Significance of granulomas in the outcomes of Crohn's disease patients

dc.contributor.authorSaade, Marie Christelle
dc.contributor.authorWehbe, Hisham
dc.contributor.authorMourad, Fadi H.
dc.contributor.authorHosni, Mohammad
dc.contributor.authorFrancis, Fadi F.
dc.contributor.authorMakki, Maha
dc.contributor.authorBinion, David G.
dc.contributor.authorTamim, Hani
dc.contributor.authorFarraye, Francis A.
dc.contributor.authorMalik, Talha
dc.contributor.authorHashash, Jana G.
dc.contributor.departmentMedicine, School of Medicine
dc.date.accessioned2023-08-30T15:05:17Z
dc.date.available2023-08-30T15:05:17Z
dc.date.issued2022
dc.description.abstractBackground: The presence of granulomas in the gastrointestinal (GI) tract is one of the characteristic histologic features of Crohn's disease (CD). The clinical significance of granulomas remains unclear. In this study, we aimed to determine whether the presence of granulomas on endoscopic pinch biopsy or surgical resection from the upper or lower GI tract is associated with worse outcomes among patients with CD. Methods: This was a retrospective chart review of patients with CD evaluated at a tertiary care center between 1996 and 2019. Patients were divided into 2 groups based on the presence or absence of granulomas on GI histology. Clinical and laboratory data, and outcomes of interest, were obtained from the electronic medical records. Patients' characteristics and outcomes were compared between the 2 groups. Results: A total of 237 patients were included in our study; 41 (17.3%) had granulomas on their biopsy/resection specimen. The presence of granulomas in the GI tract was significantly associated with the development of intra-abdominal abscesses and/or fistulas (P=0.037), greater utilization of immunomodulators (P=0.029), and greater use of immunosuppressive medications (immunomodulator and/or biologic therapy) (P=0.015). No significant differences were found between the 2 groups in terms of number of hospitalizations, presence of perianal disease, intestinal resection, mean age, mean age at initial diagnosis of CD, duration of disease, sex, or smoking history. Conclusions: The presence of granulomas in the GI tract of CD patients may serve as a prognostic biomarker of worse disease severity. Larger studies are needed to better validate this finding.
dc.eprint.versionFinal published version
dc.identifier.citationSaade MC, Wehbe H, Mourad FH, et al. Significance of granulomas in the outcomes of Crohn's disease patients. Ann Gastroenterol. 2022;35(5):503-508. doi:10.20524/aog.2022.0730
dc.identifier.urihttps://hdl.handle.net/1805/35241
dc.language.isoen_US
dc.publisherHellenic Society of Gastroenterology
dc.relation.isversionof10.20524/aog.2022.0730
dc.relation.journalAnnals of Gastroenterology
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.sourcePMC
dc.subjectCrohn’s disease
dc.subjectDisease severity
dc.subjectGranuloma
dc.subjectImmunosuppressive medications
dc.subjectPrognosis
dc.titleSignificance of granulomas in the outcomes of Crohn's disease patients
dc.typeArticle
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