[Insight into Crohn's disease]

After noting that Cohn's disease has a long history behind it, the authors show a real increase in the frequency of the disease, apparently more marked in the Anglo-Saxon countries than in France. The etiopathogenesis of the disease is completely unknown. It seems that subjects suffering from Crohn's disease present an exacerbated xenic reaction. There are strong arguments in favour of a genetic contribution. The association with ankylosing spondylarthritis and thus the HLA system is particularly interesting. Following a breif review of the clinical signs and of the complications of the disease, the authors emphasize the diagnostic value of a scoring system. The evolution is very variable: quiescence which does not mean cure, progressive and continuous aggravation, alternation of outbreaks and remissions. Symptomatic, medical therapy is certainly effective but is efficacy is limited. Medical therapy aimed at the etiopathogenic factors is without foundation. Surgical intervention, sometimes immediately beneficial, is accompanied by a 50% frequency of recurrences in a ten-year period. Crohn's disease, fatal in 5% of cases, sometimes handicapping severely the development of the individual, is worthy of further rheumatological study.