Institute of Translational Medicine, University of Liverpool, The Henry Wellcome Laboratory, Liverpool, UK.
Department of Medicine, Karolinska Institute, Stockholm, Sweden.
Gut. 2017 Feb;66(2):362-381. doi: 10.1136/gutjnl-2016-312673. Epub 2016 Oct 6.
The genetics of isolated colonic Crohn's disease place it approximately midway between Crohn's disease with small intestinal involvement and UC, making a case for considering it as a separate condition. We have therefore systematically reviewed its epidemiology, pathophysiology and treatment. Key findings include a higher incidence in females (65%) and older average age at presentation than Crohn's disease at other sites, a mucosa-associated microbiota between that found in ileal Crohn's disease and UC, no response to mesalazine, but possibly better response to antitumour necrosis factor than Crohn's disease at other sites. Diagnostic distinction from UC is often difficult and also needs to exclude other conditions including ischaemic colitis, segmental colitis associated with diverticular disease and tuberculosis. Future studies, particularly clinical trials, but also historical cohorts, should assess isolated colonic Crohn's disease separately.
孤立性结肠克罗恩病的遗传学研究将其定位于小肠受累型克罗恩病和溃疡性结肠炎之间，这使得将其视为一种独立的疾病成为可能。因此，我们系统地回顾了其流行病学、病理生理学和治疗方法。主要发现包括女性（65%）发病率较高，以及与其他部位的克罗恩病相比，发病时的平均年龄较大；黏膜相关微生物群介于回肠克罗恩病和溃疡性结肠炎之间；对美沙拉嗪无反应，但对肿瘤坏死因子的反应可能优于其他部位的克罗恩病。与溃疡性结肠炎的诊断鉴别往往很困难，还需要排除其他疾病，包括缺血性结肠炎、与憩室病相关的节段性结肠炎和结核病。未来的研究，特别是临床试验，但也包括历史队列研究，应该分别评估孤立性结肠克罗恩病。
