scholarly journals Food Allergy: A Rare Cause of Recurrent Intussusception

2017 ◽  
Vol 8 (1) ◽  
pp. 2 ◽  
Author(s):  
Emrah Aydin ◽  
Ömer Faruk Beşer
Keyword(s):  
Food Allergy ◽  
Diagnostic Work ◽  
Recurrent Intussusception ◽  
Work Up ◽  
Diagnostic Work Up

Recurrent intussusception is a management dilemma and have many causes. We report a 22-month old boy who presented multiple times for recurrent intussusception. At diagnostic work-up he was found to be suffering from non-IgE food allergy. The child did not develop further episodes of intussusception after removal of allergenic diet.

scholarly journals Cross-sectional imaging of intestinal barrier dysfunction by confocal laser endomicroscopy can identify patients with food allergy in vivo with high sensitivity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Timo Rath ◽  
Walburga Dieterich ◽  
Christiane Kätscher-Murad ◽  
Markus F. Neurath ◽  
Yurdagül Zopf
Keyword(s):  
Food Allergy ◽  
Intestinal Barrier ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Epithelial Barrier ◽  
Barrier Dysfunction ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

AbstractFood allergy (FA) affects approximately 3 to 4% of the adult population in westernized countries. Suspected FA is even more prevalent and requires extensive diagnostic work-up. Within this study, we evaluated whether assessment of the integrity of the epithelial barrier by confocal laser endomicroscopy (CLE) during colonoscopy can be used as a screening tool to identify patients with FA. 60 patients with suspected FA were prospectively included. Serology with total and food-specific IgE, anti-tissue transglutaminase, skin prick testing, food intolerance tests, food intake registration and assessment of clinical complaints were performed. During colonocopy, standardized CLE was performed in the terminal ileum and at two colorectal sites. Analysis of CLE images included functional (i.e. presence of epithelial barrier dysfunction) and quantitative parameters of intestinal architecture. 27 of 60 patients (45%) were diagnosed with FA. Barrier dysfunction was analyzed on 65.837 ileal and on 93.251 colonic images. 96% of patients with FA exhibited functional and structural barrier defects while barrier dysfunction was found in only 33% of patients without FA (p < 0.0001). Visualizing barrier dysfunction with CLE for in vivo diagnosis of FA had a sensitivity and specificity of 96% and 67%, respectively, with a positive and negative prediction of 70% and 96%, respectively. Parameters intrinsic to the crypt architecture including crypt diameter, intercrypt distance, crypt lumen diameter and colonic vasculature were not different between patients with and without FA. CLE-based imaging of the intestinal barrier during colonoscopy might help in stratifying patients with suspected FA for further diagnostic work-up.

scholarly journals The Role of Atopy Patch Test in Diagnosis of Food Allergy in Atopic Eczema/Dermatitis Syndrom in Patients over 14 Years of Age

2010 ◽  
Vol 53 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jarmila Čelakovská ◽  
Jaroslava Vaněčková ◽  
Květuše Ettlerová ◽  
Karel Ettler ◽  
Josef Bukač
Keyword(s):  
Food Allergy ◽  
Atopic Eczema ◽  
Challenge Test ◽  
Food Challenge ◽  
Diagnostic Methods ◽  
Cow Milk ◽  
Patch Tests ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Few studies concerning the importance of food allergy in adolescents and adult patients with atopic eczema exist. The atopy patch tests with food have mostly been studied in infants and children since food allergy plays a role especially in this age group. Aim: The evaluation of the contribution of atopy patch tests in the diagnostic work-up of food allergy (to wheat, cow milk, peanuts, soya and eggs) in the patients with atopic eczema older than 14 years of age. Method: 120 patients were examined in the study in the diagnostic work-up of food allergy – 86 women and 34 men, the mean age 26.5 (s.d. 9.8) and the median SCORAD at the beginning of the study 32.9 (s.d. 14.0). Complete dermatological and allergological examinations in the diagnostic work-up of food allergy were performed (assessment of personal history, assessment of serum specific IgE, skin prick tests, atopy patch tests, diagnostic hypoallergenic diet, food challenge tests with egg, soy, wheat, cow milk and double – blind, placebo – controlled food challenge test with cow milk and wheat. The results of atopy patch tests were compared with the results of other diagnostic methods in the diagnosis of food allergy. Results: The food allergy to cow milk and wheat was confirmed in double – blind, placebo controlled food challenge test in few patients in our study (4 %). The suspicion of food allergy to egg is in 8 %, to peanuts in 13 % and to soya in 4 % of patients in our study. The assessment of atopy patch tests response seems to be of great importance. The reaction in atopy patch tests with more papules has the greatest diagnostic accuracy for predicting the result of challenge tests. At the beginning and at the end of diagnostic hypoallergenic diet the severity of atopic eczema/dermatitis syndrome was recorded in all patients enrolled in the study by evaluating SCORAD. The decrease of SCORAD was statistically important. Conclusion: Atopy patch tests alone cannot be used as a single test for the determination of food allergy in patients with atopic eczema/dermatitis syndrome but such a test, together with other diagnostic methods, can help to trace the food allergy.

scholarly journals Stroke masquerading as cardiac arrest: the artery of Percheron

2021 ◽  
Vol 14 (1) ◽  
pp. e238681
Author(s):  
Megan Quetsch ◽  
Sureshkumar Nagiah ◽  
Stephen Hedger
Keyword(s):  
Cardiac Arrest ◽  
Clinical Assessment ◽  
Altered Consciousness ◽  
Cognitive Changes ◽  
Consciousness Level ◽  
Artery Of Percheron ◽  
Conscious Level ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The artery of Percheron (AOP) is a rare arterial variant of the thalamic blood supply. Due to the densely packed collection of nuclei it supplies, an infarction of the AOP can be devastating. Here we highlight a patient who had an AOP stroke in the community, which was initially managed as cardiac arrest. AOP strokes most often present with vague symptoms such as reduced conscious level, cognitive changes and confusion without obvious focal neurology, and therefore are often missed at the initial clinical assessment. This case highlights the importance of recognising an AOP stroke as a cause of otherwise unexplained altered consciousness level and the use of MRI early in the diagnostic work-up.

scholarly journals Death of unknown cause? Post-mortem diagnosis of fulminant course of an EBV-associated secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Author(s):  
Josia Fauser ◽  
Stefan Köck ◽  
Eberhard Gunsilius ◽  
Andreas Chott ◽  
Andreas Peer ◽  
...  
Keyword(s):  
Immune Response ◽  
Case Report ◽  
Macrophage Activation ◽  
Post Mortem ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up ◽  
Secondary Hemophagocytic Lymphohistiocytosis

SummaryHLH is a life-threatening disease, which is characterized by a dysregulated immune response with uncontrolled T cell and macrophage activation. The often fulminant course of the disease needs a fast diagnostic work-up to initiate as soon as possible the appropriate therapy. We present herein the case of a 71-year-old patient with rapidly progressive hyperinflammatory syndrome, which post mortem resulted in the diagnosis of EBV-associated HLH. With this case report, we intend to highlight the relevance of the HScore in the diagnosis of HLH, to create a greater awareness for EBV as a trigger of HLH, and to demonstrate the importance of treating EBV-associated HLH as early as possible.

scholarly journals COVID-19 lung injury as a primer for immune checkpoint inhibitors (ICIs)-related pneumonia in a patient affected by squamous head and neck carcinoma treated with PD-L1 blockade: a case report

2021 ◽  
Vol 9 (2) ◽  
pp. e001870
Author(s):  
Angelo Dipasquale ◽  
Pasquale Persico ◽  
Elena Lorenzi ◽  
Daoud Rahal ◽  
Armando Santoro ◽  
...  
Keyword(s):  
Lung Injury ◽  
Head And Neck ◽  
Checkpoint Inhibitors ◽  
Experimental Therapy ◽  
Common Mechanism ◽  
Nasopharyngeal Swab ◽  
Immune Mediated ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.We describe the case of a 65–year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.

scholarly journals Long-Term Follow-Up of Thyroid Incidentalomas Visualized with 18F-Fluorodeoxyglucose Positron Emission Tomography—Impact of Thyroid Scintigraphy in the Diagnostic Work-Up

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 557
Author(s):  
Kirsten Korsholm ◽  
Michala Reichkendler ◽  
Louise Alslev ◽  
Åse Krogh Rasmussen ◽  
Peter Oturai
Keyword(s):  
Emission Tomography ◽  
Thyroid Scintigraphy ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Diagnostic Work ◽  
Fdg Pet Ct ◽  
Work Up ◽  
Diagnostic Work Up

Our objective was to evaluate the frequency of malignancy in incidental thyroidal uptake on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in a cohort of Danish patients, and furthermore to evaluate the impact of thyroid scinti-graphy in the diagnostic work-up. All whole-body PET/CT reports from 1 January 2010 to 31 December 2013 were retrospectively reviewed and further analyzed if visually increased thyroidal FDG uptake was reported. Patient electronic files were searched for further thyroid evaluation. Of 13,195 18F-FDG-PET/CT scans in 9114 patients, 312 PET/CT reports mentioned incidental thyroid FDG-uptake, and 279 patients were included in the study (3.1%). The thyroid was further investigated in 137 patients (49%), and 75 patients underwent thyroid scintigraphy. A total of 57 patients had a thyroid biopsy and 21 proceeded to surgery. Surgical specimens displayed malignancy in 10 cases, and one thyroid malignancy was found by autopsy. Hence, 11 patients were diagnosed with thyroid malignancies among 279 patients with incidental thyroid 18F-FDG uptake (3.9%). In 34 patients, a biopsy was avoided due to the results of the thyroid scintigraphy. We conclude that patients with thyroid incidentalomas can benefit from further diagnostic work-up including a thyroid scintigraphy.

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