scholarly journals Granulomatous lithiasic cholecystitis in sarcoidosis

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Adriana Handra-Luca
Keyword(s):  
Abdominal Pain ◽  
Angiotensin Converting Enzyme ◽  
Medical History ◽  
Giant Cell ◽  
Ultrasound Examination ◽  
Chronic Cholecystitis ◽  
Imaging Features ◽  
Converting Enzyme ◽  
Renal Lithiasis ◽  
Gallbladder Lithiasis

Gallbladder granulomas are exceedingly rare, reported in association with tuberculosis or sarcoidosis. Here we report a case of gallbladder granulomatous cholecystitis occurring in the context of sarcoidosis. A 70-years old man presented with abdominal pain, nausea and vomiting. The medical history revealed sarcoidosis diagnosed more than 20-years previously. 2-years previously the patient showed renal lithiasis, hypercalcemia and, increased angiotensin converting enzyme. The imaging features suggested thoraco-abdominal sarcoidosis. Prednisone was given at 1.2 mg/kg/day initially, than decreased, being at 2.5 mg/day at present. The ultrasound examination showed gallbladder lithiasis. A cholecystectomy was performed. Microscopy showed subacute and chronic cholecystitis with several epithelioid and giant cell granulomas some of them perineural. In conclusion, we report a case of granulomatous cholecystitis occurring in the course of treated sarcoidosis. The perineural location of granulomas may give further insights into the pathogenesis of gallbladder dysmotility.

scholarly journals Gejala Gastrointestinal pada Pasien COVID-19

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 279
Author(s):  
Kristianty T Silangen ◽  
Bradley J Waleleng ◽  
Frans E. N. Wantania
Keyword(s):  
Abdominal Pain ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Gastrointestinal Symptoms ◽  
Hepatic Function ◽  
Converting Enzyme ◽  
Impaired Liver Function ◽  
Angiotensin Converting Enzyme 2 ◽  
Stomach Pain ◽  
Using Data

Abstract: Patients suffering from corona virus desease of 2019 (COVID-19) could have gastro-intestinal symptoms such as diarrhea, vomiting, and stomach pain. Studies show that human receptor for COVID-19 namely the angiotensin-converting enzyme 2 (ACE2) receptors are also expressed in small intestinal epithelial cells. This study was aimed to determine the gastrointestinal symptoms often found in patients with COVID-19. This was a literature review study using data-bases of Google Scholar, the keywords were (“Covid” AND “gastrointestinal symptoms”), and filtering data by time 2019-2020. The results obtained 10 literatures that fulfilled the inclusion and exclusion criteria. The review obtained that viral infection causes changes in intestinal permeability. SARS-CoV was also identified in ileal and terminal colon biopsy. Gastrointestinal symptoms are accompanied by inflammation of the intestines. The highest percentage of gastrointestinal symptoms were anorexia, followed by diarrhea, nausea/vomiting, abdominal pain. Gastrointestinal symptoms could be the first symptoms or even the only symptoms that appeared in Covid-19 patients. Gastrointestinal symptoms were also associated by impaired hepatic function. In conclusion, gastrointestinal symptoms in Covid-19 patients had a relatively high prevalence, and often appeared as anorexia, diarrhea, nausea/vomiting, and abdominal pain. Some of these symptoms were related to the severe course of Covid-19. Impaired liver function also exacerbated these symptoms as well as a marker of a poor clinical course of Covid-19.  Keywords: COVID-19, gastrointestinal symptoms                                                                                            Abstrak: Penderita COVID-19 dapat disertai gejala gastrointestinal seperti diare, muntah, dan sakit perut. Studi menunjukkan bahwa reseptor manusia untuk COVID-19 yaitu reseptor angiotensin-converting enzyme 2 (ACE2) diekspresikan juga dalam sel epitel usus kecil. Penelitian ini bertujuan untuk mengetahui gejala gastrointestinal yang sering ditemukan pada pasien dengan COVID-19. Jenis penelitian ialah literature review yang menggunakan database Google Cendekia, dan kata kunci (“Covid” DAN “gejala gastrointestinal”) dengan filter rentang waktu tahun 2019-2020 Hasil penelitian mendapatkan 10 literatur yang memenuhi kriteria inklusi dan eksklusi penelitian. Kajian mendapatkan infeksi virus menyebabkan perubahan permeabilitas usus. SARS-CoV juga diidentifikasi pada biopsi ileum dan kolon terminal. Masalah usus dikaitkan dengan tingkat keparahan infeksi. Gejala gastrointestinal disertai dengan peradangan atau kerusakan usus. Beberapa penelitian menunjukkan persentase gejala gastrointestinal tertinggi ialah anoreksia, diikuti diare, mual/muntah, dan terakhir nyeri perut. Juga disebutkan bahwa gejala gastrointestinal dapat merupakan yang pertama muncul atau bahkan satu-satunya gejala pada pasien Covid-19. Gejala gastrointestinal juga dikaitkan dengan gangguan fungsi hati. Simpulan penelitian ini ialah gejala gastrointestinal pada pasien Covid-19 memiliki prevalensi yang relatif tinggi dan sering berupa anoreksia, diare, mual/muntah, dan nyeri perut. Beberapa gejala tersebut berhubungan dengan perjalanan Covid-19 yang berat. Gangguan fungsi hati juga turut memper-berat gejala tersebut sekaligus menjadi penanda perjalanan klinis yang buruk dari Covid-19.Kata kunci:  COVID-19, gejala gastrointestinal

Possible Angiotensin-Converting Enzyme Inhibitor (ACEI)-Induced Small Bowel Angioedema

2011 ◽  
Vol 24 (6) ◽  
pp. 564-567 ◽  
Author(s):  
Emily C. Haines ◽  
Geoffrey C. Wall
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Wall Thickening ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitor ◽  
Abdominal Symptoms ◽  
Inflammatory Changes

Objective: To report a case of possible lisinopril-induced angioedema of the small bowel. Case Summary: A 67-year-old female was admitted to the hospital with abdominal pain, nausea, vomiting, and diarrhea. A computed tomography (CT) scan of the abdomen/pelvis was obtained which showed wall thickening around the area of the jejunum and scant ascites consistent with several diagnoses, including small bowel angioedema. She was treated with intravenous fluids and nasogastric decompression. Stool studies were negative. Her lisinopril was held due to the possibility of small bowel angioedema. A CT enterography obtained 5 days after the discontinuation of lisinopril showed complete resolution of the inflammatory changes and perihepatic fluid. It was felt that angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema of the small bowel was the most likely etiology of her symptoms. Discussion: Angiotensin-converting enzyme inhibitor small bowel angioedema is an uncommon cause of abdominal symptoms. In several cases, patients had been taking ACEIs for years before symptoms occur. Treatment includes cessation of the ACEI and supportive care. Conclusions: Angiotensin-converting enzyme inhibitor-related small bowel angioedema should be considered in the differential diagnosis of unexplained abdominal pain.

Sign in / Sign up

Export Citation Format

Share Document