Crohn?s disease, a disease belonging to the larger group of inflammatory bowel diseases (IBD), is named after an American gastroenterologist, Dr. Burrill B. Crohn. Crohn's disease initially came to be known as a medical entity when it was referred to by Dr. Crohn, Dr. Leon Ginzburg, and Dr. Gordon D. Oppenheimer in 1932. The first description of this condition was earlier made by the Italian physician Giovanni Battista Morgagni (1682?1771) in 1769, when he diagnosed a young man with a chronic, debilitating illness and diarrhea.
Successive cases were reported in 1898 by John Berg and by Polish surgeon Antoni Lesniowski in 1904. In 1913, Scottish physician T. Kennedy Dalziel, at the meeting of the British Medical Association, described nine cases in which the patients suffered from intestinal obstruction. On close examination of the inflamed bowel, the transmural inflammation that is characteristic of the disease was clearly evident. Abdominal cramps, fever, diarrhea and weight loss were observed in most patients, particularly young adults, in the 1920s and 1930s. In 1923, surgeons at the Mt Sinai Hospital in New York identified 12 patients with similar symptoms. Dr. Burrill B. Crohn, in 1930, pointed out similar findings in two patients whom he was treating.
On May 13, 1932, Dr. Crohn and his colleagues, Oppenheimer and Ginzburg, presented a paper on ?Terminal Ileitis?, describing the features of Crohn?s disease to the American Medical Association. This was published later that year as a landmark article in the Journal of the American Medical Association with the title "Regional Ileitis: A Pathologic and Chronic Entity." The JAMA article was published at a time when the medical community was interested in new findings. The findings were given significant recognition, while the Dalziel article in the British Medical Journal of 1913 was not. It is by virtue of alphabetization rather than contribution that Crohn's name appeared as the first author. This was the first time the condition was reported in a widely-read journal, and the disease came to be known as Crohn's disease.
This inhibition can be achieved with a monoclonal antibody such as infliximab (Remicade), adalimumab (Humira), certolizumab pegol (Cimzia), and golimumab (Simponi), or with a circulating receptor fusion protein such as etanercept (Enbrel). While most clinically useful TNF inhibitors are monoclonal antibodies, some are simple molecules such as xanthine derivatives  (e.g. pentoxifylline ) and Bupropion . Bupropion is the active ingredient in the smoking cessation aid Zyban and the antidepressant Wellbutrin.
Figure 22. Ulcerative colitis in a 27-year-old man. Contrast-enhanced CT scan shows minimal diffuse thickening of the sigmoid colon with minimal inflammatory stranding. The remainder of the colon was normal (not shown).
Figure 21. Crohn disease. CT scan obtained with oral contrast material shows moderate thickening of the terminal ileum (curved arrow) and cecum (straight arrow) with adjacent inflammatory changes in the pericolic fat.
Brian Wells, MS-3, MSM, MPH
St. George’s University School of Medicine