[Overlooked celiac disease in a 59-year old woman with severe osteomalacia]. / Overset cøliaki hos en 59-årig kvinde med svaer osteomalaci.

Coeliac disease in adults is an overlooked and undiagnosed illness. We present a case where a woman was diagnosed at the age of 59 despite symptoms suggestive of coeliac disease since childhood. At the time of diagnosis the patient had severe osteomalacia with multiple vertebral fractures of the thoracic and lumbar spine.

A case of multiple extra-adrenal pheochromocytomas.

A case report of a 37-year-old previously healthy man who contracted hypertension and insulin-dependent diabetes mellitus. Urinary catecholamine excretion was elevated. A total of nine benign pheochromocytomas with characteristic histological appearance were successfully removed. Most of the tumors were located extra-adrenally in the upper abdomen and in the pelvis. Two of the tumors were found in organ plexuses in the mesocolon sigmoideum and in the anterior wall of prostata. Because of asynchronous tumor growth a life-long follow-up is recommended.

Helicobacter pylori and risk of ulcer bleeding among users of nonsteroidal anti-inflammatory drugs: a case-control study.

BACKGROUND & AIMS: Peptic ulcer complications related to use of nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common serious adverse drug reactions. Whether Helicobacter pylori infection potentiates this gastrointestinal toxicity of NSAIDs is still unresolved. In this study, we investigated the role of H. pylori as a cause of bleeding peptic ulcer among NSAID users. METHODS: A case-control study of current users (n = 132) of NSAIDs (including acetylsalicylic acid), admitted because of bleeding peptic ulcer, was performed. Controls were 136 NSAID users without gastrointestinal complications. H. pylori was diagnosed by either increased levels of serum immunoglobulin G or by 13C-urea breath test. RESULTS: Fifty-eight (44%) case subjects had a bleeding gastric ulcer, 54 (41%) had a bleeding duodenal ulcer, 12 (9%) had both gastric and duodenal ulcers, and 8 (6%) had hemorrhagic gastritis. H. pylori was present in 75 (57%) cases compared with 59 (43%) controls. The adjusted odds ratio of bleeding peptic ulcer among NSAID users associated with H. pylori infection was 1.81 (95% confidence interval, 1.02-3.21). H. pylori accounted for approximately 24% of bleeding peptic ulcers among elderly NSAID users. CONCLUSIONS: NSAID users infected with H. pylori have an almost twofold increased risk of bleeding peptic ulcer compared with NSAID users without H. pylori.

Persistently increased intestinal fraction of alkaline phosphatase.

Persistent elevation of the intestinal fraction of the alkaline phosphatase (API) as an isolated finding has to our knowledge not been reported previously. It was found in a boy followed during a period of 5.5 years. The only symptom was transient periodic fatigue observed at home, but not apparent during hospitalization. His blood type was O, RH+, Le (a-, b+) and he was a secretor of H-substance, which may be associated with rising API activity after fat-loading. In this case API was unchanged after fat-loading. Neither intestinal nor liver diseases were found, and no other cause for the elevated phosphatase activity could be demonstrated.