Correlation of presence of granulomas with clinical and immunologic variables in Crohn's disease
T. M. Heimann, F. Miller, G. Martinelli, A. Szporn, A. J. Greenstein and A. H. Aufses Jr
Department of Surgery, Mount Sinai School of Medicine, City University of New York, NY.
Approximately 50% of patients with Crohn's disease have epithelioid
granulomas present in the diseased intestine. Some studies have associated
the presence of granulomas with a good prognosis. In this prospective
study, 44 patients with Crohn's disease requiring surgery were followed up
for five years. Twenty-two patients (50%) had granulomas. Patients with
granulomas were younger and had a shorter duration of disease. They also
had more extensive disease and a greater degree of peripheral lymphopenia.
Follow-up showed a trend toward greater recurrence rate in the patients
with granulomas. It seems that patients with aggressive and extensive
Crohn's disease are not protected from the development of symptomatic early
recurrence by the presence of epithelioid granulomas.
