ABSTRACT
Small bowel hemangiomas are benign congenital vascular lesions that can be asymptomatic or cause anemia, gastrointestinal bleeding, obstruction, or intestinal perforation. We report the case of a 75-year-old woman who, after years of study for iron-deficiency anemia, was diagnosed with a cavernous hemangioma of the jejunum by capsule endoscopy, which was confirmed after surgical resection.
Subject(s)
Anemia, Iron-Deficiency , Hemangioma, Cavernous , Hemangioma , Female , Humans , Aged , Anemia, Iron-Deficiency/etiology , Intestine, Small/diagnostic imaging , Hemangioma, Cavernous/complications , Hemangioma, Cavernous/diagnostic imaging , Hemangioma, Cavernous/surgery , JejunumABSTRACT
Vedolizumab is a monoclonal antibody that has demonstrated efficacy and a good safety profile in patients with inflammatory bowel disease. Varicella zoster virus encephalitis is a potentially serious complication not previously described with its use, highlighting the importance of vaccination, as well as early diagnosis and treatment of infections in this type of patients.
Subject(s)
Chickenpox , Encephalitis, Varicella Zoster , Herpes Zoster , Humans , Herpesvirus 3, Human , Herpes Zoster/chemically induced , Herpes Zoster/complications , Encephalitis, Varicella Zoster/complications , Encephalitis, Varicella Zoster/diagnosis , Antibodies, Monoclonal, Humanized/adverse effects , Chickenpox/complicationsABSTRACT
Recurrent abdominal pain is a common reason for consultation in Gastroenterology. The differential diagnosis includes hereditary angioedema (HAE), a rare disorder characterized by recurrent episodes of angioedema, without urticaria or pruritus, which most often affects the skin, but also mucosal tissues of the gastrointestinal tract, triggered by diverse factors such as infections, trauma, surgery, drugs, or stress. It is a disease with a difficult diagnosis due to its heterogeneous and transitory clinical features, so having a clinical suspicion in the appropriate context would allow the administration of a specific treatment and avoid unnecessary examinations. We present the case of a 19-year-old male followed-up for recurrent abdominal pain that, after numerous microbiological, endoscopic, and radiological examinations, complement tests were requested, obtaining low levels of C4 with increased levels of C1 inhibitor and reduced functional activity, being diagnosed with HAE type II.
Subject(s)
Angioedema , Angioedemas, Hereditary , Chronic Pain , Hereditary Angioedema Types I and II , Adult , Humans , Male , Young Adult , Abdominal Pain/etiology , Angioedemas, Hereditary/complications , Angioedemas, Hereditary/diagnosis , SkinABSTRACT
La enfermedad inflamatoria intestinal (EII) inducida por fármacos es una entidad clínica en aumento debido al uso frecuente de terapia inmunosupresora y biológica. Presentamos el caso de una paciente diagnosticada de enfermedad de Crohn durante el tratamiento con Ocrelizumab, anticuerpo monoclonal humanizado anti-CD20 aprobado para el tratamiento de la esclerosis múltiple. Se desconoce el mecanismo exacto por el que los fármacos inmunomoduladores pueden desencadenar EII, pero dado que la EII y la esclerosis múltiple son procesos incluidos dentro del espectro de enfermedades inmunomediadas, podríamos postular que el Ocrelizumab, al igual que otros anti-CD20 como el Rituximab o anti-TNF como Etanercept, pueda desencadenar o desenmascarar EII en pacientes genéticamente predispuestos. (AU)
Subject(s)
Humans , Male , Adult , Inflammatory Bowel Diseases , Multiple Sclerosis , Crohn Disease , TherapeuticsSubject(s)
Humans , Male , Aged , Gastrointestinal Hemorrhage/etiology , Intestinal Neoplasms , Neuroendocrine Tumors/complications , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/pathology , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Stomach NeoplasmsABSTRACT
Drug-induced inflammatory bowel disease (IBD) is a clinical entity on the rise due to the frequent use of immunomodulatory therapy. Here we report the case of Crohn's disease due to Ocrelizumab, a humanized anti-CD20 monoclonal antibody approved for the treatment of multiple sclerosis. The exact mechanism by which anti-CD20 antibodies can trigger IBD is unknown, but since IBD and multiple sclerosis are processes included within the spectrum of immunomediated diseases, we could suggest that Ocrelizumab could trigger IBD in genetically predisposed patients.
Subject(s)
Crohn Disease , Inflammatory Bowel Diseases , Multiple Sclerosis , Humans , Multiple Sclerosis/drug therapy , Crohn Disease/drug therapy , Immunologic Factors/pharmacology , Immunologic Factors/therapeutic use , Inflammatory Bowel Diseases/drug therapySubject(s)
Humans , Aortic Diseases/complications , Aortic Diseases/diagnostic imaging , Esophageal Fistula/complications , Esophageal Fistula/etiology , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Vascular Fistula/complications , Vascular Fistula/diagnostic imaging , Endoscopy , ThoraxABSTRACT
Primary aortoesophageal fistula, an abnormal communication between native aorta and oesophagus, is an extremely rare cause of upper gastrointestinal bleeding. The typical symptoms, known as the Chiari´s triad, are only present in 45% of cases. It has a high mortality, so early diagnosis is essential to increase the probability of survival. We present a case report of a patient with massive upper gastrointestinal bleeding due to primary aortoesophageal fistula.
Subject(s)
Aortic Diseases , Esophageal Fistula , Vascular Fistula , Aortic Diseases/complications , Aortic Diseases/diagnostic imaging , Endoscopy , Esophageal Fistula/complications , Esophageal Fistula/etiology , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Humans , Thorax , Vascular Fistula/complications , Vascular Fistula/diagnostic imagingABSTRACT
Human papillomavirus (HPV) infection is one of the most frequent sexually transmitted infections in the world, with great importance due to its oncogenic potential. Both the risk of infection and the development of neoplasia are increased in people with human immunodeficiency virus (HIV) infection, so HPV vaccination should be recommended in these patients.
Subject(s)
Anus Neoplasms , Carcinoma, Squamous Cell , Condylomata Acuminata , HIV Infections , Papillomavirus Infections , Anus Neoplasms/complications , Anus Neoplasms/pathology , Carcinoma, Squamous Cell/complications , Condylomata Acuminata/complications , Condylomata Acuminata/pathology , HIV Infections/complications , Human papillomavirus 16 , Humans , Immunocompromised Host , Papillomaviridae , Papillomavirus Infections/complicationsABSTRACT
Neuroendocrine tumors (NETs) are heterogeneous, slow-growing tumors whose most common locations are lung, gastrointestinal tract, and pancreas.
Subject(s)
Ileal Neoplasms , Neuroendocrine Tumors , Pancreatic Neoplasms , Gastrointestinal Hemorrhage/etiology , Humans , Ileal Neoplasms/complications , Ileal Neoplasms/diagnostic imaging , Intestinal Neoplasms , Neuroendocrine Tumors/complications , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/pathology , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Stomach NeoplasmsABSTRACT
BACKGROUND AND AIMS: The effectiveness of systemic treatment in advanced hepatocellular carcinoma (HCC) depends on the selection of patients, management of cirrhosis complications and expertise to treat adverse events. The aims of the study are to assess the frequency and management of cardiovascular events in HCC patients treated with sorafenib (SOR) and to create a scale to predict the onset of major adverse cardiovascular events (MACE). METHOD: Observational retrospective study with consecutive HCC patients treated with SOR between 2007 and 2019 in a western centre. In order to classify cardiovascular risk pre-SOR, we designed the CARDIOSOR scale with age, hypertension, diabetes, dyslipidaemia and peripheral vascular disease. Other adverse events, dosing and outcome data were collected during a homogeneous protocolled follow-up. RESULTS: Two hundred ninety-nine patients were included (219 BCLC-C). The median overall survival was 11.1 months (IQR 5.6-20.5), and duration of treatment was 7.4 months (IQR 3.3-14.7). Seventeen patients (6%) stopped SOR due to cardiovascular event. Thirty-three patients suffered MACE (7 heart failure, 11 acute coronary syndrome, 12 cerebrovascular accident and 8 peripheral vascular ischemia); 99 had a minor cardiovascular event, mainly hypertension (n = 81). Age was the only independent factor associated to MACE (HR 1.07; 95% CI 1.03-1.12; P = .002). The CARDIOSOR scale allows to identify the group of patients with higher risk of MACE (sHR 3.4; 95% CI 1.4-6.7; P = .04). CONCLUSION: The incidence of cardiovascular events in HCC patients treated with SOR is higher than expected. Multidisciplinary approach and clinical tools like CARDIOSOR scale could be helpful to manage these patients.
Subject(s)
Antineoplastic Agents , Carcinoma, Hepatocellular , Cardiovascular Diseases , Liver Neoplasms , Antineoplastic Agents/adverse effects , Carcinoma, Hepatocellular/drug therapy , Cardiovascular Diseases/chemically induced , Cardiovascular Diseases/epidemiology , Humans , Liver Neoplasms/drug therapy , Niacinamide/adverse effects , Phenylurea Compounds/adverse effects , Retrospective Studies , Sorafenib/therapeutic use , Treatment OutcomeABSTRACT
Acute hemorrhagic gastropathy is characterized by the presence of acute gastrointestinal mucosal lesions (AGML) induced by irritation or ischemia due to exogenous or endogenous factors. Most frequent endoscopy findings include mucosal congestion, hyperemia, petechiae, acute hemorrhagic erosions and superficial ulceration. We report the case of diffuse hemorrhagic gastropathy caused by necrotizing acute pancreatitis.