scholarly journals Asymptomatic and Persistent Elevation of Pancreatic Enzymes in an Ulcerative Colitis Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Elisa Liverani ◽  
Filippo Leonardi ◽  
Lucia Castellani ◽  
Carla Cardamone ◽  
Andrea Belluzzi
Keyword(s):  
Ulcerative Colitis ◽  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Drug Dosage ◽  
Pancreatic Disease ◽  
Pancreatic Enzymes ◽  
Pancreatic Damage ◽  
Bowel Diseases ◽  
One Year ◽  
Asymptomatic Elevation

Azathioprine has been extensively used in the management of inflammatory bowel diseases. It might cause pancreatic damage in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis. Here we report the case of a 61-year-old patient with ulcerative colitis who had been treated with azathioprine for three years, achieving clinical remission. During treatment he presented an asymptomatic elevation of serum pancreatic enzymes, without any signs of pancreatitis at imaging. This evidence brought us to reassess the drug dosage, without achieving a normalization of biochemical analysis. Autoimmune pancreatitis was excluded. One year after the suspension of azathioprine, we still face persistent high levels of amylase/lipase. Normalization of enzymatic values in patients who develop intolerance to azathioprine, in the form of either asymptomatic elevation in serum amylase/lipase or overt acute pancreatitis, is usually achieved in about two months after stopping drug intake. Asymptomatic elevation in serum pancreatic enzymes in the absence of pancreatic disease is reported in the literature and defined as “Gullo’s syndrome,” but nobody of the subjects studied had been treated in the past with pancreatotoxic drugs. Might this case be defined as “benign pancreatic hyperenzymemia”?

scholarly journals Evaluation of efficacy and comparative frequency of adverse events in patients with ulcerative colitis receiving the original infliximab and its biosimilar. One year of observation

2019 ◽  
Vol 91 (8) ◽  
pp. 41-46
Author(s):  
O V Knyazev ◽  
T V Shkurko ◽  
A V Kagramanova ◽  
A A Lishchinskaya ◽  
M Yu Zvyaglova ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Adverse Events ◽  
Real Life ◽  
Fecal Calprotectin ◽  
Biologic Drugs ◽  
Real Life Data ◽  
Bowel Diseases ◽  
Significant Clinical Improvement ◽  
One Year

Real - life data on the effectiveness and safety of biosimilar and biologic drugs licensed for treatment of inflammatory bowel diseases (IBD) is lacking. Aim. To investigate efficacy of original Infliximab (IFX) and its biosimilar in treating patients with ulcerative colitis (UC) and determine the frequency of adverse events during 1 year follow - up period. Materials and methods. Our cohort consisted of 98 ulcerative colitis patients, treated with original IFX and its biosimilar since December 2017 till December 2018 years. Original Infliximab was prescribed in 56 UC patients (57.1%) during 5 years and longer; 16 patients (16.3%) were switched to IFX biosimilar; 13 UC bio - naïve patients (13.3%) received original IFX, 29 (29.6%) patients - biosimilar IFX. In 14 patients (14.3%) original infliximab was rotated with biosimilar. We picked out 42 patients to assess efficacy of original IFX and biosimilar. Results and discussion. Twelve patients, received original IFX and 28 patients, treated with its biosimilar, showed significant clinical improvement by decreasing Mayo index from 9.7±0.4 and 10.2±0.2 points to 1.9±0.09 and 2.1±0.1 points, accordingly. Also we noticed positive change in laboratory markers - CRP decrease from 89.6±8.7 mg/l and 77.5±8.0 mg/l to 6.5±0.8 mg/l and 6.9±0.8 mg/l (p>0.05), albumin increase from 30.1±4.7 g/l and 29.6±3.6 g/l to 34.1±6.3 g/l and 32.8±5.9 g/l (p>0.05), increase of serum iron levels from 6.4±0.5 mcg/l and 7.1±0.65 mcg/l to 14.6±4.4 mcg/l and 15.9±5.1 mcg/l (p>0.05), hemoglobin increase from 104.7±9.8 g/l and 102.2±8.8 g/l till 124±11.3 g/l and 121±10.9 g/l (p>0.05), and fecal calprotectin decrease from 1680±134 mcg/g and 1720±126 mcg/g till 245.5±33.4 mcg/g and 230.5±29.8 mcg/g (p>0.05). During 1 year follow - up 12 UC patients, treated with original IFX and its biosimilar, developed adverse events. The majority of adverse events (n=8) were registered in patients, rotating administration of original IFX and its biosimilar. Conclusion. IFX biosimilar is effective as well as original IFX. Frequency of adverse events, occurred in patients, treated with original IFX, was comparable with adverse events frequency in patients, received biosimilar IFX. Frequency of adverse events was significantly higher in UC patients, rotating original IFX and its biosimilar.

Pancreatic disease

2018 ◽  
Author(s):  
Satish Keshav ◽  
Alexandra Kent
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Process ◽  
Pancreatic Disease ◽  
Pancreatic Enzymes ◽  
Surrounding Tissue ◽  
Systemic Effects

Acute pancreatitis is an acute inflammatory process of the pancreas and is potentially reversible. It is characterized by oedema and necrosis of peripancreatic fat and may progress to necrosis of glandular and surrounding tissue. Activation of pancreatic enzymes leads to pancreatic autodigestion and systemic effects.

scholarly journals The Diagnostic Usefulness of Circulating Profile of Extracellular Matrix Components: Sulfated Glycosaminoglycans (sGAG), Hyaluronan (HA) and Extracellular Part of Syndecan-1 (sCD138) in Patients with Crohn’s Disease and Ulcerative Colitis

2021 ◽  
Vol 10 (8) ◽  
pp. 1722
Author(s):  
Alicja Derkacz ◽  
Paweł Olczyk ◽  
Agnieszka Jura-Półtorak ◽  
Krystyna Olczyk ◽  
Katarzyna Komosinska-Vassev
Keyword(s):  
Ulcerative Colitis ◽  
Extracellular Matrix ◽  
Ecm Remodeling ◽  
Mayo Score ◽  
Extracellular Matrix Components ◽  
Adalimumab Therapy ◽  
Bowel Diseases ◽  
Diagnostic Usefulness ◽  
Quantitative Changes ◽  
One Year

The described research focused on the diagnostic usefulness of sulfated glycosaminoglycans (sGAG), hyaluronan (HA), and extracellular part of syndecan-1 (sCD138) as new markers related to extracellular matrix (ECM) remodeling in the intestine during the two most common forms of inflammatory bowel diseases (IBD), i.e., ulcerative colitis (UC) and Crohn’ disease (CD). Inflammatory markers belonging to ECM components were assessed in serum of patients with IBD using an immunoenzymatic method (HA and sCD138) and a method based on the reaction with dimethylmethylene blue (sulfated GAG). Measurements were carried out twice: at baseline and after one year of therapy with prednisone (patients with CD) or adalimumab (patients with UC). No quantitative changes were observed in serum sGAG, HA, and sCD138 concentrations between patients newly diagnosed with CD and the healthy group. In the case of patients with UC, the parameter which significantly differentiated healthy subjects and patients with IBD before biological therapy was HA. Significant correlation between serum HA level and inflammation activity, expressed as Mayo score, was also observed in patients with UC. Moreover, the obtained results have confirmed that steroid therapy with prednisone significantly influenced the circulating profile of all examined ECM components (sGAG, HA, and sCD138), whereas adalimumab therapy in patients with UC led to a significant change in only circulating sGAG levels. Moreover, the significant differences in serum HA levels between patients with UC and CD indicate that quantification of circulating HA may be useful in the differential diagnosis of CD and UC.

scholarly journals EP.FRI.353 Repeat Amylase in Acute Pancreatitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ifeoluwa Osinkolu
Keyword(s):  
Acute Pancreatitis ◽  
Diagnostic Tool ◽  
Serum Amylase ◽  
Scoring Systems ◽  
Ct Scanning ◽  
Secondary Outcome ◽  
Health Board ◽  
Female Ratio ◽  
District Hospitals ◽  
One Year

Abstract Introduction Acute pancreatitis is a common reason for acute surgical admission, with an annual incidence of 56 per 100,000 UK population. Studies have demonstrated that whilst serum amylase measurement is useful as a diagnostic tool, it has no correlation with disease severity, and its measurement after diagnosis has limited value. The aim of this audit was to review the practice of obtaining repeat serum amylase levels in patients diagnosed with acute pancreatitis in two district hospitals within the same health board. Secondary outcome was to gain up-to-date demographic information on the patient cohort.  Methods This was a retrospective study, which reviewed records of those patients admitted with pancreatitis over a one-year period (January 2019 – December 2019). Electronic records were evaluated to check if serum amylase was repeated after diagnosis. Data on demographics, underlying cause and the use of CT for diagnosis were also collected.  Results 174 patients were admitted during the study period, of which 53% (92) had their serum amylase inappropriately repeated. 14% (24) of cases were diagnosed using CT imaging. There was a 0.74:1 male to female ratio with an average age of 53. 51% of cases were caused by gallstones, 15% were caused by alcohol and 28% of cases had no identified cause. Conclusions Validated scoring systems remain the accepted method of predicting acute pancreatitis severity. This study highlights the frequent practice of inappropriately repeating serum amylase measurement in patients already diagnosed with acute pancreatitis. It also highlights the importance of CT scanning as a diagnostic tool.

Benign Exocrine Pancreatic Diseases in Inflammatory Bowel Diseases

2017 ◽  
Vol 35 (5) ◽  
pp. 449-453 ◽  
Author(s):  
Raffaele Pezzilli ◽  
Nico Pagano
Keyword(s):  
Acute Pancreatitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Pancreatic Disease ◽  
Disease Group ◽  
Pancreatic Diseases ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Group 3 ◽  
Group 2

Background: Data regarding the involvement of the pancreas during the course of inflammatory bowel disease (IBD) are scarce and conflicting. Aim: To assess the frequency of benign pancreatic diseases, that is, acute pancreatitis, chronic pancreatitis (CP), and autoimmune pancreatitis (AIP), in a population with IBD. Methods: A search for patients with IBD who presented at our hospital between January 2006 and January 2015 with a diagnosis of IBD was carried out. Patients: A total of 5,242 patients with IBD were included in this study (2,838 males, 54.1%, and 2,404 females, 45.9%, mean age 43.7 years, range 18-101 years). Of these 5,242 patients, 3,201 (61.1%) had Crohn's disease and 2,041 (38.9%) had ulcerative colitis (UC). Results: Thirteen patients developed benign pancreatic diseases (0.2%). Eight patients had acute pancreatitis (0.2%; 4 in the Crohn's disease group and 4 in the UC group), 3 had CP (0.1%, 2 in the Crohn's disease group and 1 in the UC group), 2 had AIP (0.04%), all in the group of diffuse UC (p = 0.321). Conclusions: The frequency of benign pancreatic disease was not high in patients with IBD and was probably similar to that seen in the general population.

Elevated Amylase Levels as a Result of Self-Induced Hypersalivation

PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 585-587
Author(s):  
Jacques Belik ◽  
Carl Tishler ◽  
Juhling McClung
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Pediatric Patients ◽  
Serum Amylase ◽  
Amylase Activity ◽  
Elevated Serum ◽  
Pancreatic Disease ◽  
Sensitive Indicator ◽  
Recurrent Vomiting ◽  
Serum Amylase Activity

A patient with recurrent vomiting, abdominal pain, and elevated serum amylase activity may have pancreatitis. Although elevated serum amylase levels are a sensitive indicator for acute pancreatitis, this test is not highly specific for pancreatic disease. A patient is described who illustrates the need for specific laboratory, historical, and occasional psychological evaluation in pediatric patients with elevated amylase values.

Features of the complex treatment of ulcerative colitis in clinical practice

2020 ◽  
pp. 6-11
Author(s):  
Svetlana Svetlana ◽  
Mikhail Klimentov ◽  
Olga Neganova ◽  
Alina Nazmieva ◽  
Anastasiya Kochurova
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Practice ◽  
Statistical Study ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Unknown Etiology ◽  
Number Of Patients ◽  
First Republic ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Nowadays there are certain difficulties in the early diagnosis of ulcerative colitis, proceeding with minimal intestinal symptoms. The etiology of the disease remains unclear to this day; there is no exact information about the prevalence of the disease due to the large number of latent forms and the low number of patients seeking medical help. This article presents the results of a retrospective analysis of the incidence of ulcerative colitis in the coloproctology department of the First Republic Clinical Hospital of Izhevsk. The study was conducted to assess the frequency of occurrence and determine the internal picture of ulcerative colitis. To achieve this goal, we selected 34 patients with ulcerative colitis. A statistical study was conducted on the following criteria: gender composition, age groups, forms of the disease, localization, complications, and main complaints. The length of hospital stay often was not more than 20 days. The literature on this pathology was also studied and presented in the form of a theoretical basis, which consisted of the determination and etiology of inflammatory bowel diseases. Due to the unknown etiology, insufficiently studied pathogenesis, difficult differential diagnosis with other intestinal diseases and insufficiently perfect treatment methods, there are a large number of unresolved problems in the field of ulcerative colitis. That is why, in this article we tried to reveal the problem of the features of the course and complex therapy of that disease in clinical practice.

Restoration of intestinal mucosal in Euphorbia kansui-treated severe acute pancreatitis rats is based on HMGB1/MFG-E8 expression

2020 ◽  
Vol 21 ◽  
Author(s):  
Chengjiang Qiu ◽  
Kairui Liu ◽  
Xuguang Li ◽  
Weirun Chen ◽  
Sheng Zhang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Serum Amylase ◽  
Intestinal Barrier ◽  
Enzyme Linked Immunosorbent Assay ◽  
Inflammatory Factor ◽  
Apoptotic Cells ◽  
Rat Ileum ◽  
Plasma Endotoxin ◽  
Euphorbia Kansui

Background: The pathogenesis of severe acute pancreatitis (SAP) is mediated substantially by dysfunctions in the intestinal barrier. Euphorbia kansui (EK) is a medicinal plant used widely in traditional Chinese medicine to treat inflammation; however, its efficacy and mechanism of action in SAP treatment is not yet well understood. Objective: To investigate the role of EK in intestinal barrier tissue repair and in the pathogenesis and development of SAP. Methods: The rat SAP model was established by a retrograde injection of sodium taurocholate into the pancreatic bile duct. The SAP model group and the SAP + EK treatment groups were divided into 6 subgroups according to timing: 2, 6, 12, 24, 48, or 72 h after inducing SAP. The progression of the SAP rats and of the rats receiving the EK treatment was evaluated using the ascites volume, serum amylase and plasma endotoxin levels, and histological grading of intestinal mucosal damage. In addition, serum inflammatory factor contents were measured using enzyme-linked immunosorbent assay (ELISA) tests and apoptotic cells in damaged ileum tissue were detected using TUNEL staining. Apoptosis markers and other signaling proteins in intestinal mucosal cells were detected by immunohistochemical assays and then validated by combining these data with quantitative polymerase chain reactions and western blotting. Results: Compared with the results of the SAP model rats, the results of the rats that received EK treatment demonstrated that EK could effectively reduce the ascites volume and serum amylase and plasma endotoxin levels. EK treatment also greatly reduced the abnormal intestinal morphological alterations in the rat SAP model and significantly downregulated the serum contents of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α. EK treatment inhibited the elevation of capapse-3, inhibited the decrease of the Bcl-2 protein, and decreased the number of apoptotic cells in rat ileum tissue. Finally, EK treatment abrogated the increase of HMGB1 and the suppression of MFG-E8 protein expression in the SAP + EK rat ileum tissue. Conclusion: EK suppresses SAP pathogenesis by restoring intestinal barrier function and modulating the HMGB1/MFG-E8 signaling axis.

Sign in / Sign up

Export Citation Format

Share Document