Endocrine aspects of Crohn's disease

• Published in: Medicinski glasnik Specijalne bolnice za bolesti štitaste žlezde i bolesti metabolizma Zlatibor Vol. 24; no. 73; pp. 7 - 18
• Main Authors: Ilić Saša, Gostiljac Draško, Dimitrijević-Srećković Vesna, Popović Srđan
• Format: Journal Article
• Language: English
• Published: Specijalna bolnica za bolesti štitaste žlezde i bolesti metabolizma Zlatibor 01-01-2019
• Subjects: corticosteroid therapy; crohn's disease; diabetes; osteoporosis
• ISSN: 1821-1925; 2406-131X

Introduction: Crohn's disease (CB) is idiopathic, chronic inflammatory disease that can affect any part of the gastrointestinal tract. Extraintestinal manifestations (EIM) of CD affect about 20-40% of patients. Endocrine aspect of CD can be observed through glycemic disregulation, dyslipidemia, metabolic bone disease, hypogonadism, low growth, delayed puberty and other. All endocrine manifestations are closely related to severe inflammatory response and corticosteroid therapy (CSt). The most common complications are diabetes (generally poorly regulated) and osteoporosis in the elderly and low growth (with late puberty) in the younger ones. Case Report: A 57-year-old patient, S. Z., was hospitalized at our Clinic due to unstable glycoregulation within long-term diabetes with microvascular complications (on bolus-basal insuli treatment) The CD in patient was poorly regulated with changing multiple therapeutic modalities. During hospitalization, the CD therapy was corrected and aminosalicylate therapy was replaced with CSt, the glycoregulation was further worsened and only a partial improvement in glycemia was achieved. Malabsorption was diagnosed and supstitutional therapy was introduced. Secondary osteoporosis in patient has been initially treated with intravenous bisphosphonate while monitoring the effect. Due to long-term use of CSt and poor life quality anxiety disorder has been evaluated and treated properly. Conclusion: Long-term poorly-regulated CD is predictor of extraintestinal complications. All EIMs result in poor quality of life and bad prognosis. CD therapy and chronic inflammation constitute vicious circle in which all the consequences and manifestations are inadequately regulated and require a multimodal-multidisciplinary approach.