الفهرس 
Chapter 1 : Over view of IBDOnly 14 pages are availabe for public view
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Abstract
ral ulceration of any portion of the gastrointestinal
tract (GI), most often affecting the terminal ileum and colon. Diagnosing
IBD requires a combination of clinical findings, inflammatory, laboratory
markers, endoscopic examination and histopathological evaluation.
Tumor necrosis factor-alpha is a pleiotropic immune cytokine
belonging to the TNF superfamily of receptor ligands. It is involved in
several homeostatic and inflammatory processes, and plays a major role in
autoimmune and inflammatory diseases like inflammatory bowel disease.
Vitamin D plays a role in the immune responses by influencing
macrophages and T lymphocytes and also repairs the intestinal mucosal
barrier. People with IBD are likely to be at increased risk of developing
vitamin D deficiency for a number of reasons including: impaired absorption
of nutrients and bile salt malabsorption, restricted dietary intake, and medical
advice to avoid/protect against sunlight exposure while taking immunosuppressive treatments such as thiopurines. Various studies reported the role
of vitamin D in IBD. Vitamin D deficiency may lead to a reduction in
bacterial clearance in the colon.
We aimed at this study to evaluate the role of tumor necrosis factor
alpha and vitamin D in activity and severity of inflammatory bowel disease
in Egyptian patients.
This study was conducted on 62 IBD (UC and CD) naïve patients and
31 normal persons from the GI endoscopy unit of Internal Medicine
Summary
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Department, Menoufia University hospital during the period between
November 2021 and November 2022.
The participants (who were indicated for Colonscope) were classified
into 3 groups
group (1): Ulcerative colitis patients including 31 participants
group (2): Crohn’s disease patients including 31 participants
group (3): Control group resemble normal persons including 31 participants
All participants were subjected to the following:
History taking including age, gender, special habits (smoking),
residence, consanguinity and family history.
General examination including vital signs and anthropometric
measures
Clinical data as abdominal pain, diarrhea, and number of bowel
motions, presence of abdominal masses, rectal bleeding and presence of
extra intestinal manifestations.
Routine lab investigations including CBC, ESR, LFTs, KFTs ,CRP
and fecal calprotectin.
Serum Vitamin D level and TNF alpha level measurement.
Colonoscopy examination.
This study showed highly significant difference between studied
groups as regard serum vitamin D level with low level of vitamin D in IBD
patients. This study showed no significant difference between disease
activity and serum vitamin D level. This study also showed highly significant
difference between studied groups as regard serum TNF alpha level with no
significant difference between studied groups as regard disease activity and
serum TNF alpha level.