RESUMO
Protein-losing gastroenteropathy (PLG) can occur as a manifestation of various diseases including autoimmune disorders, and optimal therapy of these underlying diseases may be the only effective remedy for PLG. In the present report, we describe a case of a 54-year-old woman with PLG associated with an autoimmune disease, presumably CREST syndrome. She failed to respond to steroid treatment. Subsequently, cyclosporine was initiated, which resulted in a rapid recovery. The patient was successfully treated with low-dose cyclosporine for five years. There has not been, to our knowledge, any report of PLG successfully treated with cyclosporine. Cyclosporine therapy may be effective not only in inducing but also in maintaining complete remission in patients with autoimmune-associated PLG, especially refractory or intolerable to steroids and/or immunosuppressive therapies.
Assuntos
Síndrome CREST/tratamento farmacológico , Ciclosporina/administração & dosagem , Imunossupressores/administração & dosagem , Enteropatias Perdedoras de Proteínas/diagnóstico , Enteropatias Perdedoras de Proteínas/tratamento farmacológico , Administração Oral , Biópsia por Agulha , Síndrome CREST/complicações , Síndrome CREST/diagnóstico , Síndrome CREST/imunologia , Relação Dose-Resposta a Droga , Esquema de Medicação , Duodeno/diagnóstico por imagem , Duodeno/patologia , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Assistência de Longa Duração , Pessoa de Meia-Idade , Enteropatias Perdedoras de Proteínas/complicações , Enteropatias Perdedoras de Proteínas/imunologia , Cintilografia , Medição de Risco , Índice de Gravidade de Doença , Estômago/diagnóstico por imagem , Estômago/patologia , Resultado do TratamentoAssuntos
Doença de Crohn/complicações , Volvo Intestinal/complicações , Adulto , Colonoscopia , Humanos , MasculinoRESUMO
A 36-year-old woman with ulcerative colitis presented with fever, chest and back pain, and fatigue sensation of the arm. Her upper limb pulses were absent. Angiography showed multiple aneurysms of the aorta and its branches, consistent with Takayasu's arteritis. She showed HLA-B35 but no B52, which is the typical haplotype among the coexistence cases of both diseases. Prednisolone was effective. The possible pathogenic association of the disorders is discussed.
Assuntos
Aneurisma Aórtico/imunologia , Ruptura Aórtica/imunologia , Colite Ulcerativa/imunologia , Arterite de Takayasu/imunologia , Adulto , Anti-Inflamatórios/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/tratamento farmacológico , Aneurisma Aórtico/etiologia , Ruptura Aórtica/etiologia , Aortografia , Colite Ulcerativa/complicações , Colite Ulcerativa/tratamento farmacológico , Evolução Fatal , Feminino , Hemorragia Gastrointestinal , Antígeno HLA-B35/imunologia , Humanos , Prednisolona/uso terapêutico , Pulso Arterial , Arterite de Takayasu/complicações , Arterite de Takayasu/tratamento farmacológicoAssuntos
Doença de Crohn , Úlcera , Adulto , Colo/patologia , Doença de Crohn/diagnóstico , Humanos , Masculino , Úlcera/diagnósticoRESUMO
To determine the effect of climbazole on hepatic microsomal cytochrome P450 (P450) and drug-metabolizing enzymes, four different P450 isoforms (CYP2B1, 3A2, 2E1, and 2C12) were examined in female Long-Evans rats. Treatment of rats with climbazole resulted in the induction of P450 content. Climbazole both induced and inhibited aminopyrine N-demethylase activity, but not erythromycin N-demethylase activity. Uridine 5'-phosphate (UDP)-glucuronosyl transferase and glutathione S-transferase activities were also increased with climbazole treatment. Immunoblot analyses revealed that climbazole induces CYP2B1 and CYP3A2 at the lower dose examined, but it failed to increase CYP2B1 at the higher dose. Northern blot analysis revealed that climbazole markedly increases P450 2B1 mRNA. These results indicate that climbazole induces and inhibits P450-dependent drug-metabolizing enzymes in vivo and may have the dose-differential effect on CYP2B1 in rat liver.