RESUMEN
Extraintestinal manifestations, e.g. of the skin, joints or liver, are frequently found in Crohn's disease. We report about a 26-year-old female patient with longstanding Crohn's disease, who was admitted to our hospital with suspicion of an acute attack with suggestive symptoms and increased significantly inflammatory parameters. Shortly before, symptomatic COVID-19 disease (SARS-CoV-2 variant omicron) had been made. Comprehensive endoscopic and imaging diagnostics ruled out active Crohn's disease. However, inflammatory thickening of the aortic arch was seen, and a diagnosis of Takayasu arteritis (type II b) was made. Steroid therapy resulted in a rapid and sustained improvement of clinical symptoms. The occurrence of Takayasu arteritis is extremely rare outside Japan. An coincidence has been described in chronic inflammatory bowel diseases and is discussed as a possible extraintestinal manifestation. The occurrence of immune-mediated disease after COVID-19 disease has been described and may be triggered by the infection. Patients with inflammatory bowel disease may represent a special risk population.
Asunto(s)
COVID-19 , Enfermedad de Crohn , Arteritis de Takayasu , Humanos , Femenino , COVID-19/complicaciones , COVID-19/diagnóstico , Adulto , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/diagnóstico , Arteritis de Takayasu/complicaciones , Arteritis de Takayasu/tratamiento farmacológico , Diagnóstico DiferencialRESUMEN
[This corrects the article DOI: 10.1155/2014/438697.].
RESUMEN
Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.
Asunto(s)
Adenocarcinoma/secundario , Endocarditis/diagnóstico , Enfermedades de las Válvulas Cardíacas/diagnóstico , Neoplasias Hepáticas/secundario , Neoplasias Pancreáticas/patología , Síndromes Paraneoplásicos/patología , Trombosis/diagnóstico , Adenocarcinoma/diagnóstico por imagen , Anciano , Diagnóstico Diferencial , Ecocardiografía , Resultado Fatal , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Neoplasias Pancreáticas/diagnóstico por imagen , Síndromes Paraneoplásicos/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Síndrome Hepatopulmonar/etiología , Síndrome Hepatopulmonar/cirugía , Derivación Portosistémica Intrahepática Transyugular , Sarcoidosis Pulmonar/complicaciones , Disnea/etiología , Femenino , Síndrome Hepatopulmonar/fisiopatología , Humanos , Hipoxia/etiología , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno , Sarcoidosis Pulmonar/fisiopatologíaRESUMEN
South Africa has the highest number of HIV-1-infected individuals in the world, with HIV-1 subtype C prevailing. However, HIV-1 subtype C accessory genes are rarely characterized in the country. These genes are important for establishing viral pathogenesis. The Vif protein has been shown to counteract the antiretroviral activity of APOBEC3G/F cytidine deaminases. In this study an additional 50 HIV-1 vif sequences are characterized. These include 48 HIV-1 subtype C and 2 HIV-1 subtype B sequences. Highly conserved HIV-1 subtype C motifs are outlined. The previously identified RLRR (90-93) motif does not seem to be conserved among our newly analyzed sequences. Conserved motifs can be useful for developing new vaccine strategies or antiretroviral drugs.