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Case Report
Azathioprine induced colitis : a case report and review of the literaturePrice: €10,00 |
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We report a case of an allergic hypersensitivity reaction on
azathioprine presenting with colitis. Allergic reactions on azathioprine
are common in patient with inflammatory bowel disease.
The clinic of the allergic reaction on azathioprine in our patient
was atypical in the way it mimicked an acute exacerbation of
inflammatory bowel disease. The pathogenesis of the allergic reaction
is still unclear. Although re-challenge can be life-threatening
and should always be done with precautions, it may definitively
proof the causal association with the drug and decide for definitive
cessation In allergic reactions there is no link with TPMT activity
but other genetically predispositions are proposed. [Product Details...] |
Cystic fibrosis presenting as diabetes insipidus unresponsive to desmopressinPrice: €10,00 |
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The diagnosis of cystic fibrosis (CF) can be confusing when only
a part of the typical symptoms is present. In children, CF is usually
suspected when dealing with chronic pulmonary symptoms
(chronic productive cough, recurrent pneumonia or bronchiolitis).
The pediatric gastroenterologist will exclude CF in all children
with a meconium ileus, rectal prolaps or a poor weight gain.
Atypical CF symptoms are hypochloremic alkalosis, recurrent
pancreatitis and increased appetite to compensate for the pancreatic
insufficiency. This case report shows how a diagnosis can be
delayed when you are mislead by atypical symptoms. It shows the
importance of looking in napkins and argues for the inclusion of
CF in the differential diagnosis of polyuria in infants. [Product Details...] |
Cytomegalovirus-associated protein losing gastropathy in an immunocompetent adult : a case reportPrice: €10,00 |
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Cytomegalovirus infection of the gastro-intestinal tract is frequent
and may be serious in the immunocompromised patient. We
report a case of cytomegalovirus infection in an immunocompetent
young man who presented total food intolerance, pleural effusion
and oedema as the result of severe protein losing hypertrophic
gastropathy. Hypertrophic gastropathy with severe mucosal protein
loss has been described in Menetriers disease, a condition of
unknown cause which involves foveolar hyperplasia of the gastric
mucosa. Related hypoalbuminemia is responsible for a clinical picture
of diffuse edema. In adults, the natural course of the disease
is marked by a chronic course and carries a bad prognosis. In our
case, the disease ran a protracted disabling course, likely shortened
by ganciclovir therapy, followed by slow clinical, endoscopic
and biochemical resolution after several months course. [Product Details...] |
Drug-induced pulmonary toxicity in a patient treated with mesalazine and azathioprine for ulcerative colitisPrice: €10,00 |
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We report a case of an 18-yr-old male with high-grade persistent
fever, productive cough, malaise, diarrhea and associated
abnormal findings on chest radiography. The patient suffered
from ulcerative colitis receiving mesalazine and azathioprine.
After a further and scrutinized work-up the diagnosis of
drug-induced pulmonary toxicity was made. His condition was
improved after discontinuing both drugs and the administration
of corticosteroids.
This is a rarely reported case of eosinophilic pneumonia.
Although it has not been reported previously, the possibility of
mesalazine and azathioprine synergism cannot be excluded. The
clinical, aetiological, diagnostic and therapeutic aspects of the
disease are discussed demonstrating the paramount importance
of bronchoalveolar lavage in the diagnosis of this disorder. One
should be aware of this entity in patients with inflammatory bowel
disease. [Product Details...] |
Severe hepatitis with prolonged cholestasis and bile duct injury due the longterm use of ornidazolePrice: €10,00 |
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Nitroimidazole derivatives are commonly used in the treatment
of protozoal and anaerobic infections, and reports of their hepatotoxicity
are rare. We report a case of severe hepatitis due to the
long-term (8 weeks) use of ornidazole. A 27-year-old woman presented
for evaluation of elevated serum transaminase and total
bilirubin levels. Liver biopsy revealed portal inflammation, hepatocellular
and canalicular cholestasis, porto-portal and portocentral
bridging fibrosis, and a tendency to form nodules. No
aetiological factors associated with chronic liver disease were identified.
The abdominal ultrasonographic findings were compatible
with chronic liver disease. We therefore made the diagnosis of
severe hepatitis resulting from the long-term use of ornidazole. We
conclude that nitroimidazole derivatives may lead to serious liver
damage, especially in female patients. [Product Details...] |
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Acta Gastro-Enterologica Belgica is indexed in NCBI/PubMed.
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica