Hepatosplenic T-cell lymphoma (HSTCL) is a rare, lethal disease generally seen in young male patients with inflammatory bowel disease. TNF-α Inhibitor treatments (infliximab, adalimumab, certolizumab, natalizumab, and etanercept) are thought to be the cause of this rare disease. Major complications
Major complications of Crohns disease include bowel obstruction, abscesses, free perforation, and hemorrhage, which in rare cases may be fatal. Other Complications
Individuals with Crohns disease are at risk of malnutrition for many reasons, including decreased food intake and malabsorption. The risk increases following resection of the small bowel. Such individuals may require oral supplements to increase their caloric intake, or in severe cases, total parenteral nutrition (TPN). Most people with moderate or severe Crohns disease are referred to a dietitian for assistance in nutrition.Small intestinal bacterial overgrowth (SIBO) is characterized by excessive proliferation of colonic bacterial species in the small bowel. Potential causes of SIBO include fistulae, strictures, or motility disturbances. Hence, patients with Crohns disease are especially predisposed to develop SIBO. As result, CD patients may experience malabsorption and report symptoms such as weight loss, watery diarrhea, meteorism, flatulence, and abdominal pain, mimicking acute flare in these patients. Pregnancy
Crohns disease can be problematic during pregnancy, and some medications can cause adverse outcomes for the fetus or mother. Consultation with an obstetrician and gastroenterologist about Crohns disease and all medications facilitates preventive measures. In some cases, remission occurs during pregnancy. Certain medications can also lower sperm count or otherwise adversely affect a mans fertility.
Crohns is responsible for 10% of vesicoenteric fistulae, and is the most common cause of ileovesical fistulae.Symptoms caused by intestinal stenosis, or the tightening and narrowing of the bowel, are also common in Crohns disease. Abdominal pain is often most severe in areas of the bowel with stenosis. Persistent vomiting and nausea may indicate stenosis from small bowel obstruction or disease involving the stomach, pylorus, or duodenum.Intestinal granulomas are a walled-off portions of the intestine by macrophages in order to isolate infections. Granuloma formation is more often seen in younger patients, and mainly in the severe, active penetrating disease. Granuloma is considered the hallmark of microscopic diagnosis in Crohns disease (CD), but granulomas can be detected in only 21-60% of CD patients. Cancer
Crohns disease also increases the risk of cancer in the area of inflammation. For example, individuals with Crohns disease involving the small bowel are at higher risk for small intestinal cancer. Similarly, people with Crohns colitis have a relative risk of 5.6 for developing colon cancer. Screening for colon cancer with colonoscopy is recommended for anyone who has had Crohns colitis for at least eight years.Some studies suggest there is a role for chemoprotection in the prevention of colorectal cancer in Crohns involving the colon; two agents have been suggested, folate and mesalamine preparations. Also, immunomodulators and biologic agents used to treat this disease may promote developing extra-intestinal cancers.Some cancers, such as Acute Myelocytic Leukaemia have been described in cases of Crohns disease.