scholarly journals Gastrointestinal disorders in COVID-19 patients: a great imitator

2021 ◽  
Author(s):  
Ari Fahrial Syam
Keyword(s):  
Abdominal Pain ◽  
Clinical Manifestation ◽  
Respiratory Tract Infections ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Etiologic Agent ◽  
Gastrointestinal Disorders ◽  
Delayed Treatment ◽  
Gastrointestinal Complaints ◽  
Tract Infections

Up to this point, the coronavirus disease 2019 (COVID-19) pandemic is still ongoing. Some studies with a large number of cases have reported its clinical manifestations, concluding that the disease is a great imitator. Patients may present with symptoms other than the main symptoms of respiratory tract infections, such as diarrhea, abdominal pain, nausea, or vomiting, which may sometimes cause a delayed treatment in managing COVID-19 patients. Reports of various hospitals have also demonstrated gastrointestinal complaints as a clinical manifestation in those patients. The patients may come with gastrointestinal symptoms as their early clinical manifestation, or the gastrointestinal symptoms may be found in hospitalized COVID-19 patients, which indeed can be explained since the SARS-CoV-2, an etiologic agent of COVID-19 infection, can obviously be found along the gastrointestinal tract. Hence, the virus can be found in fecal and anal, and therefore, rectal swabs can be used as a diagnostic tool for COVID-19 infection.

scholarly journals Gastrointestinal symptoms as the first manifestation of antiphospholipid syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojuan Zou ◽  
Zhongqi Fan ◽  
Ling Zhao ◽  
Weiling Xu ◽  
Jin Zhang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Antiphospholipid Syndrome ◽  
Clinical Manifestation ◽  
High Titer ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Recurrent Abdominal Pain ◽  
Anticardiolipin Antibodies ◽  
Glycoprotein I ◽  
Gastrointestinal Lesions

Abstract Background Antiphospholipid syndrome (APS) is an acquired pre-thrombotic autoimmune condition, which produces autoantibodies called antiphospholipid antibodies (APL) against phospholipid-binding plasma proteins. The diagnosis of APS requires at least one of Sapporo standard clinical manifestations and one laboratory criteria (persistently medium/high titer anticardiolipin antibodies, and/or medium/high titer anti-β2-glycoprotein I antibodies, and/or a positive lupus anticoagulant test). Gastrointestinal lesions are rarely reported in APS patients. APS cases with recurrent abdominal pain as the first clinical manifestation are even rarer. Case presentation This report describes an APS case with recurrent abdominal pain as the first clinical manifestation of antiphospholipid syndrome. The patient has a history of two miscarriages. Computed tomography of the abdomen confirmed mesenteric thrombosis and intestinal obstruction while laboratory tests for serum antiphospholipid and anti-β2-glycoprotein I antibodies were positive. This led to the diagnosis of APS. Conclusions This paper provides useful information on gastrointestinal manifestations and APS, also including a brief literature review about possible gastrointestinal symptoms of APS.

scholarly journals Are functional gastrointestinal disorders a clinically significant comorbid factor for acute respiratory infection in children?

2020 ◽  
Vol 48 (4) ◽  
pp. 231-239
Author(s):  
E. R. Meskina ◽  
M. K. Khadisova
Keyword(s):  
Clinical Symptoms ◽  
Respiratory Infections ◽  
Past History ◽  
Functional Gastrointestinal Disorders ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Resistance Index ◽  
Gastrointestinal Disorders ◽  
Acute Respiratory Infections ◽  
Tract Infections

Rationale: Functional gastrointestinal disorders (FGID) are highly prevalent in children worldwide. Current concept of FGID pathophysiology implies contributions from various mechanisms. Information in the role of acute respiratory infections in the development of FGID in children is lacking.Aim: To determine the prevalence of FGID in children hospitalized to the department of infectious diseases with acute respiratory tract infections (ARTI) and their association with demographic, medical biological factors and clinical manifestations.Materials and methods: We performed observational and cross-sectional study with continuous patient sampling. The study included 180 ARTI patients, whose mothers agreed to fill in the proposed questionnaire of 41 items. The diagnosis of FGID during in-hospital stay was made based on clinical data in accordance with the Rome criteria IV (2016) and by standard collection of the information from the parents. The stool characteristics were assessed with the Bristol scale. The rate of recurrent ARTI was assessed by the resistance index of above 0.5. We considered clinical symptoms of ARTI at the admittance, the rates of bacterial complications and the need in antibacterial treatment.Results: The prevalence of FGID in hospitalized children with ARTI below 4 years of age (n = 134) was 35.1% (95% confidence interval [CI]) 27.0– 43.9); they had higher rates of functional diarrhea (14.9%, 95% CI 9.4–22.1) and constipation (14.2%, 95% CI 8.8–21.3). Among those above 4 years of age (n = 46), FGID were diagnosed in 50% (95% CI 34.9–65.1) of the cases; with most frequent symptoms being abdominal pain (39.1%, 95% CI 25.1–54.6) and irritable bowel syndrome (10.8%). Irrespective of their age, the children with FGID had higher rates of ARTI recurrence (by 34.0%, 95% CI 20.0–48.1; relative risk 1.98, 95% CI 1.47–2.69; odds ratio 4.13, 95% CI 2.18–7.85) and intestinal infections in their past history, compared to those without any gastrointestinal symptoms during the index hospitalization. In children with FGID, ARTI were more frequently complicated by otitis and they had higher requirement in antibiotics. The mothers of the infants and toddlers with FGID had lower educational level (smaller proportion of those with high school education) and were less satisfied with their home and living conditions, whereas their fathers were older and more frequently employed in vehicle operations and less frequently were occupied in communication-related professions.Conclusion: Acute respiratory infections, especially recurring, may plaу a significant role in the development and maintenance of FGID in children. Further studies are necessary, which may result in useful information for the development of tailored strategies to treatment and prevention.

scholarly journals Clinical and event-based outcomes of patients with mucopolysaccharidosis VI receiving enzyme replacement therapy in Turkey: a case series

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aslı İnci ◽  
İlyas Okur ◽  
Leyla Tümer ◽  
Gürsel Biberoğlu ◽  
Murat Öktem ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Respiratory Tract Infections ◽  
Clinical Manifestations ◽  
Case Series ◽  
Enzyme Replacement ◽  
Mps Vi ◽  
Cardiac Valve Disease ◽  
Tract Infections ◽  
Event Based

Abstract Background The objective of this study was to describe clinical manifestations and events of patients with mucopolysaccharidosis (MPS) VI in Turkey who are treated with galsulfase enzyme replacement therapy (ERT). Clinical data of 14 children with MPS VI who were followed up at the Department of Pediatrics of the Gazi University Faculty of Medicine in Ankara, Turkey were retrospectively collected from the patients’ medical records. Patients were selected based on availability of a pre-ERT baseline and follow-up clinical data for a similar period of time (1.9–3.2 years). Event data (occurrence of acute clinical events, onset of chronic events, surgeries) collected during hospital visits and telemedicine were available for up to 10 years after initiation of ERT (2.5–10 years). Results Age at initiation of ERT ranged from 2.8 to 15.8 years (mean age 7.5 years). All patients presented with reduced endurance and skeletal abnormalities (dysostosis multiplex) on radiography. Other common clinical manifestations were cardiac valve disease (N = 13), short stature (N = 11), cranial abnormalities on MRI (N = 10), spinal abnormalities on MRI (N = 7), and mild cognitive impairment (N = 6). School attendance was generally poor, and several patients had urinary incontinence. After 1.9 to 3.2 years of ERT, most patients showed improvements in endurance in the 6-min walk test and 3-min stair climb tests; the frequency of urinary incontinence decreased. ERT did not seem to prevent progression of cardiac valve disease, eye disorders, hearing loss, or bone disease. Long-term event-based data showed a high incidence of respiratory tract infections, adenotonsillectomy/adenoidectomy, reduced sleep quality, sleep apnea, and depression before initiation of ERT. The number of events tended to remain stable or decrease in all patients over 2.5–10 years follow-up. However, the nature of the events shifted over time, with a reduction in the frequency of respiratory tract infections and sleep problems and an increase in ophthalmologic events, ear tube insertions, and depression. Conclusions This case series shows the high disease burden of the MPS VI population in Turkey and provides a unique insight into their clinical journey based on real-life clinical and event-based data collected before and after initiation of ERT.

FAMILIAL RETICULOENDOTHELIOSIS: CONCURRENCE OF DISEASE IN FIVE SIBLINGS

PEDIATRICS ◽  
1966 ◽  
Vol 38 (6) ◽  
pp. 986-995
Author(s):  
Denis R. Miller
Keyword(s):  
Central Nervous System ◽  
Bone Marrow ◽  
Nervous System ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Failure To Thrive ◽  
Etiologic Agent ◽  
Pulmonary Insufficiency ◽  
Reticulum Cell ◽  
Tract Infections

A fatal syndrome characterized by failure to thrive, eczema, recurrent skin, ear, and respiratory tract infections, lymphadenopathy hepatosplenomegaly, pulmonary infiltrations, and terminal peripheral pancytopenia and hypergammaglobulinemia is described in a complete sibship of five girls. Histologically, there was diffuse reticulum cell infiltration in the lungs, liver, spleen, lymph nodes, bone marrow, gastrointestinal and genitourinary tracts, and central nervous system. The lymphoid architecture was obliterated and there was a marked plasmacytosis. Death occurred between the ages of 20 months and 4 9/12 years and was associated with pulmonary insufficiency, septicemia, and candidiasis. Attempts to identify an etiologic agent were unsuccessful. Although similar to other reviewed cases of familial reticuloendotheliosis, the involvement of a complete sibship appears to be a unique occurrence.

scholarly journals Mounier-Kuhn syndrome

2011 ◽  
Vol 68 (12) ◽  
pp. 1068-1070
Author(s):  
Dragica Pesut ◽  
Ruza Stevic ◽  
Jelica Milosavljevic ◽  
Spasoje Popevic ◽  
Tijana Cvok
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Imaging Techniques ◽  
Clinical Manifestations ◽  
Sporadic Case ◽  
Pulmonary Medicine ◽  
Normal Limits ◽  
Important Differential Diagnosis ◽  
Tract Infections ◽  
Recurrent Respiratory Tract Infections

Background. Mounier-Kuhn syndrome or tracheobronchomegaly is a rare disorder characterized by marked dilatation of the trachea and main bronchi, bronchiectasis, and recurrent respiratory tract infections. Its clinical presentation may vary and mimick a variety of disorders. Case report. A 43-year-old female patient, non smoker, complained of intermittent mild dyspnea. Lung function tests and cardiologic findings were within normal limits. The diagnosis was established by computed tomography, which was undertaken due to recurrent lower respiratory tract infections suggestive of bronchiectasis. The transversal tracheal diameter was 2.8 cm that was the criteria for making the diagnosis. In this sporadic case, no association with other disease or condition known to cause secondary tracheobronchomegaly was established. Conclusion. Although rare in clinical practice, Mounier-Kuhn syndrome is an important differential diagnosis in cardio-pulmonary medicine due to a variety of its clinical manifestations. Nowadays, it is easy to diagnose it owing to advanced imaging techniques.

scholarly journals Heiner Syndrome and Milk Hypersensitivity: An Updated Overview on the Current Evidence

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1710
Author(s):  
Stefania Arasi ◽  
Carla Mastrorilli ◽  
Luca Pecoraro ◽  
Mattia Giovannini ◽  
Francesca Mori ◽  
...  
Keyword(s):  
Respiratory Tract Infections ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Signs And Symptoms ◽  
Current Evidence ◽  
Recurrent Fever ◽  
X Rays ◽  
Critical Approach ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Infants affected by Heiner syndrome (HS) display chronic upper or lower respiratory tract infections, including otitis media or pneumonia. Clinically, gastrointestinal signs and symptoms, anemia, recurrent fever and failure to thrive can be also present. Chest X-rays can show patchy infiltrates miming pneumonia. Clinical manifestations usually disappear after a milk-free diet. The pathogenetic mechanism underlying HS remains unexplained, but the formation of immune complexes and the cell-mediated reaction have been proposed. Patients usually outgrow this hypersensitivity within a few years. The aim of this review is to provide an updated overview on the current evidence on HS in children, with a critical approach on the still undefined points of this interesting disease. Finally, we propose the first structured diagnostic approach for HS.

Clinical, epidemiological and etiological features of severe acute respiratory infections in hospitalized patients

2021 ◽  
Vol 19 (1) ◽  
pp. 64-70
Author(s):  
S.S. Smirnova ◽  
◽  
E.V. Lelenkova ◽  
A.Yu. Markaryan ◽  
I.V. Vyalykh ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Hospitalized Patients ◽  
Influenza Viruses ◽  
Acute Respiratory Infections ◽  
Upper Respiratory Tract ◽  
Severe Acute Respiratory Infections ◽  
Tract Infections

Objective. To study the clinical, epidemiological and etiological characteristics of severe acute respiratory infections (SARI) in in-patients in Ekaterinburg during the epidemic season 2017–2018. Patients and methods. 403 individual medical records were studied. Etiological decoding was carried out by isolating RNA or DNA of respiratory viruses from nasopharyngeal swabs by polymerase chain reaction. Results. SARI in hospitalized patients were caused by both influenza viruses (В Yamagata – 25.2% and А(H1N1)pdm09 – 11.0%) and viruses of non-influenza etiology (respiratory syncytial virus (RS-virus) – 13.3%, rhinovirus – 12.9%, metapneumovirus – 11.0%). It was found that viruses were more often secreted in children than in adults; among children of the younger age group (0–2 years old) viruses of non-influenza etiology were detected significantly more often, and in children 7–14 years old, influenza viruses were more often isolated. Patients with upper respiratory tract infections were significantly more likely to have influenza viruses (78.9%) than patients with lower respiratory tract infections (21.1%). Conclusion. The results of the study indicate the importance of hospital surveillance for SARI from the point of view of the etiological diagnosis of respiratory infections, the study of epidemiology and typical clinical manifestations for the timely diagnosis and development of additional preventive and anti-epidemic measures. Key words: hospital surveillance, influenza, PCR diagnostics, respiratory infections, epidemiology, etiology

Recurrent Abdominal Pain in School Age Children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohammed Hamdy Saber ◽  
Ahmed Tohamy Ahmed Ibrahim ◽  
Ola Adel Abdellah Mahdy
Keyword(s):  
Abdominal Pain ◽  
Urine Analysis ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Recurrent Abdominal Pain ◽  
School Age Children ◽  
Stool Examination ◽  
School Age ◽  
Functional Abdominal Pain ◽  
Cross Sectional

Abstract Background Abdominal pain defined as any type of pain or discomfort that occurs in any area from the lower chest to the groin. Abdominal pain is symptom of a wide variety of mild to serious diseases, disorders, conditions. Abdominal pain can result from infection, malignancy, inflammation, obstruction and other abnormal processes. Aim of the Work To define the causes of recurrent abdominal pain among a sample of school age children. Subjects and Methods This cross sectional study was carried out to evaluate those children who presented to the Pediatric Outpatient Clinic, Children Hospital, Ain Shams University because of recurrent abdominal pain they were diagnosed in the pediatric Gastroenterology unit between June 2016 and July 2017. History taking included full analysis of abdominal pain, associated gastrointestinal symptoms and associated systemic manifestations. Examination included anthropometric measurements, general and local abdominal examination. Routine investigations included complete blood counts, urine analysis and culture, microscopic stool examination and pelviabdominal US. Other specific investigations were selected according to clinical manifestations to reach an organic cause. After reaching the definitive diagnosis, patients were classified into 2 groups organic causes and functional abdominal pain. Results During the study period, 100 children presented with recurrent abdominal pain. Results revealed that only 28% of the recurrent abdominal pain causes were attributed to organic factors; the most commonly encountered organic causes of recurrent abdominal pain were urinary tract infection (12%) while 72% of children presented with functional recurrent abdominal pain. The most common causes of function recurrent abdominal pain in our study was irritable bowel syndrome. Conclusion Most of the cases of RAP among school age children are due to functional abdominal pain (72%).

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