scholarly journals Eosinophilic Gastrointestinal Diseases in Childhood

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 18-28 ◽  
Author(s):  
Eleni Koutri ◽  
Alexandra Papadopoulou
Keyword(s):  
Clinical Symptoms ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Gastrointestinal Diseases ◽  
Esophageal Stenosis ◽  
Eosinophilic Inflammation ◽  
Gi Tract ◽  
Laboratory Findings ◽  
Systemic Steroids ◽  
Steroid Dependent

Eosinophilic gastrointestinal diseases (EGIDs) comprise a group of chronic, inflammatory diseases of the gastrointestinal (GI) tract, that are characterized, clinically, by symptoms related to the dysfunction of the involved segment(s) of the GI tract, and histologically, by dense eosinophilic inflammation, in the absence of an identifiable secondary cause. The group of EGIDs comprises eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), and eosinophilic colitis (EC). EoE is the most common and the best described EGID compared to EG, EGE, and EC. The clinical presentation of the EGIDs differs depending on the location and the extent of the eosinophilic infiltration in the GI tract, as well as its depth through the bowel wall. In the absence of biological markers, the diagnosis is based on the combination of clinical symptoms with the histological features of EGIDs, after the exclusion of secondary causes of eosinophilic inflammation of the GI tract. Treatment is individualized and includes elimination diets (mainly empiric or elemental) and/or drugs, according to the involved GI segment: proton pump inhibitors or local steroids in EoE; local or oral systemic steroids in EG/EGE limited to the duodenum; oral systemic steroids in EGE with lower small intestine and/or colon involvement. In patients with EoE, maintenance treatment with lower doses may be considered following histological remission with the means of drugs. In patients treated with elimination diets, disease food triggers identified during food reintroduction need to be further eliminated. Esophageal stenosis despite medical treatment requires endoscopic dilation, while the use of thiopurines or anti-TNF drugs may be considered in refractory or steroid-dependent EGID (other than EoE). The aim of this review is to provide the available evidence on each of the above disorders, to aid clinicians to interpret the clinical manifestations and the laboratory findings and choose the best available treatment option.

scholarly journals Clinical Manifestation and Laboratory Finding of Sclerosis Systemic Patient in Dr. Hasan Sadikin General Hospital Bandung : A Descriptive Quantitative Study

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Annisa Meivira Budiman ◽  
Sumartini Dewi ◽  
Marietta Shanti Prananta
Keyword(s):  
Systemic Sclerosis ◽  
General Hospital ◽  
Clinical Manifestation ◽  
Clinical Symptoms ◽  
Laboratory Finding ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Rheumatology Clinic ◽  
Quantitative Design

Background Systemic sclerosis is a chronic progressive multisystem autoimmune disease in connective tissue, characterized by its heterogeneous clinical manifestation. The purpose of this study is to give information regarding clinical manifestations and laboratory findings of systemic sclerosis patients to establish diagnosis of disease. Methods This study was conducted using descriptive quantitative design in September−October 2016. Data was collected from medical records of patients visiting Rheumatology Clinic Dr. Hasan Sadikin General Hospital from 1 July 2015−30 June 2016 using total sampling method. The collected data were expected to comprise patient’s clinical manifestation and laboratory finding. Results Most of patients had cutaneous 57 (100.0%) and musculoskeletal 40 (70.2%) involvement. Some of the disease manifestations were Raynaud’s phenomenon 38 (66.7%), fingertip lesion 33 (57.9%), stiffness in skin 34 (59.6%), and arthalgia 29 (50.9%). Gastrointestinal involvements were present in 29 (50.9%) patients. Renal involvement were determined from urinalysis result showed proteinuria 10 (17.5%) and hematuria 8 (14.0%), found in 24 (42.1%) patients, while pulmonary and cardiac involvements were found in 30 (52.6%) patients, acknowledged from clinical symptoms such as dyspnea 12 (21.1%). Identification of autoantibodies was found in 12 (21.1%) patients, with 10 (17.5%) patients had reactive ANA and 3 (3.5%) had positive anti-Scl70. Conclusion Most of systemic sclerosis patients had cutaneous involvement. Renal, pulmonary, and cardiac involvement were concluded based on laboratory findings. Keywords: Systemic sclerosis, clinical manifestation, laboratory finding

scholarly journals Clinical and laboratory findings in patients with dengue associated with hepatopathy

2011 ◽  
Vol 44 (6) ◽  
pp. 674-677 ◽  
Author(s):  
Delso do Nascimento ◽  
Ana Rita Coimbra Motta de Castro ◽  
Íris Bucker Froes ◽  
Gláucia Bigaton ◽  
Éveny Cristine Luna de Oliveira ◽  
...  
Keyword(s):  
Low Income ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Dengue Infection ◽  
Clinical Manifestations ◽  
Laboratory Findings ◽  
Mato Grosso ◽  
Mortality And Morbidity ◽  
Average Value ◽  
Grade Ii

INTRODUCTION: Hepatic disorders caused by dengue infection may progress to severe manifestations, including mortality and morbidity. Cytokines are involved in it, such as the migration inhibitory factor of macrophages (MIF), tumor necrosis factor (TNF), natural killer cells (NK), B lymphocytes, and macrophages. METHODS: This study was carried out from January to April 2007 at a public hospital from the Federal University of Mato Grosso do Sul, Campo Grande, Brazil. Sixty-eight patients were studied concerning hepatic alterations, with 56 reported having classic dengue, 6 with hemorrhagic dengue grade I, and 6 with hemorrhagic dengue grade II. RESULTS: Among the 56 with classic dengue, 83.3% had aspartate aminotransferase (AST) alterations, and 69.6% had altered alanine aminotransferase (ALT). For those with hemorrhagic dengue grade I, 100% had AST alterations, and 83.3% had altered ALT. All the patients with hemorrhagic dengue grade II had AST and ALT alterations. AST variations reached 22.0 and 907.0, with an average value of 164.6. For ALT, we found variations between 25.0 and 867.0, with an average value of 166.07. There had been statistical significance between dengue clinical shapes and hepatic function markers. CONCLUSIONS: We conclude that the infection was predominant in adults, females, and in those with low income and education. The liver enzymes were of larger amount in hemorrhagic dengue, but there was weak statistical evidence of the clinical manifestations and transaminases. Major signs and clinical symptoms were fever, headache, myalgia, arthralgia, weakness, severe pain behind the eyes, and rashes.

Some Clinical Manifestations and Laboratory Findings of Human Gigantica Fascioliasis in Pregnant Women and Children in Central-Coastal Provinces, Vietnam, 2003-2017

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Pregnant Women ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Fasciola Gigantica ◽  
World Health ◽  
Laboratory Findings ◽  
Laboratory Parameters ◽  
Women And Children

Introduction: Fascioliasis is a disease of the hepatobiliary system, caused by Fasciola spp that are increasing and threating of public health in the tropic areas, including of Central coastal of Vietnam. World Health Organisation estimates that at least 2.4 million people are infected in more than 70 countries worldwide, with several million at risk, and particularly, no continent is free from fascioliasis. This study carried out to evaluate several typical clinical and paracinical aspects in the pregnant women and children groups with fascioliasis. Methods: With the descriptive cross-sectional study design, and sample size in line with hospital based data. Results: the data post-analysis showed that total of 94 pregnant women and 212 child with gigantica fascioliasis were enrolled:- In the pregnant women group: the major clinical symptoms of epigastric and Chauffard Rivet triangle pain (95.74%), subshoulder muscle pain (97.87%), gastrointestinal disturbances as abdominal pain plus constipation (14.89%), loosed stool (22.34%), nausea and/or vomit (29.78%), mild fever (68%), allergic reaction with pruritis and urticaria (64.89%), mild anemia (4.26%), rare symptoms may be hepatomegaly (6.38%), chest pain, dyspnoea (43.62%), jaundice (2.13%); Laboratory parameters were positive ELISA test with Fasciola gigantica antigen (95.74%), hepatobiliary lesions by ultrasound (97.87%), majority in right liver (90.32%), eosinophilia is the predominant indicator (90.42%), In the children group: the clinical manifestations included of epigastric and Chauffard-Rivet area pain (94.34%), flatuence, nausea and intermittent vomiting (76.41%), digestive disoders (40.57%), allergy (30.66%), fatigue plus weight loss (12.74%); laboratory findings included of hepatobiliary lesions by US (100%), positive ELISA with Fasciola gigantica antigen (96.70%), eosinophil of 93.39% and 1.90% positive copro-examination with Fasciolae eggs. Conclusions: In pregnant women, symptoms are indistinguishable from hepatobiliary, digestive tract diseases or overlap with gestation terrains, and clinical signs of paediatric fascioliasis may mimic a wide spectrum of hepatobiliary disorders laboratory parameters and imaging diagnostics, especially in FasELISA, hypereosinophilia and liver lesions by ultrasound were very useful in positive diagnosis.

scholarly journals Wheat Consumption Leads to Immune Activation and Symptom Worsening in Patients with Familial Mediterranean Fever: A Pilot Randomized Trial

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1127 ◽  
Author(s):  
Antonio Carroccio ◽  
Pasquale Mansueto ◽  
Maurizio Soresi ◽  
Francesca Fayer ◽  
Diana Di Liberto ◽  
...  
Keyword(s):  
Familial Mediterranean Fever ◽  
Clinical Symptoms ◽  
Inflammatory Diseases ◽  
Activity Index ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Double Blind ◽  
Amyloid A ◽  
Tnf Α ◽  
Mediterranean Fever

We have identified a clinical association between self-reported non-celiac wheat sensitivity (NCWS) and Familial Mediterranean Fever (FMF). Objectives: A) To determine whether a 2-week double-blind placebo-controlled (DBPC) cross-over wheat vs. rice challenge exacerbates the clinical manifestations of FMF; B) to evaluate innate immune responses in NCWS/FMF patients challenged with wheat vs. rice. The study was conducted at the Department of Internal Medicine of the University Hospital of Palermo and the Hospital of Sciacca, Italy. Six female volunteers with FMF/NCWS (mean age 36 ± 6 years) were enrolled, 12 age-matched non-FMF, NCWS females, and 8 sex- and age-matched healthy subjects served as controls. We evaluated: 1. clinical symptoms by the FMF-specific AIDAI (Auto-Inflammatory Diseases Activity Index) score; 2. serum soluble CD14 (sCD14), C-reactive protein (CRP), and serum amyloid A (SSA); 3. circulating CD14+ monocytes expressing interleukin (IL)-1β and tumor necrosis factor (TNF)-α. The AIDAI score significantly increased in FMF patients during DBPC with wheat, but not with rice (19 ± 6.3 vs. 7 ± 1.6; p = 0.028). sCD14 values did not differ in FMF patients before and after the challenge, but were higher in FMF patients than in healthy controls (median values 11357 vs. 8710 pg/ml; p = 0.002). The percentage of circulating CD14+/IL-1β+ and of CD14+/TNF-α+ monocytes increased significantly after DBPC with wheat vs. baseline or rice challenge. Self-reported NCWS can hide an FMF diagnosis. Wheat ingestion exacerbated clinical and immunological features of FMF. Future studies performed on consecutive FMF patients recruited in centers for auto-inflammatory diseases will determine the real frequency and relevance of this association.

scholarly journals Increased Total Serum Immunoglobulin E Is Likely to Cause Complications of Mycoplasma pneumoniae Pneumonia in Children

2021 ◽  
Vol 11 ◽  
Author(s):  
Lili Zhou ◽  
Yuan Li ◽  
Zhufei Xu ◽  
Xuyun Peng ◽  
Xiaoyan Gong ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Pulmonary Complications ◽  
Serum Immunoglobulin ◽  
Total Serum ◽  
Laboratory Findings ◽  
Significant Difference ◽  
Mycoplasma Pneumoniae Pneumonia

ObjectiveTo investigate the correlation between serum immunoglobulin E (IgE) levels and the complications in children with Mycoplasma pneumoniae pneumonia (MPP).MethodsA retrospective study of MPP patients hospitalized from May 2019 to July 2021 was performed. We analyzed the clinical manifestations, complications, laboratory findings, and treatments.ResultsA total of 275 patients who met the inclusion criteria were enrolled in the study. We divided patients into two groups based on whether there were complications. Complications occurred in 147 patients, of which pulmonary complications were more common than extrapulmonary complications. The IgE level in the complication group was higher than that in the non-complication group with p = 0.041. Patients with complications of necrotizing pneumonitis, pneumothorax, skin rash, or bronchiolitis obliterans had higher IgE levels. There was no statistically significant difference in IgE levels between pulmonary complications and extrapulmonary complications. The older the age, the greater the probability of complications (p = 0.001). The group with complications was more likely to have chest pain (p = 0.000), while the group without complications was more likely to have wheezing (p = 0.017). The use of bronchoscopy and glucocorticoids was higher in the complication group than in the non-complication group (p = 0.000).ConclusionsMPP patients with higher IgE levels had more severe clinical symptoms and complications. We speculated that IgE might be a biomarker for complications after MP infection.

scholarly journals Necrotizing fasciitis in obstetric practice: review of literature and description of own clinical саse

2019 ◽  
pp. 150-155
Author(s):  
V. M. Husiev ◽  
V. M. Astakhov ◽  
S. A. Dubyna
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Soft Tissues ◽  
Clinical Symptoms ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Fatty Tissue ◽  
Superficial Fascia ◽  
Surgical Infection ◽  
Surgical Infections

Despite the successes of modern medicine, the problem of purulent surgical infection still remains relevant and is one of the unsolved and most debatable in clinical surgery. In the structure of purulent-inflammatory diseases of soft tissues, there are forms of surgical infections that are characterized by progressive necrosis of fascial formations and particular clinical course. They are accompanied by the development of endotoxemia, which further leads to the development of severe sepsis and multiple organ failure. Among generalized surgical infections, necrotizing fasciitis is of particular interest – one of the varieties of a large group of surgical infections of soft tissues, in the pathomorphological basis of which lies the rotten-necrotic lesion of the superficial fascia and subcutaneous fatty tissue. It has various clinical manifestations, the absence of specific signs that make it difficult for clinicians of various specialties to diagnose in time, the development of serious complications and deaths. The basis for the early diagnosis of necrotizing soft tissue infections, therefore, the key to successful treatment of these seriously ill patients, as before, is the timely analysis of anamnestic data and clinical symptoms. The treatment of necrotizing fasciitis is a difficult and complex task, which is explained by the peculiarity of the pathological process, the success of which is determined by early diagnosis and urgent radical surgical intervention. Rarely rare publications on this issue are the cause of the information vacuum and the lack of awareness of the majority of doctors in this pathology, potential for the development of critical states, once again necessitates the imperative informing of narrow specialists, as well as doctors practicing in the outpatient network and hospital level. Тhe article describes the own clinical observation of the fulminant form of necrotising fasciitis diagnosed by autopsy data.

Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis

1989 ◽  
Vol 121 (1) ◽  
pp. 129-135 ◽  
Author(s):  
Rainer Gutekunst ◽  
Wiard Hafermann ◽  
Thomas Mansky ◽  
Peter C Scriba
Keyword(s):  
Medical Records ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Thyroid Volume ◽  
Diagnostic Procedures ◽  
Needle Aspiration ◽  
Epidemiological Studies ◽  
Laboratory Findings ◽  
Fine Needle ◽  
Lymphocytic Thyroiditis

Abstract. The value of ultrasonography compared with established diagnostic procedures was investigated by reviewing medical records of 92 patients (88 women and 4 men, age 11–81 years, mean age 47) with lymphocytic thyroiditis. Clinical manifestations of the disease and serum antimicrosomal antibodies and TSH were determined in all patients. The thyroid was examined by ultrasound. Both lobes were aspirated by a fine needle under sonographic control and smears examined cytologically. A total of 27 (29.3%) patients had no clinical symptoms. Antimicrocosmal antibodies were undetectable in 12 (13%) patients, 16 (17.4%) had low titres 1:32–1:100, and 64 (69.6%) ≥ 1:320. TSH (reference values 0.3–3.9 mU/l) was < 0.3 in 4 (4.3%) 0.3–3.9 in 41 (44.6%), 4–20 in 26 (28.3%), and > 20 in 21 (22.8%) patients. Ultrasound revealed a scattered sonolucent echo in 87 (94.6%) patients, and in 45 (48.9%) a normal thyroid volume (women < 18, men < 25 ml). Cytology alone was diagnostic in 84 (91.3%) patients. In conclusion, ultrasound can suggest lymphocytic thyroiditis. If antimicrosomal antibodies are undetectable or titres are not significant and/or clinical symptoms are uncertain, fine-needle aspiration can confirm the sonographic finding. Epidemiological studies including ultrasonography are necessary to obtain reliable data on the prevalence of lymphocytic thyroiditis.

scholarly journals Cerebrospinal Fluid Analysis in Multiple Sclerosis Diagnosis: An Update

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 245 ◽  
Author(s):  
Bruna Lo Sasso ◽  
Luisa Agnello ◽  
Giulia Bivona ◽  
Chiara Bellia ◽  
Marcello Ciaccio
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Demyelinating Disease ◽  
Clinical Symptoms ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Laboratory Diagnosis ◽  
Oligoclonal Bands ◽  
Csf Biomarkers ◽  
Laboratory Findings

Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system (CNS) with brain neurodegeneration. MS patients present heterogeneous clinical manifestations in which both genetic and environmental factors are involved. The diagnosis is very complex due to the high heterogeneity of the pathophysiology of the disease. The diagnostic criteria have been modified several times over the years. Basically, they include clinical symptoms, presence of typical lesions detected by magnetic resonance imaging (MRI), and laboratory findings. The analysis of cerebrospinal fluid (CSF) allows an evaluation of inflammatory processes circumscribed to the CNS and reflects changes in the immunological pattern due to the progression of the pathology, being fundamental in the diagnosis and monitoring of MS. The detection of the oligoclonal bands (OCBs) in both CSF and serum is recognized as the “gold standard” for laboratory diagnosis of MS, though presents analytical limitations. Indeed, current protocols for OCBs assay are time-consuming and require an operator-dependent interpretation. In recent years, the quantification of free light chain (FLC) in CSF has emerged to assist clinicians in the diagnosis of MS. This article reviews the current knowledge on CSF biomarkers used in the diagnosis of MS, in particular on the validated assays and on the alternative biomarkers of intrathecal synthesis.

scholarly journals Comorbidities in chronic «overcrowded posterior cranial fossa» syndrome

2013 ◽  
Vol 94 (2) ◽  
pp. 221-227
Author(s):  
A T Zabbarova ◽  
E I Bogdanov ◽  
D K Khusainova ◽  
L S Fatkheeva
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
General Population ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Gastrointestinal Diseases ◽  
Posterior Cranial Fossa ◽  
Cranial Fossa

Aim. To analyze the prevalence and role of comorbidities in variety of clinical manifestations in patients with congenital occipital hypoplasia - «overcroded posterior cranial fossa» syndrome. Methods. Clinical history and physical examination of 200 patients (aged 16-74 years, males 108, females 92) with «overcrowded posterior cranial fossa» syndrome, including 134 with cerebellar ectopia, 92 with syringomyelia, 24 with hydrocephalus, were analyzed. Results. The diseases identified in patients with «overcrowded posterior cranial fossa» syndrome were combined into six groups: cardiovascular diseases (n=120; 60.0%), infectious and inflammatory diseases (n=39; 19.5%), gastrointestinal diseases (n=37; 18.5%), metabolic and endocrine diseases (n=31; 15.5%), diseases of the musculoskeletal system and connective tissue (including cervical vertebral stenosis (n=53; 26.5%), scoliosis (n=50; 25.0%), arthropathies (n=21; 10.5%), other diseases and pathological conditions (including mild traumatic brain injury (n=74; 37.0%), seizures (n=13; 6.5%). In patients with «overcrowded posterior cranial fossa» syndrome the prevalence of cardiovascular, gastrointestinal diseases, traumatic brain injury, obesity, primary or secondary cervical vertebral stenosis was significantly higher (p 0.05) compared to general population. In patients with syringomyelia a higher rate (p0.05) of scoliosis and traumatic brain injury was revealed. Conclusion. The prevalence of comorbidities in patients with «overcrowded posterior cranial fossa» syndrome was higher compared to general population. The differences of the type and rate of the concomitant diseases in patients with various forms of the syndrome may contribute to the variety of clinical manifestations of «overcrowded posterior cranial fossa» syndrome.

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