Primary intestinal lymphangiectasia presenting as limb convulsions: A case report.

BACKGROUND: Primary intestinal lymphangiectasia (PIL) is a rare protein-losing enteropathy characterized by abnormally dilated lymphatic structures, resulting in leakage of lymph (rich in protein, lymphocytes, and fat) from the intestinal mucosal and submucosal layers and thus hypoproteinemia, lymphopenia, hypolipidemia, and pleural effusion. CASE SUMMARY: A 19-year-old Chinese male patient complained of recurrent limb convulsions for the last 1 year. Laboratory investigations revealed low levels of calcium and magnesium along with hypoproteinemia and high parathyroid hormone levels, whereas gastroscopy exhibited chronic non-atrophic gastritis and duodenal lymphatic dilatation. Subsequent gastric biopsy showed moderate chronic inflammatory cell infiltration distributed around a small mucosal patch in the descending duodenum followed by lymphatic dilatation in the mucosal lamina propria, which was later diagnosed as PIL. The following appropriate medium-chain triglycerides nutritional support significantly improved the patient's symptoms. CONCLUSION: Since several diseases mimic the clinical symptoms displayed by PIL, like limb convulsions, low calcium and magnesium, and loss of plasma proteins, it is imperative to conduct a detailed analysis to avoid any misdiagnosis while pinpointing the correct clinical diagnosis and simultaneously ruling out other clinical aspects in the reported cases without any past disease history. A careful assessment should always be made to ensure an accurate diagnosis in a timely manner so that the patient can be delivered quality health services for a positive health outcome.

GLP-1 expression in von Ebner's gland of diabetic rats.

GLP-1, a peptidergic endocrine hormone, which associate with appetite control, glucose homeostasis and satiety. It might play an important role in the gustatory system. We tried to investigate the expression of GLP-1 in von Ebner's gland of diabetic and control rats, and the ultrastructure changes on von Ebner's gland of diabetes rats. GLP-1 expression in von Ebner's gland was evaluated by immunohistochemistry. The number of GLP-1 positive cells in diabetic rat von Ebner's gland was significantly higher than that in normal controls. Electron micrographs showed that a series of pathologic changes in von Ebner's gland of diabetes rats. The results suggest that GLP-1 have some effects within the gustatory systems, and elevated von Ebner's gland GLP-1 expression may be one cause of diabetic taste impairment.

Expression of sulfonylurea receptors in rat taste buds.

To test the possibility that a fast-onset promoting agent repaglinide may initiate prandial insulin secretion through the mechanism of cephalic-phase insulin release, we explored the expression and distribution character of sulfonylurea receptors in rat taste buds. Twenty male Wistar rats aged 10 weeks old were killed after general anesthesia. The circumvallate papillae, fungiform papillae and pancreas tissues were separately collected. Immunohistochemical staining was used to detect the expression and distribution of sulfonylurea receptor 1 (SUR1) or sulfonylurea receptor 2 (SUR2) in rat taste buds. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to analyze the expression of SUR1 or SUR2 mRNA. The pancreatic tissues from the same rat were used as positive control. This is the first study to report that SUR1 is uniquely expressed in the taste buds of fungiform papillae of each rat tongue, while the expression of SUR1 or SUR2 was not detected in the taste buds of circumvallate papillae. SUR1 is selectively expressed in rat taste buds, and its distribution pattern may be functionally relevant, suggesting that the rapid insulin secretion-promoting effect of repaglinide may be exerted through the cephalic-phase secretion pathway mediated by taste buds.

Differential expression of connexin 43 in human autoimmune thyroid disease.

Gap junctions provide a pathway for cell-to-cell communication. Reduced thyroid epithelial cell-cell communication has been reported in some animal models of autoimmune thyroid disease. In order to assess whether this change was similar to human autoimmune thyroid disease, we identified some connexin proteins and their corresponding mRNA in human thyroid gland. The aim of our study was to explore the expression of connexin 43 (Cx43) in the thyroid gland from normal and diseased human thyroid tissue by immunohistochemistry and reverse transcription polymerase chain reaction (RT-PCR). The expression levels of Cx43 in Grave's disease were significantly increased in comparison with those of normal thyroid tissue. There was a significant decrease in expression of Cx43 in Hashimoto's thyroiditis, compared with normal thyroid tissue. These data indicate that changes of Cx43 expression in human autoimmune thyroid disease were associated with variations in thyroid function and hormone secretion.

Expression of alpha-gustducin in the circumvallate papillae of taste buds of diabetic rats.

Taste impairment is a complication of Diabetes mellitus and some studies have shown this taste disorder in diabetes. Diabetes can decrease the ability of individuals to detect and recognize sweet, salty and bitter tastes. alpha-Gustducin is a transducin-like G-protein selectively expressed in 20 - 30% of taste receptor cells, which has been shown to be involved in bitter, sweet and umami taste responses. The present study was performed to explore the protein and mRNA expression of alpha-gustducin in the taste buds of diabetic and control rat circumvallate papillae. Our results showed that the positive expression of alpha-gustducin in diabetic rat taste bud cells is higher than that in normal controls as shown by both immunohistochemistry and RT-PCR. There may be some variant of bitter, sweet or umami taste transduction during diabetes and that taste transduction variant may be one cause of diabetic taste impairment.

Expression of glucagon-like peptide-1 in the taste buds of rat circumvallate papillae.

Glucagon-like peptide-1 (GLP-1), a 30-amino-acid peptide hormone, is a typical peptide of the brain-gut axis and can affect the metabolism of various tissues and organs. GLP-1 is secreted by intestinal L cells in response to nutrient ingestion. Some studies have shown that taste signaling elements were co-expressed in enteroendocrine cells of the small intestine, and in particular by L-cells. The present study was performed to explore the protein and mRNA expression of GLP-1 in the taste buds of rat circumvallate papillae and to try to determine the significance of its secretion. GLP-1 immunoreactivity was observed in spindle-shaped taste bud cells, with positive cells displaying a characteristic distribution of reaction product that was confined to the cytosol. Reverse transcription polymerase chain reaction (RT-PCR) assay showed that GLP-1 mRNA was expressed in circumvallate papillae. The expression of GLP-1 suggests that it may play an important role in the taste stimulation of nutrients and gut hormone secretion.