.8%) and 532 had ulcerative rectocolitis (53.2%). 627 patients were found with at least one form of extra-intestinal manifestation (315-59.2% had ulcerative retocolitis and 312-66.7% had Crohn\'s disease). The average duration time of the intestinal inflammatory disease of the patients who had extra-intestinal manifestations was of 10.23 years, compared to 7.89 years of those who had no disease, being statistically significant. It was also evident that the extra-intestinal manifestations came about more frequently subsequently to intestinal symptoms of the disease. CONCLUSIONS: In ulcerative rectocolitis, the greater extension of the disease in the colon was proportional to the incidence of extra-intestinal manifestations, whereas in Crohn\'s disease, when there was some colonic assault, the incidence of these manifestations was greater. Only the urologic manifestations have greater predisposition for Crohn\'s disease and in these ones, in the masculine sex. Articular and dermatological manifestations were more prevalent in the feminine sex both for ulcerative rectocolitis and for Crohn\'s disease. In Crohn\'s disease there was also greater prevalence of hepatic manifestations in the feminine sex. Articular, dermatological and vascular manifestations had greater correlation with the intestinal disease activity in both groups.