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Ixekizumab is one of the three biologic agents including Secukinumab and Brodalumab that targets the Interleukin-17 (IL-17) pathway to reduce inflammation in psoriasis and ankylosing spondylitis. In this report we present the case of 42-year-old woman, who was diagnosed with psoriasis and psoriatic arthritis. One week after first administration of Ixekizumab, she developed diffuse abdominal pain, bloody diarrhea (7-8 stools/day) and fever. Following imaging (colonoscopy, computed tomography) and laboratory investigations, she was diagnosed with acute severe ulcerative colitis complicated with toxic megacolon. The medical treatment (first corticotherapy, then infliximab) has failed and the patient needed emergency colectomy. Based on the immunological mechanisms and the observation from other studies, Ixekizumab should be considered an etiology for new-onset inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

Background. Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are perceived different pathologies, one organic and the other functional, which influence the quality of life (QOL). We aimed to compare the relative impact of the disease on QOL in two groups of outpatients suffering from IBS and IBD attending our outpatient clinic at a university hospital in Romania and to compare them with a healthy group of students. Methods. The studied groups completed an SF-36 quality of life form, the associations between gastrointestinal (GI) symptoms, psychosocial score (PS) and mental status (MS) were analyzed by multiple linear regressions. Results. QOL appears to be similarly reduced in both disease groups (global mean SF-36 value: 57.2 +/- 14.2 in IBS patients versus 55.4 +/- 17.3 in IBS patients IBD: P > 0.05) compared with the control group. GI symptoms were associated with changes in the PS, but not with the MS in both groups, significantly lower than in the control group (p<0.01). The most important predictor of the change in the mental score was depression (p<0.01). Anxiety significantly contributed to the decrease of the three scores (GI, PS, MS) in all studied groups. Conclusions. Patients with IBS present healthrelated quality of life, mental distress and psychosocial status similar to those with IBD. Anxiety and depression change the psychosocial and mental status even in healthy patients. [ABSTRACT FROM AUTHOR]

Introduction. There are an inverse association between Helicobacter Pylori (H. pylori) infection and prevalence of IBD [5, 10,11,12]. Also studies have reported an inverse association between H. pylori prevalence and disease severity of IBD [13]. H. pylori is one of the environmental infections causing changes in gut microbiota and immune system dysregulation, which may affect IBD activity. The current study aimed to compare the clinical, laboratory, and histological severity of the newly diagnosed IBD with the presence or absence of H. pylori infection. Methods. This was a retrospective study that included 50 newly diagnosed inflammatory bowel disease patients (30 ulcerative colitis patients and 20 Crohn's disease patients). Diagnosis of IBD was based on both endoscopy/colonoscopy and biopsy. Also, for assesing Disease activity was quatified by CDAI for Crohn disease and UCDAI dor ulcerative colitis. Also, fecal calprotectine was evaluated. The presence of H. pylori was evaluated by the H. pylori stool antigen test (HpSA). Results: The overall positivity of H. pylori infection in patients with IBD was 19.2%. Patients with HpSA had a significantly lower fecal calprotectine (145.57 ± 28.12 vs. 320.57 ± 67.54 (μg/mg); P= 0.02), Mayo score (4.12 ± 1.09 vs. 8.01 ± 1.23; P < 0.001) and CDAI score (112 ± 67 vs. 198 ± 89; P < 0.001) compared to those with negative HpSA. Conclusion. We reported a significantly lower H. pylori infection rate in IBD patients. H. pylori-positive IBD patients have a milder disease with less activity compared to H. pylori-negative IBD patients. [ABSTRACT FROM AUTHOR]

This study aims to assess the impact of inflammatory bowel diseases (IBD): ulcerative colitis (UC) and Crohn's disease (CD) on the patients' quality of life (QoL) and to identify the significant changes in QoL depending on the developmental particularities of IBD and the epidemiological parameters. A prospective study was conducted over a period of 36 months (October 2011-October 2014) at the Institute of Gastroenterology and Hepatology, Iai. The study was conducted on 254 patients diagnosed with IBD, 187 patients with UC and 67 patients with CD. The quality of life was assessed using the questionnaire IBDQ-32 (Inflammatory Bowel Disease Questionnaire), which is one of the most widely used questionnaires in QoL assessment. The total IBDQ score was slightly more reduced in the patients with UC compared to the patients with CD. Of the 4 subscales of the IBDQ score, the scores highlighting the emotional and social component were significantly more reduced in the patients with UC, while the scores for the bowel symptoms were significantly more reduced in the patients with CD. In both the patients with UC and with CD, the correlations between the UCDAI, respectively CDAI score and the IBDQ score were indirect, highlighting reduced values of IBDQ in patients with a severe activity of the disease. The severe flare of the disease had a negative impact on the patients' QoL. The present study confirms the fact that the activity of the disease is the factor likely to have the highest impact on QoL in IBD patients. [ABSTRACT FROM AUTHOR]

Introduction. Vitamin D deficiency is commonly diagnosed among patients with inflammatory bowel disease. Vitamin D normalization is associated with reduced risk of relapse, reduce risk of IBD related surgeries and improvement in quality of life. The aim of this study was to evaluate the possible therapeutic role of Vitamin D supplementation in mild and moderate Crohn disease. Methods. We performed a double-blind randomized placebo-controlled study conducted over a period of 6 months. The study enrolled 30 patients diagnosed with mild and moderate Crohn disease with Crohn 's Disease Activity Index (CDAI Score) <450 and Vitamin D deficiency levels <30 ng/ml. Serum 25(OH)D levels were measured in all patients enrolled in the study. We assigned 30 CD patients with 2000 UI Vitamin D per day or placebo for 6 months. We determined CDAI score and serum 25(OH)D levels at 0 and 6 months. Results. 11 patients had Vitamin D levels <10 ng/ml, 14 patients had Vit D levels between 11-20 ng/ml, and 5 patients presented VD levels between 21 and 30 ng/ml. At 6 months, 25(OH)D concentrations were significantly higher in those who were treated (p<0.003). In the placebo groupd 25(OH)D concentrations stayed approximately the same. At 6 months, patients with 25(OH)D levels >30 ng/ml had significantly lower CDAI score (p=0.05). Discussion/Conclusion. Vitamin D supplementation significantly increased 25(OH)D levels in CD patients with mild and moderate disease activity and was associated with lower CDAI score. Our analysis indicates that Crohn disease patients due dietary malabsorption should supplement their diets with Vitamin D. These results should provide directions for future research, as more exploration is needed. [ABSTRACT FROM AUTHOR]

Introduction. Fecal calprotectin (FC) is the most popular and well-studied non-invasive biomarker in diagnosing and monitoring inflammatory bowel disease (IBD) patients and it is routinely tested and widely used in clinical practice. Aim. to evaluate the usefulness of FC in predicting clinical relapse in IBD patients treated with anti-TNF agents, during one year of follow-up. Methods. We conducted a retrospective study including 50 IBD patients treated with anti-TNF agents (Infliximab, Adalimumab), in clinical remission (defined according to clinical Mayo and CDAI score) for at least 6 months, evaluated in a tertiary center between April 2021 through April 2022. For each patient, demographic and clinical parameters, data on the extent of the disease, type of treatment and FC value were collected. The patients included in the study were reevaluated 1 year later after the initial evaluation, regarding clinical remission/relapse. Results. There were 29 patients with ulcerative colitis (UC) (58 %) and 21 with Crohn's disease (CD) (42 %)), with a mean age of 42 years (21-63 years). 28 patients (18 with UC and 10 with CD) were treated with Infliximab and 22 (11 UC, 11 CD) with Adalimumab. Out of 50 IBD patients, 28 (56%) had FC <50 μg/g, 15 (30%) had FC between 50 - 150 μg/g and 7 (14%) had FC ≥ 150 μg/g. After 12 months, we observed persistent clinical remission rates of 82.75% (24) for UC and 71.42% (15) for CD. Clinical relapse was present in no patient with FC <50 μg/g, in 47% of patients with FC between 50 - 150 μg/g, and in 71.42% of the patients with FC ≥ 150 μg/g. All UC who relapsed had initial FC value more than 150 μg/g. There were no differences in clinical relapse in patients treated with Infliximab vs Adalimumab. Conclusion. FC more than 150 μg/g is a good noninvasive marker for 1 year clinical relapse in IBD patients treated with anti-TNF. The predictive role is more obvious for patients with UC compared to CD, regardless of the type of anti-TNF used. [ABSTRACT FROM AUTHOR]

Unlabelled: The aim of the study is to assess the impact of Crohn's Disease (CD) on quality of life (QoL) patients with and to identify the significant modifications in QoL, depending on both the development particularities of CD and the epidemiologic parameters., Material and Methods: a prospective study was conducted at the Institute of Gastroenterology and Hepathology Iaşi, between October 2011 and August 2014. The study enrolled 63 patients with CD. The CD diagnosis was based on clinical, biological, endoscopic and histological criteria. QoL was assessed by means of the IBDQ-32 questionnaire (Inflammatory Bowel Disease Questionnaire)., Results: The total IBDQ score varied from 70 to 200, registering a slightly higher value in female patients. Parameters such as age, sex and smoking/non-smoking status did not present significant differences in the IBDQ score. The values of the IBDQ score were in indirect, mild correlation with the CDAI score; over 49% of the subjects with higher CDAI had a lower IBDQ score., Conclusions: Except for the disease activity periods, the results of the studies investigating the impact of the various factors on the QoL in patients with CD are contradictory. Further research is needed in order to define the subgroups of patients likely to suffer from poorer QoL.

Unlabelled: Crohn's disease is an inflammatory disease of the gastro-intestinal tract with an evolution marked by activity and remission periods. Lately, the incidence and evolution models of Crohn's disease significantly changed, an increasing number of patients presenting more severe forms. The aim of the study is to analyze Crohn's disease in its phenotypic classification and to establish correlation between the localization, the behavior and the activity of Crohn's disease., Material and Methods: A transversal study on 53 patients with Crohn's disease was conducted., Results: from the 53 patients, 56.6% were males, 85% from the urban areas. Under the phenotype aspect, the colonic localization (49.1%) and the inflammatory behavior (52.8%) were predominant. More severe forms of activity were discovered to patients with ileal localization (57.1%) or with penetrant phenotype (33.3%)., Conclusions: Male patients from urban areas were predominant. The most frequent forms are the colonic and ileocolonic forms. From a behavioral point of view, we observed an obvious predominance of the inflammatory phenotype. The moderate--severe activity was predominant for the ileal localization and the mild-- moderate activity for the colonic and ileocolonic localization. A mild--moderate activity is present for the stenosing forms and a moderate--severe one for the penetrant forms.