scholarly journals A rare complication of acute severe ulcerative colitis

2021 ◽  
Vol 84 (3) ◽  
pp. 525-526
Author(s):  
E Dias ◽  
R Coelho ◽  
A.C. Nunes ◽  
P Andrade ◽  
L Malheiro ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Rare Complication ◽  
Wall Thickening ◽  
Extensive Disease ◽  
Spontaneous Bleeding ◽  
Reactive Protein ◽  
Free Air ◽  
Oral Corticosteroids ◽  
Tomography Scan ◽  
New Onset

A 21-year-old female with ulcerative colitis presented with abdominal pain and bloody diarrhea. Laboratory studies revealed markedly elevated C-reactive protein and thrombocytosis. Flexible sigmoidoscopy revealed severe endoscopic activity with ulceration and spontaneous bleeding along rectum and sigmoid colon. Ulcerative colitis had been diagnosed 3 years before, presenting as severe and extensive disease (pancolitis). She had previously failed therapy with infliximab and vedolizumab and had recently started induction therapy with golimumab. She responded well to intravenous corticosteroids but, when switched to oral corticosteroids, there was symptomatic recurrence. Intravenous corticosteroids were re-started and she was evaluated for surgery. At this time, she developed new-onset tachycardia. Electrocardiogram revealed sinus tachycardia with heart rate of approximately 120 bpm. Because tachycardia could result from worsening colitis with potential serious complications, abdominal computerized tomography scan was performed and demonstrated mild lumen dilation and wall thickening consistent with acute colitis without evidence of pneumoperitoneum or toxic megacolon. Surprisingly, thoracic planes revealed the presence of free air dissecting mediastinal space (Figure 1). What is your diagnosis?

scholarly journals Tracheobronchitis in ulcerative colitis: a case report of therapeutic response with infliximab and review of the literature

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lisa Horgan ◽  
Siobhain Mulrennan ◽  
Lloyd D’Orsogna ◽  
Andrew McLean-Tooke
Keyword(s):  
Ulcerative Colitis ◽  
Case Report ◽  
Inhaled Corticosteroids ◽  
Rare Complication ◽  
High Dose ◽  
Clinical Effects ◽  
Case Presentation ◽  
First Case ◽  
Oral Corticosteroids ◽  
Symptomatic Remission

Abstract Background The extra-intestinal manifestation of tracheobronchitis is a rare complication of ulcerative colitis (UC). Here, we present a case of UC-related tracheobronchitis wherein the positive clinical effects of infliximab are demonstrated. Case presentation We report the case of a 39-year old woman who presented with a chronic productive cough on a distant background of surgically managed ulcerative colitis (UC). Our patient failed to achieve a satisfactory clinical improvement despite treatment with high dose inhaled corticosteroids, oral corticosteroids and azathioprine. Infliximab therapy was commenced and was demonstrated to achieve macroscopic and symptomatic remission of disease. Conclusions We present the first case report documenting the benefits of infliximab in UC-related tracheobronchitis.

scholarly journals A rare complication of the duodenal diverticulum

2019 ◽  
Vol 11 (1) ◽  
pp. 81-82
Author(s):  
Hiroshi Sugimoto ◽  
Aoi Fujikawa ◽  
Akihiro Kishida
Keyword(s):  
Computed Tomography ◽  
Rare Complication ◽  
Duodenal Diverticulum ◽  
Computed Tomography Scan ◽  
Axial Section ◽  
Rebound Tenderness ◽  
Reactive Protein ◽  
The Right ◽  
Tomography Scan ◽  
Retroperitoneal Air

IntroductionAn 80-year-old woman presented to the emergency department with severe right-sided abdominal pain that had started after her last meal. Physical examination revealed fever (38.6°C) and rebound tenderness in the right upper quadrant of the abdomen. The laboratory studies showed a leucocyte count of 11.3×109/L (normal, 3.7–8.0×109/L) and a C-reactive protein level of 2.34 mg/dL (normal, <0.03 mg/dL). There were no other significant findings. A CT scan of the abdomen with contrast revealed retroperitoneal air around a duodenal diverticulum (figures 1 and 2).Figure 1Computed tomography scan of the abdomen with contrast (coronal section). A diverticulum in the second portion of the duodenum (arrow) and retroperitoneal air (asterisk) are shown.Figure 2Computed tomography scan of the abdomen with contrast (axial section). The area with retroperitoneal air (asterisk) is marked.QuestionWhat is the most likely diagnosis and the cause underlying the condition?

New-Onset Ulcerative Colitis After Kidney Transplant Immunosuppression

Consultant ◽  
2020 ◽  
Vol 60 (3) ◽  
pp. 95-96
Author(s):  
We’am Hussain ◽  
Drew Triplett ◽  
Sangeeta Agrawal
Keyword(s):  
Ulcerative Colitis ◽  
Kidney Transplant ◽  
New Onset

scholarly journals Relationship between serum angiopoietin-like 4 levels and recurrence of atrial fibrillation

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098839
Author(s):  
Zhongping Ning ◽  
Xinming Li ◽  
Xi Zhu ◽  
Jun Luo ◽  
Yingbiao Wu
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Peroxisome Proliferator ◽  
C Reactive Protein ◽  
Peroxisome Proliferator Activated Receptor ◽  
Reactive Protein ◽  
New Onset

Objective To investigate the association between serum angiopoietin-like 4 (ANGPTL4) levels and recurrence of atrial fibrillation (AF) after catheter ablation. Methods This retrospective study recruited patients with AF undergoing catheter ablation and they were divided into two groups (new-onset AF group and recurrent AF group). Demographic, clinical, and laboratory parameters were collected. Results A total of 192 patients with AF were included, including 69 patients with recurrence of AF. Serum ANGPTL4 levels were lower in patients with recurrent AF than in those with new-onset AF. Serum ANGPTL4 levels were positively correlated with superoxide dismutase and peroxisome proliferator-activated receptor γ, and negatively correlated with the CHA2DS2-VASC score, left atrial diameter, and levels of brain natriuretic peptide, malondialdehyde, high-sensitivity C-reactive protein, and interleukin-6. The receiver operating characteristic curve showed that the best cut-off for recurrent AF was serum ANGPTL4 levels  < 19.735 ng/mL, with a sensitivity and specificity of 63.9% and 74.5%, respectively. Serum ANGPTL4 levels were significantly associated with recurrence and new onset of AF (odds ratio, 2.241; 95% confidence interval, 1.081–4.648). Conclusions Serum ANGPTL4 levels are lower in patients with recurrent AF than in those with new-onset AF, and are associated with cardiac hypertrophy, oxidative stress, and inflammation.

scholarly journals Fecal Calprotectin, CRP and Leucocytes in IBD Patients: Comparison of Biomarkers With Biopsy Results

2020 ◽  
Author(s):  
Barry D Kyle ◽  
Terence A Agbor ◽  
Shajib Sharif ◽  
Usha Chauhan ◽  
John Marshall ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Fecal Calprotectin ◽  
Dependent Manner ◽  
Ascending Colon ◽  
C Reactive Protein ◽  
Concentration Dependent Manner ◽  
Reactive Protein ◽  
Inflammatory Bowel ◽  
Descending Colon ◽  
Active Inflammation

Abstract Background This study aimed to compare fecal calprotectin (FC) levels with other commonly used parameters as part of patient care during evaluation for inflammatory bowel disease (IBD). Methods We recruited adult IBD patients with ulcerative colitis (UC) and Crohn’s disease (CD) and compared the results of the patient’s biopsy results (i.e., inflamed versus noninflamed) for six sites (i.e., ileum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum) with concentrations of C-reactive protein (CRP), total leucocytes and fecal calprotectin (FC). Results We found that FC was significantly elevated in a concentration-dependent manner that correlated with the number of active inflammation sites reported in biopsy. Although CRP and leucocyte measurements trended upwards in line with inflammation reported from biopsy, the results were highly variable and highlighted poor reliability of these biomarkers for indicating IBD inflammation. Conclusions These results strongly suggest that FC correlates best with biopsy reports and is a superior marker than CRP and leucocytes.

Oral Corticosteroids for Induction of Remission in Ulcerative Colitis

2012 ◽  
Vol 107 ◽  
pp. S663-S664
Author(s):  
Malcolm Wells ◽  
Marko Mrkobrada ◽  
Nilesh Chande ◽  
John MacDonald ◽  
Sean Feagan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Oral Corticosteroids

Ulcerative colitis is not a rare complication of Takayasu arteritis

2013 ◽  
Author(s):  
Ryu Watanabe ◽  
Tomonori Ishii ◽  
Kyohei Nakamura ◽  
Tsuyoshi Shirai ◽  
Hiroshi Fujii ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Takayasu Arteritis ◽  
Rare Complication

scholarly journals Understanding patient journey in ulcerative colitis prior to biologic initiation: a 5-year exploration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiting Wang ◽  
Rupa Makadia ◽  
Christopher Knoll ◽  
Jill Hardin ◽  
Erica A. Voss ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Health Care ◽  
Health Care Utilization ◽  
Corticosteroid Treatment ◽  
Biologic Agent ◽  
Care Utilization ◽  
Biologic Treatment ◽  
Patient Journey ◽  
Care Experience ◽  
Oral Corticosteroids

Abstract Background There has been a more pronounced shift toward earlier, more aggressive therapies in Crohn’s disease than in ulcerative colitis (UC). The aim of this study was to describe the pre-biologic treatment and health care experience, including co-morbidities and overall health care utilization, for UC patients who initiated biologic therapies, in the 5 years prior to the initiation of the first biologic agent. Methods UC patients who initiated a biologic agent approved for UC between 9/15/2005 and 1/30/2018 were identified from the IBM® MarketScan® Commercial Database, a large US database. The date of the first recorded UC biologic exposure was defined as the index date, and ≥ 5 years of pre-index records were required to evaluate patients’ treatment, disease progression and overall health care utilization prior to initiating biologic agents. Results Among the 1891 eligible patients, treatment with oral corticosteroids, 5-aminosalicylates, and other non-biologic immunomodulators, all increased progressively across the 5 years prior to the index. From within year-five to within year-one prior to the index, the median duration of oral corticosteroid treatment increased from 34 to 88 days per year and the proportion of patients who experienced more extensive/pancolitis disease increased from 16 to 59%. Overall, the frequency of all-cause health care visits also increased. Conclusions Patients with UC experienced increasing morbidity and treatment burden in the 5 years prior to initiating biologic therapy. To achieve reduced corticosteroids in UC management, better risk stratification is needed to help identify patients for more timely biologic treatment.

1074 Gallstone Ileus: Two Decades After Cholecystectomy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Matwala ◽  
M R Iqbal ◽  
T Shakir ◽  
D W Chicken
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
Open Cholecystectomy ◽  
Gallstone Ileus ◽  
Proximal Small Bowel ◽  
Solid Diet ◽  
History Of ◽  
Ileocaecal Junction ◽  
Tomography Scan

Abstract Introduction Gallstone ileus is a rare complication of gallstones that occurs in 1%-4% of all cases of bowel obstruction. We present a surprising case of gallstone ileus causing small bowel obstruction 19 years after open cholecystectomy. Case Report A 77-year-old male presented with a 3-day history of abdominal pain, 4 episodes of vomiting and absolute constipation. He had a surgical background of an open cholecystectomy and open appendicectomy 19 years and 45 years ago respectively. Medically, he had well-controlled hypertension and experienced a TIA 5 years prior. Computed Tomography Scan of the abdomen and pelvis revealed features consistent with an obstructing, heterogenous opacity in the distal small bowel without pneumobilia. The patient subsequently underwent diagnostic laparoscopy. Intraoperatively, an obstructing gallstone, measuring 4 cm, was found 50cm proximal to the ileocaecal junction, with dilatation of the proximal small bowel and distal collapse. Enterotomy and removal of the stone was done. Post-operatively, this gentleman recovered without complications and was discharged home two days later after being able to tolerate a solid diet. Conclusions This is the second reported case of gallstone ileus in a patient with previous cholecystectomy about two decades ago, according to our literature search. Although extremely rare, absence of the gallbladder does not exclude the possibility of gallstone ileus.

Topical corticosteroids in ulcerative colitis

1975 ◽  
Vol 13 (2) ◽  
pp. 5-7
Keyword(s):  
Ulcerative Colitis ◽  
Corticosteroid Therapy ◽  
Systemic Corticosteroid ◽  
Extensive Disease ◽  
Double Blind ◽  
Topical Corticosteroids ◽  
Systemic Corticosteroid Therapy ◽  
Blind Trials

Since the usefulness of topical corticosteroids in the treatment of ulcerative colitis was first reported1 double-blind trials have confirmed their effectiveness, and they are now widely used.2 For disease localised to the rectum suppositories, and for more extensive disease, retention enemas containing various corticosteroids are available (see table). In severe cases these preparations also valuably supplement systemic corticosteroid therapy, with or without sulphasalazine (Salazopyrin).

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