Editor-in-Chief, Deputy Editor 2017-2019

 

Editor-in-Chief:

Tom MOREELS

 

Deputy Editor:

Nicolas LANTHIER

 

Reviews



"A review of the literature on three extraintestinal complications of ulcerative colitis : an ulcerative colitis flare complicated by Budd-Chiari syndrome, cerebral venous thrombosis and idiopathic thrombocytopenia"


Price: €10,00

Extraintestinal manifestations are well described and recognized in association with ulcerative colitis. Immunologically mediated and thrombotic events are among the more rare manifestations associated with flares. These manifestations include Budd-Chiari syndrome, idiopathic thrombocytopenia, and cerebral venous thrombosis. A 22 year-old male with a three-year history of ulcerative colitis presented with worsening hematochezia, fatigue, headache and upper respiratory symptoms. Laboratory evaluation demonstrated a platelet count of 24 × 109/L (normal baseline platelet count noted 3 months prior) and hemoglobin of 8.6 × 109/L. Imaging demonstrated hepatic venous thrombosis consistent with Budd-Chiari syndrome and cerebral venous thrombosis. Based on peripheral smear analysis and eventual marked response to steroids, a diagnosis of idiopathic thrombocytopenia was made. He was started on prednisone 40mg daily with brisk improvement in both his ulcerative colitis flare and his platelet count increasing above 100 × 109/L. He was therapeutically anticoagulated for the cerebral venous thrombosis. He continued to do well and was discharged on therapeutic enoxaparin and a 40 mg prednisone taper without recurrent flare or idiopathic thrombocytopenia two weeks post-hospitalization. To our knowledge, this is the first report of all three known but rare complications diagnosed concurrently in the same patient. This review examines three extraintestinal complications of ulcerative colitis, including the presentation, diagnosis, and treatment. (Acta gastroenterol. belg., 2013, 76, 311- 316). [Product Details...]



Alveolar Echinococcosis in a Belgian Urban Dweller


Price: €10,00

Human alveolar echinococcosis is a rare parasitic disease caused by larvae of the tapeworm E. multilocularis that colonizes the intestines of foxes. The disease predominantly affects the liver and mimics slow growing liver cancer. With a mere 13 reports coming mostly from southern rural regions Belgium has so far been spared from the disease. However alveolar echinococcosis appears to be slowly spreading to non-endemic European countries like Belgium and to urban centres. We report the first autochthonous case involving a patient having lived exclusively in downtown Brussels. Heightened awareness by the medical community is necessary to detect this lethal disease at an early curable stage. In patients with an undetermined focal liver lesion – especially if calcified – and no firm evidence of malignancy, serological screening should be performed to exclude alveolar echinococcosis. (Acta gastroenterol. belg., 2013, 76, 317-321). [Product Details...]



The use of fecal calprotectin and lactoferrin in patients with IBD. Review.


Price: €10,00

Endoscopy has been the gold standard for diagnosing and following patients with inflammatory bowel disease. However, ileocolonoscopy is still an expensive and invasive method. Secondly we do know that clinical scores for ulcerative colitis and Crohn’s disease are subjective which creates several problems. And thirdly, when using the known serological markers such as C-reactive protein, white blood cell count en albumin, one should take into account that these markers are not perfect or superior to the current diagnostic techniques given their low sensitivity and specificity. Fecal markers may prove to have a greater specificity. Calprotectin can differentiate between active and inactive inflammatory bowel disease and between inflammatory bowel disease and irritable bowel syndrome. It correlates with the severity of symptoms and it may predict relapse especially in ulcerative colitis. Finally it can be used as a surrogate marker for the endoscopic response during treatment given a normal value of calprotectin is a reliable marker for mucosal healing. Lactoferrin also seems to be a sensitive and specific marker for the detection of chronic inflammation and for predicting relapse. The relationship with the endoscopic activity is significant and lactoferrin values are significantly higher in active endoscopic disease as compared to inactive disease. Finally, given the significant correlation with endoscopic activity, lactoferrin can function as an adequate marker for the monitoring of therapy. (Acta gastroenterol. belg., 2013, 76, 322-328). [Product Details...]


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