Yara Sarkis, MD Profile picture
Apr 17 16 tweets 130 min read Twitter logo Read on Twitter
@MondayNightIBD 1/Differential of Non-infectious Non -IBD colitis:
🔆 Drug-induced
🔆 Common Variable Immunodeficiency
🔆 Behcet disease
🔆 Segmental Colitis Associated w/ Diverticulosis
🔆 Ischemic Colitis
🔆 Radiation Colitis
🔆 Malignancy

🤔Can you think of other dx?
#MondayNightIBD
@MondayNightIBD 2/Immune Checkpoint Inhibitor Enterocolitis
📌ICI = monoclonal antibodies that reactivate immune response to tumor cells
📌Activation of T‐cells can cross‐react with host antigens
📌Enterocolitis ⬆️anti‐CTLA‐4 > anti‐PD‐1/PD‐L1 agents
📌Diarrhea
⬆️risk perforation if unrecognized Image
@MondayNightIBD @SanjeevaniTomar @halesj126 @JosephHabibi_MD @RomyChamoun @MarcelYibirin @ifrahfatima @GroverDheera @dunleavy_katie @drsophiadar @Spencerkelley7 3/ICI + Diarrhea:
📐R/o infection
🔦C-Scope: appearance of IBD; but mucosa can look normal -> always biopsy; consider EGD +Bx
🔬Path can have chronic IBD changes, crypt apoptosis
💊Depends on severity: budesonide -> IV steroids-> Biologic
#IBDAlgorithm👇
Image
@MondayNightIBD @SanjeevaniTomar @halesj126 @JosephHabibi_MD @RomyChamoun @MarcelYibirin @ifrahfatima @GroverDheera @dunleavy_katie @drsophiadar @Spencerkelley7 @DCharabaty @BassiMehak @TabibianMDPhD @EugeneYenMD @DivyaBhattMD @DevikaGandhiMD @DrJessicaA @AstinWordenMD @drmonrezapour @KReddyMD 4/Capecitabine (oral 5-FU) induced colitis
🎯Diarrhea in up to 50%
🎯Rarely ileitis, severe watery or bloody diarrhea, Protein-losing enteropathy
🎯Bx: severe inflammatory changes, necrosis
🎯Pathophysiol: Ischemia?
📌💊Rx: stop capecitabine, IVF Image

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More from @yaransarkis

Aug 22, 2022
@MondayNightIBD 1/ Hello and Welcome to today's #MondayNightIBD #Back2Basics!

Classifications are💎in IBD‼️Why⁉️:
🔹Clear assessment of disease location/extent/behavior
🔹Objective measure of flare severity
🔹Objective measure of endoscopic activity
➡️Determine treatment and prognosis‼️ Image
@MondayNightIBD @MN_GIMD @JosephHabibi_MD @DCharabaty @RomyChamoun @AllonKahn @drsusankais 2/ Classifications in CD:
1⃣Montreal Classification🟰Clinical Classification:
🔹A=Age at dx, L=Location in GI tract, B=Behavior (cf. Slide)
⚠️Behavior pearls:
🔻B1 can progress into B2 or B3
🔻Pts can present with B2 or B3 or both
🔻Perianal disease possible with any B phenotype Image
@MondayNightIBD @MN_GIMD @JosephHabibi_MD @DCharabaty @RomyChamoun @AllonKahn @drsusankais @AdvaniRashmiMD @DVinsard @SanjeevaniTomar @BassiMehak @GroverDheera 3/ Crohn's disease activity index (CDAI) 🟰 Clinical score
🔹Assess disease activity
🔹Quantify symptoms
🔹8 variables
🔹Index score
🔻<150: Remission
🔻221-450: Mod to Severe Image
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