Crohn'sCanada
  Addressing the alarming rise of the bacterium "Mycobacterium avium Paratuberculosis"
 
in the environment and the growing evidence linking this bacterium to Crohn's
disease.
 
 
 
Dr Chiodini's Tables
 
 
 
Table 1 - by Dr Chiodini
 
Pathogenic Characteristics and Mycobacteria Isolated from Crohn’s Disease Patients and Controls
 
Organism Reservoir
Classification
Infection Associated with
Natural Reservoir
 
M. chelonei
Opportunistic
Innumocompromised and
Traumatic Wounds
Environment
 
M. fortuitum
Opportunistic
Immunocompromised
Environment
 
M. avium (MAI)
Opportunistic
Immunocompromised
Environment
 
M. intracellulare (MAI)
Opportunistic
Immunocompromised
Environment
 
M. kansasii
Opportunistic
Underlying chronic disease
Environment
 
M. paratuberculosis
Animal pathogen
Disease
Diseased animals

Table 2 - by Dr Chiodini
 
Clinical Similarities Between Crohn’s Disease and Mycobacterioses
 
Feature
Crohn's Disease
Intestinal TB
Paratuberculosis
 
Diarrhea
Yes
Yes
Yes
 
Intermittent Diarrhea
Yes
Yes
Yes
 
Abdominal Pain
Yes
Yes
N/A (b)
 
Weight Loss
Yes
Yes
Yes
 
Obstruction
Yes
Yes
No
 
Mass in region of Ileum
Yes
Yes
No
 
Blood in stool
Rare
Rare
Rare
 
Vomiting
Yes
Yes
No (c)
 
Quiet Periods
Yes
Yes
Yes

(b)
- not available, domestic animals generally fail to display chronic pain.
(c) - Vomiting (regurgitation) is a normal function of ruminants.

Table 3 - by Dr Chiodini
 
Pathologic Similarities Between Crohn’s Disease and Mycobacterioses
 
Feature
Crohn's Disease
Intestinal TB
Paratuberculosis
Other Mycobacterioses
 
Segmental
Distribution
Yes
Yes
Yes
Leprosy
 
Strictures
Yes
Yes
No
(nk)(b)
 
Obstruction
Yes
Yes
No
(nk)
 
Skip-lesions
Yes
Yes
Yes
Leprosy
 
Perforations
Yes
Yes
(nk)
(nk)
 
Stenosis
Yes
Yes
Yes
(nk)
 
Abdominal mass
Yes
Yes
No
(nk)
 
Fibrosis
Yes
Yes
No
(nk)
 
Ulcerations
Yes
Yes
Yes
Leprosy
 
Transmural
inflammation
Yes
Yes
Yes
(nk)
 
Abdominal edema
Yes
No
Yes
(nk)
 
Fissures
Yes
Yes
No
(nk)
 
Fistulae-Internal
Yes
Yes
No
Various
 
Fistulae-external
Yes
Yes
No
Various
 
Sinus tracts
Yes
Yes
No
(nk)
 
Lymphoid
hyperplasia
Yes
Yes
Yes
Leprosy
 
Pseudopolyps
Yes
Yes
No
(nk)
 
Granulomas
Yes
Yes
Yes
All
 
Non-caseating
granulomas
Yes
Yes (25%)
Yes
Various
 
Non-specific
inflammation
Yes
Yes
Yes
Various
 
Giant Cells-
Foreign-body
Yes
Yes
Yes
(nk)
 
Giant Cells-
Langhans'
Yes
Yes
Yes
All

(nk) - not known
(b) - not known or not applicable due to site specificity.

Table 4 - by Dr Chiodini
 
Pathologic Similarities Between Crohn’s Disease and Mycobacterioses
 
Feature
Crohn's Disease
Intestinal TB
Paratuberculosis
Other Mycobacterioses
 

Arthritis

Yes

Yes

Yes

Leprosy

 

Erythema nodosum

Yes

Yes

Yes (b)

Yes

 

Amyloidosis

Yes

Yes

Yes

Leprosy

 

Granulomatous hepatitis

Yes

Yes

Yes

Leprosy

 

Nephrolithiasis

Yes

No

Yes

(nk) (c)

 

Oral Ulcers (mouth)

Yes

Yes

(nk)

(nk)

 

Ocular

Yes

(nk)

Yes

Leprosy


(nk) - not known
(b) - skin lesions often exhibited as alopecia.
(c) - not known or not applicable due to site specificity.


Table 5 - by Dr Chiodini
 
Epidemiologic Features of Crohn’s Disease and Mycobacterioses
 
Feature
Crohn's disease
Intestinal TB
Paratuberculosis
 
Female preponderance
30-75%
70-75%
Unknown (b)
 
Ileocecal disease
85%
85%
Majority
 
Primary age incidence
15-25
15-24
Prime of life
 
Incidence under 40
84%
65-85%
Majority (c)
 
Bimodal age incidence
Maybe
Maybe
Unknown (d)
 
Familial Association
Yes
Yes
Yes


(b) - females comprise major population in domestic livestock such that preponderance
       cannot be determined.
(c) - age designation beyond lifespan of domestic livestock. Paratuberculosis rarely occurs
        in older animals.
(d) - normal agricultural life of livestock not long enough to determine.
 


Glossary of Terms - by MAP-Canada
 
Term
Definition
 
 
 
Clinical
features
  Characteristics of a disease that are apparent on direct observation.
 
Systemic
features
  Characteristics of a disease that can be found throughout the body.  
 
Pathologic
features
  Tissue abnormalities caused by a disease.
 
Epidemiologic
features
  Sum of factors that can alter the course of a disease in a population.  These can include age, sex, diet, geography, soil, environment, etc.
 
Ileum
  Last section of the small intestine, immediately adjacent to the colon.
 
Ruminants
  Animals with a 4-chambered stomach that regurgitate and chew their cud.
 
Erythema
nodosum
  Recurrent and painful skin condition that causes tender nodules, usually on lower legs - often seen as complication of infections, particularly TB.
 
Amyloidosis
  Condition where deposition of protein aggregates in various tissues  - can affect 1 organ or be multi-system.
 
Obstruction
  Blockage that can be either partial or complete.
 
Nephrolithiasis
  Kidney stones
 
Segmental
Distribution
  Diseased tissue is distributed in distinct segments, or sections separated by healthy tissue.
 
Stenosis
  Abnormal narrowing of the diameter a bodily passage, which when severe, can eventually cause obstruction.    
 
Skip-lesions
  Lesions mingled with sections of healthy tissue.
 
Fibrosis
  Increase in interstitial (between cells) fibrous tissue typical of scarring.
 
Transmural
inflammation
  Deep inflammation that extends throughout all the layers of tissue, as opposed to superficial inflammation.
 
Abdominal
edema
  Swelling of the abdomen.
 
Fissures
  Lesions or wounds.
 
Fistula
  Abscess that can tunnel from one organ to body surface or to another organ.  
 
Lymphoid
hyperplasia
  Increase in cellular components of a lymph node or extranodal lymphoid tissue. This may create an increase in the size of the tissue, such as in a lymph node or tonsil – often due to increase in cell division and multiplication.
 
Pseudopolyps
  Cyst-like growths caused by intense regeneration of tissue.
 
Macrophage
  Special cells of the immune system responsible for ingesting, killing and digesting foreign invaders in a process called phagocytosis.
 
Granuloma
  A special form of chronic inflammation. It is formed most often when either a foreign body or persistent microorganism, such as the tubercle bacillus, evades destruction by the unmodified chronic inflammatory response. In its most classical form, a granuloma consists of concentric layers of cells that, together, form the distinctive lesion.   
 
Granulomatous hepatitis
  Condition of the liver characterized by granulomatous inflammation.  
 
Caseating
  Conversion of necrotic (dead) tissue into a soft cheesy substance - often seen in center of granulomatous inflammation - common in TB.
 
Giant Cells
Langhans'
  Large cells with multiple nuclei forming a horseshoe arrangement, leaving centre free of nuclei – commonly seen in Tuberculosis.
 
Giant Cells
Foreign body
  Large cells with multiple nuclei in haphazard arrangement.
 
Ileocecal
  Part of the intestine, which comprises end section of the small intestine and beginning section of the colon.
 
Bimodal Age
incidence
  Incidence showing a pattern of having 2 distinct ages of usual onset.
 
Alopecia
  Patches of hair loss.
 
Ocular
  Referring to eyes or vision.
 
Prevalence
  A measure of the total number of people affected at a specific point in time  – usually tabulated per 100 000 population.
 
Incidence
  A measure of the total number of new cases divided by the population “at risk” of getting the disease over a specific period of time, usually per year – usually tabulated per 100 000 population.
 
Zoonotic
Potential
  A disease of animals that may be transmitted to humans under natural conditions.  
 
   

MAP-Canada would like to extend a very sincere thank you to Yanik Chicoine at www.mirweb.com for his generosity and assistance in hosting and the mounting of this site.

MAP-Canada aimerait remercier sincerement Yanik Chicoine a www.mirweb.com pour sa générosité et son assistance pour l'hébergement et la programation du site