Case ReportsIncreased intestinal permeability precedes the onset of Crohn's disease in a subject with familial risk☆
Section snippets
Case report
An asymptomatic 13-year-old girl underwent intestinal permeability testing in 1989 as part of a study to examine gut permeability of relatives and cohabitants of patients with Crohn's disease (see below). Both her mother and an older brother had gastroduodenal, terminal ileal, and rectal Crohn's disease, and had required multiple surgical resections. Her 24-hour urinary excretion of 51Cr-labeled EDTA was elevated at 2.5% of the orally administered dose (normal, <1.95%). At the time of
Discussion
Our patient was at increased risk of developing Crohn's disease because of a strong family history, with 2 affected first-degree relatives. Her risk was at least 10-fold that of the general population, with an absolute risk of approximately 11.5%.5, 6, 7 She had no symptoms and no endoscopic, radiographic, or histologic evidence of Crohn's disease when investigated extensively at age 13 because of increased intestinal permeability to 51Cr-labeled EDTA. Investigation at age 21, 1 year after
Acknowledgements
The authors thank the following colleagues: Marysia Donnelly and Tara Srinivasan for collating the permeability data; Dr. Ian Zealley for reviewing the radiology; and Drs. Stephen Collins, Mary Perdue, and Johan Soderholm for their helpful suggestions to improve the manuscript.
References (31)
- et al.
The sugar permeability test reflects disease activity in children and adolescents with inflammatory bowel disease
J Pediatr
(1998) Permeability in Crohn's disease: altered barrier functions in healthy relatives?
Gastroenterology
(1993)- et al.
Risk of ulcerative colitis and Crohn's disease among offspring of patients with chronic inflammatory bowel disease
Am J Gastroenterol
(1999) - et al.
Intestinal permeability: an overview
Gastroenterology
(1995) - et al.
A double-blind placebo-controlled pilot study of glutamine therapy for abnormal intestinal permeability in patients with AIDS
Am J Gastroenterol
(1998) - et al.
Intestinal permeability and the prediction of relapse in Crohn's disease
Lancet
(1993) - et al.
Epithelial permeability to proteins in the non-inflamed ileum of Crohn's disease?
Gastroenterology
(1999) - et al.
Effect of the fecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum
Lancet
(1991) - et al.
Early lesions of recurrent Crohn's disease caused by infusion of intestinal contents in excluded ileum
Gastroenterology
(1998) - et al.
Intestinal permeability changes in response to acetylsalicylic acid in relatives of patients with Crohn's disease
Gastroenterology
(1996)
Intestinal permeability in patients with Crohn's disease and their healthy relatives
Gastroenterology
Is small intestinal permeability really increased in relatives of patients with Crohn's disease?
Gastroenterology
Clustering of increased small intestinal permeability in families with Crohn's disease
Gastroenterology
Intestinal permeability in Crohn's disease
Aliment Pharmacol Ther
51Cr-EDTA permeability: a marker of environmental and genetic risk in Crohn's disease (abstr)
Gastroenterology
Cited by (229)
Benefits and safety of probiotics in gastrointestinal diseases
2023, Antidotes to Toxins and Drugs: From Natural Sources to Drug Discovery in ToxicologyMetallothionein 2 activation by pravastatin reinforces epithelial integrity and ameliorates radiation-induced enteropathy
2021, EBioMedicineCitation Excerpt :Uncontrolled intestinal permeability can increase susceptibility to develop external stimuli-associated intestinal inflammation [3]. Clinical evidence also suggests that increased intestinal barrier dysfunction is a risk factor for GI disease because disturbance of epithelial integrity is typically present before inflammatory bowel disease (IBD) onset in human subjects [4]. Damaged mucosa from IBD patients has characteristics of altered intercellular junction structure and epithelial permeability [5].
In Vitro Models for Investigating Intestinal Host–Pathogen Interactions
2024, Advanced ScienceThe epithelium takes the stage in asthma and inflammatory bowel diseases
2024, Frontiers in Cell and Developmental BiologyRole of Muscarinic Acetylcholine Receptors in Intestinal Epithelial Homeostasis: Insights for the Treatment of Inflammatory Bowel Disease
2023, International Journal of Molecular Sciences
- ☆
Address requests for reprints to: E. Jan Irvine, M.D., Division of Gastroenterology (4W8), Department of Medicine, McMaster University Medical Centre, 1200 Main Street West, Hamilton, Ontario L8N 3Z5. e-mail: [email protected]; fax: (905) 521-4958.