Long-term azathioprine usage

I think anytime something new comes up it is a good idea to let your doctor know.

i did that for alomost 10 years.. had problems after surgery in 99 and the guts were like hamburger and wouldnt hold a stitch.. thats why i stopped it..

rlsnights, do you have any links or supporting documentation for this statement: "sinus infections (actually the underlying inflammation that makes you susceptible to infection) can be an extraintestinal manifestation of CD"?

It's not that I'm doubting your statement, because I have severe chronic sinusitis with my Crohn's (and I'm not on immunosuppression). It's just that I've seen very little in the literature relating the two (the one thing I did see being a small study in the Journal of Rhinology - I think - saying people with IBD had higher rates of sinus infections, but it didn't clarify whether it was talking about sinus infections as a result of immunosuppressant meds or as an extraintestinal manifestation of Crohn's *not* related to the meds.)

Thanks for the link Ides. That case doesn't really sound like mine - my septum is fine and my sinusitis is more along the lines of chronic recurring inflammation with no granulomas, but it was interesting to read about this case nevertheless.

I would start with the first article. It's a PDF of a 2007 article titled " Ear-nose-throat manifestations in Inflammatory Bowel Diseases" from the Annals of Gastrolenterology.

http://www.annalsgastro.gr/index.php/annalsgastro/article/viewFile/621/466

http://www.clinicaladvances.com/article_pdfs/gh-article-200802-wiesen.pdf

http://www.springerlink.com/content/c7803354g2517761/

http://www.jvoice.org/article/S0892-1997(02)00098-X/abstract

http://www.thefreelibrary.com/Extraintestinal+Crohn's+disease%3A+Case+report+and+review+of+the...-a076636539

http://informahealthcare.com/doi/abs/10.1080/00016480310015326?journalCode=oto

All of these articles say over and over how rare these manifestations are. Personally I think they are not really all *that* rare. I think they just go undiagnosed.

Take my son. His pediatrician said "it's just from dry air" when we first went to see him about the sores. But nothing we did made them better. the inside of his nostrils were nothing but bloody sores that didn't hurt.

They got worse and worse, finally tested positive for staph so he did oral antibiotics. Helped but the sores still didn't completely go away. Then, suddenly for no apparent reason, in a matter of days they healed up completely.

about 3 months later - suddenly the sores are back. No infection that time so we just did topical ointments to help prevent infection and, just like before, suddenly they were gone.

Went through that for about a year. His labs were good but not perfect.

Now it's been 9 months since the last round of nasal sores. Now his labs are perfect in every way.

Was it CD? Who knows. 

Walks like a duck, quacks like a duck, looks like a duck - is it a duck?

Patricia

You're welcome.

The thing to remember, or so I have been told by more than one doctor, is that at the embryonic stage, our intestines and our skin are created from the same kind of cell. So it makes sense that if you have a chronic disease that involves inflammation of your intestines you would have problems with your skin and mucus membranes in particular. At least that makes sense to me and seems to be confirmed by the doctors we have consulted about my son's asthma, nasal/sinus issues and chronic skin infections.

Best wishes,

Patricia