Characterization of Lymphoid follicles with a red ring sign as first manifestation of early Crohn's disease

Background and Aims: Clinical observations suggest that the initial inflammation in inflammatory bowel disease (IBD), mainly in Crohn's disease (CD), might take place in the lymphoid follicle (LF) especially in those with red ring sign (RRS). Therefore, the aim of this study was to evaluate the role of LFs in patients with IBD compared to healthy controls. The LFs with RRS were additionally analyzed using immunohistochemistry and confocal laser endomicroscopy. Methods: 146 patients (84 male, 62 female; median age 34.4 years, range 19–55 years) were enrolled in this prospective study when undergoing an ileo-colon…