scholarly journals Compromiso gastrointestinal inusual en paciente pediátrico con vasculitis asociada a anticuerpos anticitoplasma de neutrófilos. Reporte de un caso

2021 ◽  
Vol 51 (4) ◽  
Author(s):  
Gustavo Javier Tagliaferro ◽  
Verónica Busoni ◽  
María Cecilia Bertinotti ◽  
Carmen De Cunto ◽  
Marina Orsi
Keyword(s):  
Gastrointestinal Bleeding ◽  
Blood Vessels ◽  
Pediatric Patient ◽  
Clinical Condition ◽  
Inflammatory Process ◽  
Gastrointestinal Involvement ◽  
Intestinal Involvement

Vasculitis is characterized by presenting inflammation of the wall of blood vessels, one type of these diseases are those associated with anti-neutrophil cytoplasm antibodies. They usually occur in adulthood and are rare in childhood. The disease generally affects the lung, kidney, and skin, with gastrointestinal involvement being rare. Here we describe the case of a pediatric patient with gastrointestinal bleeding secondary to ANCA positive vasculitis. Endoscopy revealed patchy erythematous lesions and wall hematoma at the level of the colon. Although we report a fairly infrequent clinical condition, it is not without complications. We believe it is appropriate to suspect it, first of all, intestinal involvement where the underlying inflammatory process is not clear, even more so when it involves other organs.

Role of Leukocytes and Endothelial Cells in the Development of Angiogenesis in Inflammation and Wound Healing

2001 ◽  
Vol 125 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Mark W. Lingen
Keyword(s):  
Wound Healing ◽  
Endothelial Cells ◽  
Blood Vessels ◽  
Peripheral Blood ◽  
Inflammatory Process ◽  
Signs And Symptoms ◽  
Critical Component ◽  
Complex Environment ◽  
Seminal Article

Abstract The basic signs and symptoms of inflammation and wound healing have been appreciated for thousands of years. However, the specific cells involved and their roles in this complex environment are still being elucidated today. In 1926, the origin of the phagocytic mononuclear ameboid wandering cell (macrophage) had not been determined. One popular theory was that the cells were differentiated from the endothelial cells of the nearby blood vessels, whereas others believed that the cells came from the peripheral blood or resting wandering cells. The purpose of this article is to review the seminal article published by Lang regarding this topic nearly 75 years ago. In addition, this article will review what is now known with regard to the role of the macrophage and endothelial cells in the development of angiogenesis, which is arguably the most critical component of successful inflammatory process or wound healing.

COVID-19-related Gastrointestinal Bleeding in a Pediatric Patient With ALL

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Małgorzata Wojciechowska ◽  
Joanna Renke ◽  
Ninela Irga-Jaworska
Keyword(s):  
Gastrointestinal Bleeding ◽  
Pediatric Patient

Gastrointestinal Bleeding Following Ketorolac Administration in a Pediatric Patient

1996 ◽  
Vol 23 (4) ◽  
pp. 479-481 ◽  
Author(s):  
Andrés Alcaraz ◽  
Jesús López-Herce ◽  
Carlota Seriñá ◽  
Aleth Bueso-Inchausti ◽  
Maria J. Saez ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Pediatric Patient

scholarly journals Optic nerve and retinal damage in a patient with post-hemorrhagic anemia

2015 ◽  
Vol 96 (6) ◽  
pp. 1074-1078
Author(s):  
E E Grishina ◽  
A A Ryabtseva ◽  
T V Belova ◽  
O M Andryukhina
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Blood Vessels ◽  
Clinical Examination ◽  
Hemoglobin Level ◽  
Retinal Damage ◽  
Field Of Vision ◽  
The Right

There is a number of literature data on ischemic optic neuropathy development in acute hemorrhage. However, ocular disorders in prolonged chronic hemorrhage and iron-deficiency anemia are not well studied. We present a clinical case of optic nerve and retinal damage in a patient with prolonged chronic gastrointestinal bleeding. 53-year-old patient S. presented with complaints on dramatic sudden loss of vision of his right eye (visual acuity was 0/02 and was not improving with correction). Visual acuity of the left eye was good. Ophthalmoscopy revealed right optic nerve swelling, flame-shaped disc and peripapillary hemorrhages, and multiple soft exudates along blood vessels of the right eye. Optic nerve head of the left eye was pale pink, with well-defined borders. Multiple soft exudates along blood vessels and few flame-shaped hemorrhages were identified as well. Clinical examination revealed iron-deficiency post-hemorrhagic anemia. The diagnosis of anterior ischemic neuropathy of the right eye, ischemic neuroretinopathy of left eye associated with post-hemorrhagic anemia was established. Conservative treatment increased hemoglobin level up to 82 g/l, the red blood cells count - up to 2,88×1012/L, hematocrit was 0.25%, platelet count reached 344×109/L, but the signs of rectal bleeding remained. The patient underwent surgery for hemorrhoids. After the increase of hemoglobin level, visual acuity of the right eye improved to 0.1, the visual acuity of the left eye was 1.0. According to the results of computed peripheral vision test (Humphrey Full Field 120 Point Screening Test), central scotoma and scotomas in the lower half of the field of vision of the right eye remained. In the field of vision of the left eye, the area of absolute arcuate scotoma in the lower-nasal quadrant decreased significantly. Reduced visual acuity was the main complaint of the patient with a longstanding gastrointestinal bleeding. A careful history and thorough clinical examination allowed to establish the cause of the optic nerve and retinal damage, to assign pathogenetically based treatment, which led to an improvement in visual function.

Recurrent gastrointestinal bleeding due to jejunal artery vasculitis as debut presentation of granulomatosis with polyangiitis

2021 ◽  
Vol 14 (1) ◽  
pp. e237876
Author(s):  
Saddam Yasin ◽  
Kanwal Mehmood
Keyword(s):  
Mortality Rate ◽  
Respiratory Tract ◽  
Gastrointestinal Bleeding ◽  
Lower Respiratory Tract ◽  
Granulomatosis With Polyangiitis ◽  
Surgical Excision ◽  
Gastrointestinal Involvement ◽  
Small Arteries ◽  
Arteries And Veins ◽  
Late Manifestation

Granulomatosis with polyangiitis (GPA) is characterised by systemic necrotising vasculitis of small arteries and veins with multitude of organ involvement, with the most common being the upper and lower respiratory tract and renal system. Gastrointestinal involvement is a rare late manifestation with a high mortality rate and usually results in intestinal perforation. Our patient presented with gastrointestinal bleeding secondary to jejunal artery vasculitis. Gastrointestinal bleeding as initial presentation of GPA is very rarely documented. CT mesenteric angiogram is helpful for the localisation of bleed in these cases. In case of refractory bleeding, surgical excision is required.

Successful Treatment of Intractable Gastrointestinal Hemorrhage with Low Dose of Recombinant FVIIa (Novoseven®) in Pediatric Patient without Coagulation Deficiencies.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3972-3972
Author(s):  
Ji Yoon Kim ◽  
Kun Soo Lee ◽  
Soon Hak Kwon ◽  
Byung Ho Choe ◽  
Sang Kyun Sohn
Keyword(s):  
Gastrointestinal Bleeding ◽  
Pediatric Patient ◽  
Gastrointestinal Hemorrhage ◽  
Low Dose ◽  
Factor Viia ◽  
Whole Body ◽  
Prior History ◽  
Factor X ◽  
Dose Administration ◽  
History Of

Abstract Recombinant FVIIa (Novoseven®) was initially developed for the treatment of bleeding in patient with congenital hemophilia with antibodies against factors VIII and IX and FVII deficiency. The mechanism of action is to induce hemostasis at the site of injury both by forming complexes with exposed tissue factor and by directly activating factor X upon the surface of an activated platelet. More recently it has begun to use gradually in the management of bleeding patient without congenital coagulation defect. We report the successful use of recombinant factor VIIa in a pediatric patient who has intractable gastrointestinal bleeding despite of conventional medical therapy. Case: The patient is a 13-year-old female and her body weight is only 10 kg, with a prior history of cerebral palsy and epilepsy. Recently she presented a recurrent massive hematemesis and melena probably due to stress ulcer for 8 days. She had no personal or family history of a suggestive bleeding disorder. The patient had a normal platelet count and coagulation screening test. Her hospital course was complicated by recurrent gastrointestinal hemorrhage but an endoscopic intervention was not permitted due to her poor condition. Despite of conventional medication with omeprazole and sucralfate over 20 days, she suffered from recurrent hematemesis and melena. In the gastrointestinal bleeding scan with 99mTc-labeled RBCs, small intestinal hemorrhage was found. The following day, the patient was given three doses of Novoseven® at 100 μg/kg, as bolus doses with 2 hour interval, which resulted in resolution of hematemesis and melena after last dose administration. Although she had mild whole body rash after third dose administration, it was subsided soon after medication of antihistamine and steroid. No evidence of hemorrhage was documented at a follow-up gastrointestinal bleeding scan that was taken after 4 days later of treatment. The patient made a full recovery and no further treatment was required. Conclusion: We suggest that low dose of recombinant FVIIa (Novoseven®) were effective in treatment of pediatric intractable gastrointestinal hemorrhage.

scholarly journals Effect of cryoprecipitate on neoangiogenesis in patients with purulent pyelonephritis

2020 ◽  
Vol 10 (1) ◽  
pp. 43-49
Author(s):  
Yuliya G. Chernova ◽  
Aleksandr I. Nejmark ◽  
Andrey P. Momot
Keyword(s):  
Surgical Treatment ◽  
Blood Vessels ◽  
Inflammatory Process ◽  
Conservative Therapy ◽  
High Efficiency ◽  
Control Group ◽  
Healthy Donors ◽  
Group 2 ◽  
Angiopoietin 2 ◽  
Group 1

The aim of the study is to investigate the effectiveness of conservative therapy with the inclusion of cryoprecipitate in its composition and its effect on the angiogenesis of renal blood vessels in patients with purulent pyelonephritis. Materials and methods. The study included 30 patients aged from 20 to 45 years (6 men, 24 women) with acute purulent pyelonephritis. All patients were assessed for markers of angiogenesis in blood plasma: vascular endothelial growth factor (VEGF-A), angiopoietin 1 (Ang1) and angiopoietin 2 (Ang2). The patients were divided into two groups. Patients of group 1 (n = 15) received conservative therapy with the inclusion of cryoprecipitate, patients of group 2 (n = 15) received surgical treatment. The control group consisted of 10 healthy donors aged 2035 years, whose blood angiogenesis markers were determined to obtain reference values. Results. In the course of preliminary studies, the blood content of angiogenesis markers was determined in 10 healthy donors. The level of VEGF-A in patients of both groups and the level of Ang1 in patients of group 1 at admission to the hospital significantly exceeded the corresponding values in the control group. In group 2 patients, the level of VEGF-A and Ang1 remained elevated during treatment, which indirectly indicated an ongoing inflammatory process. The level of Ang2 in patients of both groups did not change significantly. Conservative treatment of group 1 patients showed high efficiency, which was confirmed by positive dynamics of clinical and laboratory indicators, as well as data from instrumental examination. Conclusions. The results obtained indicate the effectiveness of conservative therapy with the administration of cryoprecipitate in patients with purulent pyelonephritis, and the effectiveness of such treatment is comparable to the effectiveness of surgical treatment . The use of cryoprecipitate has an endothelioprotective and anti-inflammatory effect on blood vessels, stabilizes the processes of angiogenesis, which contributes to limiting the inflammatory process and its regression.

Diagnosis and Management of Upper Gastrointestinal Tract Bleeding in the Pediatric Patient

1990 ◽  
Vol 12 (4) ◽  
pp. 107-116
Author(s):  
Marvin E. Ament
Keyword(s):  
Differential Diagnosis ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Pediatric Patient ◽  
Gastrointestinal Hemorrhage ◽  
Pediatric Population ◽  
Coffee Ground ◽  
Ligament Of Treitz ◽  
Gastrointestinal Tract Bleeding ◽  
Upper Gastrointestinal

Gastrointestinal bleeding in patients at any age is frightening. The fear stems from the knowledge that bleeding, if severe enough and sustained for long intervals, may lead to shock and death. Fortunately, in both pediatric and adult patients, instances in which bleeding is so massive and uncontrollable that it leads to rapid demise are extremely rare. The approach to diagnosis and treatment of gastrointestinal hemorrhage by the physician should be calm, logical, and expeditious to help allay the fears of the patient and family, and to reduce the morbidity associated with the hemorrhage in the event its cause is found to be serious. Fortunately, the causes of gastrointestinal bleeding in the pediatric population are fewer than in adults; accordingly, the differential diagnosis is usually shorter, although not necessarily easier. In contrast to adults, the age of the pediatric patient may play a key role in determining the differential diagnosis. MANIFESTATION OF BLEEDING (Table 1) Before discussing the pathophysiology of bleeding, we will establish definitions of the words frequently associated with gastrointestinal bleeding. Hematemesis is the vomiting of blood. The blood may be either bright red or "coffee ground" in appearance if it has been altered by gastric acid. Hematemesis implies that the site of bleeding is proximal to the ligament of Treitz.

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