Crohn's disease. Rifampin treatment of the ocular and gut disease.

Idiopathic Uveitis (IU) may occur as either an isolated ocular disease or with other systemic diseases such as Crohn's Disease (CD). As many as 33% of CD patients demonstrate IU, and frequently their gut and IU course and severity are similar. Rifampin produces remissions of isolated IU, and Rifampin has been used to treat gut CD with varying success. In this investigation 4 CD patients, whose gut but not IU had partially responded to corticosteroids, the addition of Rifampin was associated with improvement in both their CD Activity Index and IU, allowing steroid discontinuation; Rifampin withdrawal was associated with exacerbations of both gut disease and IU; and re-institution of Rifampin was associated with another gut and IU disease remission. Since mouse ocular and systemic inflammatory disease producing non-cultivatable ultrastructurally unusual bacteria are commonly found within isolated chronic IU vitreous polymorphonuclear (PMN) leukocytes, a search for these bacteria in CD eye and gut disease seems justified, as the beneficial results of Rifampin in this study may have been an antimicrobial action on these bacteria.