RESUMO
Intrahepatic cholestasis of pregnancy (ICP) is a liver condition commonly occurring during pregnancy, with an unclear etiology. This condition not only causes significant discomfort for the mother due to severe itching but also poses serious risks to the fetus. Effective and timely management of ICP, including diagnosis, consistent monitoring, and treatment, is crucial to mitigate maternal discomfort and prevent fetal complications. The challenges in managing ICP include the absence of clear initial diagnostic criteria, delays in lab results, evolving treatment guidelines, and the financial burden of therapy. This case report shares the author's personal encounter with ICP, detailing the diagnosis, treatment pathway, impacts on the newborn, and the emotional journey during and after pregnancy. This report aims to enhance understanding and awareness of ICP, particularly among populations in the United States where the disease is less prevalent.
RESUMO
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by inflammation and eosinophilic accumulation of the esophagus, resulting in dysphagia and food impaction. While the exact etiology of EoE remains unclear, it is believed to be triggered by food allergens and dynamic environmental factors, resulting in various clinical manifestations, from inflammation to fibrosis. Although clinical presentation varies with age, the number of eosinophils in esophagogastroduodenal endoscopy remains the diagnostic gold standard. While diet elimination, proton pump inhibitors (PPIs), topical corticosteroids, and biological therapy are promising treatment options for EoE, there are insufficient data to determine the optimal therapeutic treatment approach. Combination therapies - the use of dietary therapies in conjunction with other treatment modalities, such as PPIs, topical corticosteroids, or biologic agents - have also emerged as a potential management strategy for EoE. In this systematic review, we attempt to highlight the recent advances in EoE therapies and provide updated guidance to their management. From 2017 to 2022, we conducted a comprehensive electronic search of PubMed (MEDLINE) using specific keywords related to our objective and eventually included a total of 44 articles.