Rationelle und therapierelevante Diagnostik des Morbus Crohn
Diagnostic in crohn's disease. A. Schneider, J. F. Riemann
Medizinische Klinik C (Direktor: Prof. Dr. med. J. F. Riemann) Klinikum der Stadt gGmbH, Akademisches Lehrkrankenhaus der Johannes-Gutenberg-Universität Mainz, Ludwigshafen
Vor der Diagnosestellung „Morbus Crohn” steht häufig eine breite Palette diagnostischer Maßnahmen. Ein zentrales Problem ist hierbei die Abgrenzung dieser chronisch-entzündlichen Darmerkrankung gegenüber zahlreichen differentialdiagnostisch zu erwägenden Krankheitsbildern. Zudem wird angesichts differenzierter Therapieoptionen auch zunehmend eine zuverlässige Quantifizierung der Krankheitsaktivität gefordert. Diese geht häufig über eine rein klinische Bewertung hinaus. Die vorliegende Übersicht gibt eine Leitstruktur zum sinnvollen und therapierelevanten Einsatz notwendiger diagnostischer Maßnahmen in der Diagnostik des M. Crohn und anderer chronisch-entzündlicher Darmerkrankungen. Sowohl etablierte als auch neue Optionen werden bezüglich ihrer Indikation und dem potentiellen Nutzen bewertet.
A wide range of diagnostic methods often precedes the diagnosis of „CrohnŽs disease”. Apart from qualitative criteria, the increasing availability of elaborated therapies also requires a quantification of disease activity. Clinical data are still of major interest in the diagnostic workup of chronic inflammatory bowel disease. Yet laboratory, endoscopic, radiologic and histopathologic methods may provide complementary relevant information. This review gives an overview on currently available diagnostic methods. Their relevance for the assessment of diagnosis, disease activity and complications is discussed.
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