1/22. Mistaken diagnosis of eosinophilic colitis.A 69-year-old male chronic alcohol abuser suffering from diarrhoea and with a number of discrete pruriginous and erythematous lesions of the trunk was referred to our Unit with a diagnosis of idiopathic eosinophilic colitis in order that we might determine corticosteroid treatment. diagnosis was based on the presence of marked peripheral eosinophilia and massive eosinophilic infiltration at colonic biopsy, and the exclusion of parasitic infection by means of two different microscopic stool examinations of five samples. However, repeated stool examinations of ten samples collected on separate days and evidence of impaired cell-mediated immunity allowed a definite diagnosis of strongyloides stercoralis autoinfection or hyperinfection. Due to the poor sensitivity of stool examination in the diagnosis of strongyloides stercoralis infection, a careful search for this parasite should be made in all patients with comparable clinical findings before formulating a diagnosis of idiopathic eosinophilic colitis, because consequent steroid treatment may have a fatal outcome by inducing widespread dissemination of the parasite.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/22. colitis in chronic granulomatous disease.BACKGROUND: Involvement of the gut in chronic granulomatous disease (CGD) has been previously described and colitis highlighted. However, the nature and histopathology of the colitis are unclear and have been thought to be non-specific or similar to Crohn's disease. methods: Seven patients with CGD, suffering from gastrointestinal symptoms were prospectively studied. RESULTS: All patients had anaemia; other symptoms were failure to thrive (5/7) and diarrhoea (5/7). Most had microcytic anaemia (5/7), increased platelets (7/7), and increased erythrocyte sedimentation rate (6/6). Endoscopically there was a friable erythematous mucosa in 6/7. The histological features present in all patients consisted of a colitis with paucity of neutrophils, increased numbers of eosinophils, eosinophilic crypt abscesses, pigmented macrophages, and nuclear debris. In some granulomas were present (2/7). CONCLUSIONS: colitis is a common cause of gastrointestinal symptoms in CGD and is caused by a non-infective inflammatory process. The histology has specific features, which are distinctive from those seen in Crohn's disease.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
3/22. Collagenous colitis in symptomatic subjects without endoscopic morphologic evidence: case report.Collagenous colitis (CC) is a rare pathology and, even though various etiopathogenetic hypotheses have been put forward, the etiology and pathology are still not well defined. We report the case of a female patient suffering from chronic watery diarrhoea, positive for guaiac-based fecal occult blood test and morphologically negative to endoscopic investigation, but histologically classifiable as CC. This case report suggests that the clinical history must lead towards the execution of a colonoscopy with bioptic samples done even on apparently normal mucosa. Furthermore, the clinic should always signal a suspect CC to the anatomopathologist in order to have a correct diagnosis.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
4/22. A case of severe CMV-colitis in an hiv positive patient despite moderate immunodeficiency.CMV-colitis is rare in hiv positive patients with CD4 counts higher than 100 microl(-1). We report a patient who was suffering from extensive CMV-colitis despite modest immune defect. The diagnosis was confirmed by repeated biopsies. The patient experienced an unusually long recovery which was only achieved after initiation of HAART.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
5/22. Hemolytic uremic syndrome associated with shiga toxin producing escherichia coli infection in a healthy adult woman.A 49-year-old healthy Japanese woman presented with hemorrhagic diarrhea because of shiga toxin producing escherichia coli infection, and then hemolytic uremic syndrome (HUS) developed in the patient. She was successfully treated with continuous hemodiafiltration, plasma exchange, and endotoxin adsorption therapy. An analysis of previous case reports suggests that females aged between 16 and 65 years are at an increased risk of HUS resulting from hemorrhagic colitis. We propose that adult female patients with hemorrhagic colitis should be carefully monitored regardless of their medical history, physical presentation, or laboratory data.- - - - - - - - - - ranking = 0.14461416385638keywords = physical (Clic here for more details about this article) |
6/22. Collagenous gastritis in a Korean child: a case report.Collagenous gastritis, a counterpart of collagenous colitis, is an extremely rare disorder. The first case of collagenous gastritis in a Korean boy in his pre-teens who had been receiving treatment for refractory iron deficiency anemia has been reported. The patient had been suffering from intermittent abdominal pain, recurrent blood-tinged vomiting and poor oral intake. The gastric endoscopy revealed diffuse cobblestone appearance of the mucosa with easy touch bleeding throughout the stomach but no abnormalities in the esophagus, duodenum, and colon. Pathologic examination of the gastric biopsies from the antrum, body and cardia showed a subepithelial collagen deposition with entrapped dilated capillaries, moderate infiltrates of lympho-plasma cells and eosinophils of the lamina propria, and marked hypertrophy of the muscularis mucosa. The collagen deposition appeared as discontinuous bands with focally irregular extension into the deeper part of the antral mucosa. It measured up to 150 microm. helicobacter pylori infection was not detected. The biopsies from the duodenum, esophagus and colon revealed no pathologic abnormalities.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
7/22. Ultrasonic and CT findings in penicillin-induced nonpseudomembranous colitis.The findings of ultrasonography (US) and computed tomography (CT) of the abdomen in two cases of nonpseudomembranous colitis (NPMC) induced by penicillin are described. Both imaging methods revealed diffuse thickening of the colon in patients who were endoscopically diagnosed as suffering from this disease. The clinical and radiographic features of this entity are presented along with a brief review of pertinent literature.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
8/22. Familial occurrence of collagenous colitis. A report of two families.Collagenous colitis is a rare condition characterized clinically by chronic diarrhea and histologically by a thickened subepithelial collagenous band in colonic biopsies in an endoscopically normal colon. Familial occurrence of collagenous colitis has to our knowledge never been described. Here we report two families in which two first-degree related members suffered from collagenous colitis. In one family, two sisters were affected by chronic diarrhea and autoimmune disorders such as thyroid disease, rheumatoid arthritis, and pernicious anemia. Collagenous colitis was diagnosed in one of these sisters, based on colonic biopsies. Colonic biopsies of the other sister showed microscopic colitis. review of colonic biopsies of this patient taken 11 years earlier, however, showed definite histological features of collagenous colitis. In the other family, in a father and son, both with diarrhea for several years but not suffering from any other diseases, a diagnosis of collagenous colitis was made on colonic biopsies. Human leukocyte antigen (HLA) typing showed that only the HLA A2 antigen was present in all 4 patients.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
9/22. cytomegalovirus cholecystitis and colitis associated with the acquired immunodeficiency syndrome.cytomegalovirus (CMV) is an important cause of acalculous gangrenous cholecystitis in immunocompromised persons. We report a case of acalculous acute cholecystitis and active colitis associated with CMV in a patient suffering from the acquired immune deficiency syndrome. The condition was treated successfully with surgery and 9-(1,3,-dihydroxy-2-propoxymethyl)guanine intravenously.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
10/22. Acute pancreatitis as a complication of Crohn's disease.Two cases of Crohn's disease coincidental with acute pancreatitis are described. Both patients were diagnosed as suffering from acute pancreatitis by hyperamlasemia and ultrasonography. Both had received a previous diagnosis of Crohn's ileocolitis. Crohn's disease was active in one patient at the onset of pancreatitis but was inactive in the other. We saw no factor that was obviously responsible for the pancreatitis in these patients. We also review other cases of Crohn's disease accompanied with pancreatitis that have been reported previously in the literature. In six cases, no cause was established for the pancreatitis, other than the Crohn's disease itself. We assume that pancreatitis, although rare, may be one of the extra-intestinal complications of Crohn's disease.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
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