CAM202 Lecture Notes - Lecture 9: Pyoderma Gangrenosum, Erythema Nodosum, Ankylosing Spondylitis
Document Summary
Clinical features: chronic episodic disease, propensity to arise in adolescent and young adults, estimates of the annual incidence of uc range from 4-20/100,000, most patients have mild to moderate colitis with relapsing. Second incidence peak in middle aged men mucus) with pains/cramps relieved by defecation. Sacroiliitis: migratory polyarthritis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, clubbing of fingertips, primary sclerosing cholangitis, cirrhosis of the liver (?, pericholangitis, uveitis, cholangiocarcinoma (rare) Pathogenesis: exact cause unknown, very controversial, multiple theories over the years, variety of factors appear important (eg. genetic and environmental etc. , environmental, childhood infection, diet, climate, physical activity, appendectomy. Smoking: does increase risk of uc and relapse, genetic, no specific gene identified, multiple susceptibility genes most likely involved. Immunosuppressive treatment works; suggests genetic plays a part: current models suggest combination of genetic susceptibility, bacterial antigens and disturbances of mucosal immunity lead to development of uc. Pathological features: grossly, uc involves rectum with continuous involvement of colon proximally.
