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1.
Ann Allergy Asthma Immunol ; 124(3): 219-226, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31778820

RESUMO

OBJECTIVE: To review novel therapeutics in development for treatment of eosinophilic gastrointestinal disorders (EGIDs). DATA SOURCES: Clinical trial data (clinicaltrials.gov) and literature search on PubMed. STUDY SELECTIONS: Studies on treatment and clinical trials in EGIDs were included in this review. RESULTS: During the past decade, significant progress has been made in understanding disease mechanisms in EGIDs. As a result, a variety of novel therapeutics have been developed for treatment of these disorders. Several monoclonal antibodies against targets, including interleukin (IL) 4, IL-5, IL-13, integrins, and siglec-8, have shown promise in early trials. Novel formulations of corticosteroids are also in development. CONCLUSION: The field of EGID research has advanced rapidly, and disease-modifying therapeutics are closer to clinical application.


Assuntos
Enterite/terapia , Eosinofilia/terapia , Gastrite/terapia , Terapia Biológica , Biomarcadores , Ensaios Clínicos como Assunto , Terapia Combinada , Gerenciamento Clínico , Suscetibilidade a Doenças , Enterite/diagnóstico , Enterite/etiologia , Enterite/metabolismo , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Eosinofilia/metabolismo , Gastrite/diagnóstico , Gastrite/etiologia , Gastrite/metabolismo , Humanos , Terapia de Alvo Molecular , Padrão de Cuidado , Resultado do Tratamento
2.
Acta Chir Belg ; 120(1): 53-56, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30139299

RESUMO

Acute necrotizing gastritis, which appears to be a variant of phlegmonous gastritis is the rarest cause of gastric necrosis. We report a case of a 57-year-old female patient with an acute necrotizing gastritis caused by a Group A ß-hemolytic streptococcus. The case presented herein is of unusual interest because only a limited number of case reports on this etiology have been published. Diagnosing infectious necrotizing gastritis remains complex because of its rarity and nonspecific clinical presentation. Nevertheless, prompt diagnosis is of high importance because necrotizing gastritis can progress rapidly into a more advanced stage causing septic shock or even death. In our opinion, early resection of necrotic gastric wall combined with adequate antimicrobial therapy is the cornerstone in treatment of necrotizing gastritis. We will present a case in which adequate medical treatment was not successful.


Assuntos
Gastrite/microbiologia , Gastrite/terapia , Infecções Estreptocócicas/patologia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes , Doença Aguda , Feminino , Gastrite/patologia , Humanos , Pessoa de Meia-Idade , Necrose
3.
Medicine (Baltimore) ; 98(51): e18365, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860996

RESUMO

INTRODUCTION: Cyclic vomiting syndrome (CVS) is a potentially exhausting disorder and has an adverse impact on quality of life, but it is poorly recognized and is always misdiagnosed leading to a diagnostic delay of several years, especially in adults. PATIENT CONCERNS: We report a case of a 32-year-old woman with recurrent severe nausea, vomiting, and abdominal pain, and repeated visits to the emergency department or the outpatient department for 4 years. Each time she was diagnosed with gastroenteritis or gastritis, and recovered after supportive treatment including antiemetics, maintenance of water and electrolyte balance, and a proton pump inhibitor. DIAGNOSIS: Laboratory examinations, gastroenteroscopy, chest and abdominal computed tomography, and brain magnetic resonance imaging all failed to reveal abnormalities that would explain her symptoms. Based on typical symptoms and the exclusion of other diseases associated with repeated vomiting, the diagnosis was made as CVS. INTERVENTIONS: She was given orally amitriptyline, 50 mg per night, and olanzapine, 1.25 mg per night. OUTCOMES: The treatment was effective in inducing remission, and symptoms did not recur after treatment. The treatment lasted for 2 months and stopped. Her symptoms did not recur over the 10-month follow up. CONCLUSION: CVS is not rare in adults, but its diagnosis is usually delayed due to poor recognition of the condition. Clinician awareness of CVS should be enhanced to improve early diagnosis.Core tip: Cyclic vomiting syndrome has a tremendous impact on the quality of life, but it is poorly recognized and is always misdiagnosed leading to a diagnostic delay of several years, especially in adults. The article presented a case report of cyclic vomiting syndrome of adult; we hope the article will attribute to increased awareness of physician and reduce delayed diagnosis.


Assuntos
Gastrite/diagnóstico , Gastrite/terapia , Vômito/diagnóstico , Vômito/terapia , Dor Abdominal/etiologia , Adulto , Antieméticos/uso terapêutico , Doença Crônica , Diagnóstico Precoce , Feminino , Humanos , Náusea/etiologia , Inibidores da Bomba de Prótons/uso terapêutico , Recidiva , Síndrome , Equilíbrio Hidroeletrolítico
5.
Klin Lab Diagn ; 64(8): 484-489, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31479604

RESUMO

The aim of research was to evaluate the effectiveness of the effect of eradication therapy on the cytokine status of gastric juice in patients with chronic non-atrophic gastritis (CNG) and duodenal ulcer (DU) associated with Helicobacter pylori. Clinical observations and laboratory-instrumental studies performed in 95 patients aged 20 to 55 years with CNG and duodenal ulcer with determination of cytokine content of IL-1ß, IL-6 and TNF-α in the fasting portion of gastric juice. The most pronounced decrease in the content of proinflammatory cytokines in gastric juice on the background of treatment was found in patients of the 1st group who received combined therapy according to the scheme omeprazole + clarithromycin + amoxicillin. Analysis of the content of proinflammatory cytokines (IL-1ß, IL-6 and TNF-α) in gastric juice in patients with acute exacerbation showed that their concentration in all 8 patients after the course of therapy exceeded the norm (P < 0.05) and was IL -1ß - 30,30 + 1,15 pg/l, IL-6 - 10,4 + 0,83 pg / l and TNF-α - 32,5 + 1,13 pg / l. At the same time, the level of proinflammatory cytokines in gastric juice correlated with the degree of dissemination of H. pylori in the mucosa of the gastroduodenal zone. Helicobacter pylori infection in inflammation and ulceration in the mucous membrane of the stomach and duodenum, possibly in addition to other mechanisms, affects the activation of pro-inflammatory cytokines (IL-1beta, IL-6, TNF-alpha) in gastric juice. Incomplete eradication of H. Pylori after treatment during clinical endoscopic remission in patients with duodenal ulcer in the vast majority of cases is accompanied by the preservation of an increased level of pro-inflammatory cytokines in gastric juice, which may be one of the reasons for the relapse of the disease.


Assuntos
Citocinas/análise , Suco Gástrico/química , Gastrite/terapia , Infecções por Helicobacter/terapia , Adulto , Mucosa Gástrica , Gastrite/microbiologia , Helicobacter pylori , Humanos , Pessoa de Meia-Idade , Adulto Jovem
6.
Zhongguo Zhen Jiu ; 39(6): 615-8, 2019 Jun 12.
Artigo em Chinês | MEDLINE | ID: mdl-31190498

RESUMO

OBJECTIVE: To explore the specificity of the relevant points along the governor vessel in chronic gastritis through the synchronous observation of the tenderness reaction and tenderness threshold on the back along the governor vessel in the volunteers with chronic gastritis and make the comparison with healthy volunteers. METHODS: A chronic gastritis group and a healthy volunteer group were prepared, 30 cases in each one. Using synchronous comparison, the tenderness reaction at the point inferior to each of the spinous processes from T1 to L3 along the governor vessel was observed. The mechanical pressure pain threshold was determined. RESULTS: Regarding the tenderness reaction at the point inferior to each spinous process on the back along the governor vessel, the occurrence rate was different significantly between the chronic gastritis group and the healthy volunteer group (P<0.01). The tenderness threshold at the point inferior to each spinous process from T1 to L3 along the governor vessel in the chronic gastritis group was lower than the healthy volunteer group, the tenderness thresholds from T4 to T9 and T12 were different significantly between the two groups (P<0.01, P<0.05). The tenderness reaction at the point inferior to each spinous process on the back along the governor vessel presented the significant negative correlation with the tenderness threshold in the chronic gastritis group (P<0.01), and the correlation was not displayed in the healthy volunteer group (P>0.05). CONCLUSION: The point inferior to the spoinous process of T4 on the governor vessel, Shendao (GV 11, T5) and Lingtai (GV 10, T6) are the points with the high specificity in chronic gastritis, which provides the reference to clinical treatment with acupuncture and moxibustion. The occurrence rate of high tenderness reaction and the low tenderness threshold may be the important manifestation of the point specificity on the back along the governor vessel in chronic gastritis.


Assuntos
Terapia por Acupuntura , Gastrite , Moxibustão , Pontos de Acupuntura , Gastrite/terapia , Humanos , Pressão , Sensibilidade e Especificidade
7.
Aliment Pharmacol Ther ; 49(9): 1134-1172, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30924176

RESUMO

BACKGROUND: Functional dyspepsia, consisting of epigastric pain syndrome and postprandial distress syndrome, is a prevalent functional gastrointestinal disorder. To date, only limited treatment options are available and conflicting results in terms of efficacy have been reported. Consequently, nonpharmacological treatment options are increasingly being explored for functional dyspepsia. AIM: To provide an overview of current pharmacological and nonpharmacological treatment options for functional dyspepsia. METHODS: A literature search was conducted on Pubmed and other sources to identify relevant studies. RESULTS: Acid suppressive therapy reduced symptoms in 30%-70% of the patients, with higher benefit in epigastric pain syndrome and superior effectiveness for proton pump inhibitors compared to H2 -antagonists. Prokinetic agents, primarily used to treat postprandial distress syndrome, showed variable efficiency: 59%-81% responder rate for dopamine receptor antagonists, 32%-91% for serotonin-4-receptor agonists and 31%-80% for muscarinic receptor antagonists. H Pylori eradication, recommended in infected patients, was effective in 24%-82%. Refractory symptoms are addressed with neuromodulators. However, their efficacy in functional dyspepsia remains incompletely elucidated, available data showing symptom reduction in 27%-71% of the patients. Regarding herbal agents, peppermint oil reduced symptoms in 66%-91%, rikkunshito in 29%-34% and iberogast in 20%-95%. Lastly, acupuncture, cognitive behavioural therapy and hypnotherapy may help to provide symptom control, but research on their efficacy remains sparse. CONCLUSIONS: None of the available therapies is effective in the majority of patients without being associated with major side effects. Developing new treatment options is challenging due to the heterogeneity of functional dyspepsia, the lack of readily identified target mechanisms and the poor association between pathophysiological disturbances and symptoms.


Assuntos
Dispepsia/terapia , Dor Abdominal/terapia , Anti-Infecciosos/uso terapêutico , Terapias Complementares/métodos , Terapias Complementares/tendências , Dispepsia/diagnóstico , Dispepsia/fisiopatologia , Gastrite/microbiologia , Gastrite/fisiopatologia , Gastrite/terapia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Antagonistas dos Receptores Histamínicos H2/uso terapêutico , Humanos , Manejo da Dor/métodos , Fitoterapia/métodos , Fitoterapia/tendências , Período Pós-Prandial/efeitos dos fármacos , Inibidores da Bomba de Prótons/uso terapêutico
8.
Clin Rev Allergy Immunol ; 57(2): 272-285, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30903439

RESUMO

Eosinophilic gastrointestinal disorders (EGID) are a group of disorders characterized by pathologic eosinophilic infiltration of the esophagus, stomach, small intestine, or colon leading to organ dysfunction and clinical symptoms (J Pediatr Gastroenterol Nutr; Spergel et al., 52: 300-306, 2011). These disorders include eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), eosinophilic enteritis (EE), and eosinophilic colitis (EC). Symptoms are dependent not only on the location (organ) as well as extent (layer invasion of the bowel wall). Common symptoms of EoE include dysphagia and food impaction in adults and heartburn, abdominal pain, and vomiting in children. Common symptoms of the other EGIDs include abdominal pain, nausea, vomiting, early satiety, diarrhea, and weight loss. These disorders are considered immune-mediated chronic inflammatory disorders with strong links to food allergen triggers. Treatment strategies focus on either medical or dietary therapy. These options include not only controlling symptoms and bowel inflammation but also on identifying potential food triggers. This chapter will focus on the clinical presentation, pathophysiology, and treatment of these increasingly recognized disorders.


Assuntos
Enterite/epidemiologia , Enterite/terapia , Eosinofilia/epidemiologia , Eosinofilia/terapia , Esofagite Eosinofílica/epidemiologia , Esofagite Eosinofílica/terapia , Gastrite/epidemiologia , Gastrite/terapia , Adolescente , Corticosteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Biológica , Criança , Pré-Escolar , Dietoterapia , Enterite/diagnóstico , Enterite/fisiopatologia , Eosinofilia/diagnóstico , Eosinofilia/fisiopatologia , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/fisiopatologia , Feminino , Gastrite/diagnóstico , Gastrite/fisiopatologia , Predisposição Genética para Doença , Humanos , Fatores Imunológicos/uso terapêutico , Lactente , Masculino , Pessoa de Meia-Idade , Inibidores da Bomba de Prótons/uso terapêutico , Fatores Sexuais , Adulto Jovem
10.
Acta Paediatr ; 108(1): 154-159, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30054943

RESUMO

AIM: This study assessed the prevalence, clinical presentation and outcome of lymphocytic colitis (LC) and eosinophilic gastrointestinal disease (EGID) in children with severe, recurrent abdominal pain (RAP), by describing the predominant symptoms, diagnostic approaches and treatment options. METHODS: We performed a retrospective follow-up study at a Danish regional hospital by reviewing the histology reports of the children who had undergone gastrointestinal endoscopy for RAP. Data were retrieved from the medical records of those who met the diagnostic criteria for LC and, or, EGID from 2011 to 2016. The study population comprised 381 patients who underwent a diagnostic process to clarify RAP. RESULTS: A total of 74 patients (39 females) aged 2-17 years, with severe RAP as the most predominant symptom underwent gastrointestinal endoscopy. This identified 16/74 (21.6%) with LC (n = 6) and, or, EGID (n = 11), which equated to 4.2% with RAP. No biochemical patterns of abnormalities were found. Medical treatment and, or, diet generally induced and maintained clinical remission. CONCLUSION: We found 16 children with LC and, or, EGID. The predominant symptom was severe RAP. All patients had a macroscopically normal mucosa at endoscopy, a specific histopathological feature and no characteristic biochemical findings. Endoscopy should be considered in these cases.


Assuntos
Dor Abdominal/diagnóstico , Colite Linfocítica/diagnóstico , Dieta , Endoscopia Gastrointestinal/métodos , Enterite/diagnóstico , Eosinofilia/diagnóstico , Gastrite/diagnóstico , Dor Abdominal/epidemiologia , Adolescente , Fatores Etários , Assistência Ambulatorial , Budesonida/uso terapêutico , Criança , Pré-Escolar , Colite Linfocítica/epidemiologia , Colite Linfocítica/terapia , Estudos Transversais , Dinamarca , Enterite/epidemiologia , Enterite/terapia , Eosinofilia/epidemiologia , Eosinofilia/terapia , Feminino , Seguimentos , Mucosa Gástrica/patologia , Gastrite/epidemiologia , Gastrite/terapia , Humanos , Mucosa Intestinal/patologia , Masculino , Prednisolona/uso terapêutico , Recidiva , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento
11.
Int J Med Mushrooms ; 21(11): 1137-1150, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32450023

RESUMO

Hericium erinaceus (HE) is an edible and medicinal mushroom traditionally used for the treatment of gastric injury in clinical practice. However, scientific evidence of its pharmacological activities has not yet been revealed. This study was designed to investigate the therapeutic effect of HE mycelia in submerged culture on ethanol-induced chronic gastric injury (ECGI) in mice. Gastric injury model was induced by ethanol with chronic and binge ethanol feeding in mice, and then mice were treated with HE mycelia. The stomachs were removed for histopathological examination and inflammatory cytokines measurement. Meanwhile, total proteins of gastric tissue were analyzed by isobaric tags for relative and absolute quantification (iTRAQ) labeling analysis to quantitatively identify differentially expressed proteins (DEPs) in three groups of animals. Bioinformatics analysis of DEPs was conducted through clustering analysis, Venn analysis, Gene Ontology (GO) annotation enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways enrichment. The histopathologic characteristics and biochemical data showed that HE mycelia (0.5 and 1.0 g/kg) exhibited therapeutic effects on the ECGI mice. Based on the results of iTRAQ analysis, a total of 308 proteins were differentially expressed in the ethanol group when compared with the control group; 205 DEPs in the high dose of HE (HEH) group when compared with control group; and 230 DEPs in HE group (1.0 g/kg) when compared with ethanol group. KEGG analysis showed that the p53 signaling pathway was closely related to the therapeutic effect of HE mycelia on ECGI. Furthermore, the expression levels of several DEPs, including keratin (KRT) 16, KRT6b and transglutaminase E (TGE), were verified by quantitative real-time polymerase chain reaction (qRT-PCR). In conclusion, H. erinaceus mycelia could relieve ethanol-induced chronic gastric injury in mice by ameliorating inflammation as well as regulating epidermal differentiation.


Assuntos
Agaricales , Alcoolismo/complicações , Terapia Biológica/métodos , Doença Crônica/terapia , Gastrite/terapia , Micélio , Animais , Modelos Animais de Doenças , Gastrite/patologia , Perfilação da Expressão Gênica , Histocitoquímica , Camundongos , Resultado do Tratamento
12.
São Paulo; s.n; 2019. 19 p.
Tese em Português | HomeoIndex - Homeopatia | ID: biblio-996571

RESUMO

Gastrite é a inflamação das paredes do estômago. Por meio de inúmeras causas, há um enfraquecimento da mucosa estomacal, permitindo que suco digestivo possa provocar dano a parede, através da quebra da barreira mucosa. Ela pode ser classificada em aguda ou crônica, e o tratamento é sempre medicamentoso. Geralmente nos casos agudos, podemos relacionar a um agente causador medicamentoso, infeccioso ou estressor - físico ou psíquico. Apesar do tratamento medicamentoso convencional, em alguns casos, o paciente ainda pode apresentar-se sintomático. Este presente relato de caso, diz respeito a um paciente que apesar do tratamento convencional, apresentava-se sintomático. A causa principal do seu problema, era atribuída principalmente ao estresse psíquico. Desta maneira, resolveu procurar a homeopatia, como medicina complementar. O tratamento homeopático, individualizado, mostrou ser muito eficaz no caso apresentado, com melhora dos sintomas iniciais da epigastralgia e também, de sintomas secundários, que não foram, motivadores da consulta. (AU)


Assuntos
Humanos , Masculino , Adulto , Strychnos nux-vomica/uso terapêutico , Homeopatia , Coffea Cruda , Natrium Muriaticum , Gastrite/terapia
13.
Arq Gastroenterol ; 55(3): 279-282, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30540092

RESUMO

BACKGROUND: Helicobacter pylori (H. pylori) has been introduced by since 1983 by Marshal and Warren to play the main role in the pathophysiology of gastritis and gastric ulcers. Almost half of the world population1 is infected by H. pylori. Current therapeutic regimen against H. pylori includes the use of a proton pump inhibitor plus two or more antibiotics. However, the efficacy of this regimen is decreasing mainly due to antibiotic resistance and side effects of medications. This fact has resulted in public interest in other therapeutic options and the role of probiotics merits special attention in this regard. OBJECTIVE: This study aims to evaluate the efficacy of honey-derived Lactobacillus rhamnosus on H. pylori-induced gastric inflammation and gastro-intestinal infection in C57BL/6 Mice. METHODS: The 24 C57BL/6 Mice were randomly divided into three groups of eight mice each. All the mice were fed with 1cc suspension containing 5*1010 CFU/ mL of ATCC43504 strains of H. pylori for 3 consecutive days, twice daily via polyethylene gavage tubes. At the end of 4th week, infection with H. pylori was confirmed with stool Ag (ELISA) and following sacrifice of one mouse from each group, histopathologic study confirmed gastritis. The groups were subjected to different therapies as stated, 1: without Bismuth (Bi), Omeprazole (Om) and L. rhamnosus prescription, 2: Bi, Om and Clarithromycin (Cl) and 3: Bi, Om plus 1cc of suspension of 109 CFU/mL of L. rhamnosus. After 2 weeks, the stool was analyzed for Ag and the mice were sacrificed for evaluation of histopathologic changes. RESULTS: Treatment with L. rhamnosus group provided Zero titer of stool Ag and was associated with improved gastric inflammation in all subjects, similar to the clarithromycin group. CONCLUSION: Honey-derived L. rhamnosus probiotics provides similar results as clarithromycin in terms of improvement of H. pylori infection and gastritis in C57BL/6 Mice model, without its cons of antibiotic resistance.


Assuntos
Gastrite/terapia , Infecções por Helicobacter/terapia , Helicobacter pylori , Mel/microbiologia , Lactobacillus rhamnosus , Probióticos/uso terapêutico , Animais , Antibacterianos/farmacologia , Claritromicina/farmacologia , Contagem de Colônia Microbiana , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Masculino , Camundongos Endogâmicos C57BL , Distribuição Aleatória , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento
14.
Medicine (Baltimore) ; 97(51): e13535, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30572453

RESUMO

RATIONALE: Radiation-induced hemorrhagic gastritis is an infrequent cause of upper gastrointestinal bleeding and difficult to manage. The current standard treatment has not been well established. PATIENT CONCERNS: We described a 32-year-old male patient with hemorrhagic gastritis induced by external radiotherapy for hepatocellular carcinoma recurrence. DIAGNOSES: The endoscopic examination showed a diffuse area of bleeding in the gastric antrum. INTERVENTIONS: After failure of conventional hemostasis treatment, we successfully stopped the hemorrhage with repeated endoscopic argon plasma coagulation (APC) combined with low-dose polyglycerol sclerotherapy. OUTCOMES: The patient was followed up for 6 months to date without recurrence. LESSONS: Based on this case, we think that endoscopic APC combined with low-dose polidocanol sclerotherapy can be tried as a treatment for potentially life-threatening radiation-induced hemorrhagic gastritis.


Assuntos
Coagulação com Plasma de Argônio , Endoscopia do Sistema Digestório , Gastrite/terapia , Hemorragia Gastrointestinal/terapia , Lesões por Radiação/terapia , Escleroterapia , Adulto , Carcinoma Hepatocelular/radioterapia , Gastrite/diagnóstico por imagem , Gastrite/etiologia , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Humanos , Neoplasias Hepáticas/radioterapia , Masculino , Recidiva Local de Neoplasia/radioterapia , Lesões por Radiação/diagnóstico por imagem
15.
Nihon Shokakibyo Gakkai Zasshi ; 115(9): 797-803, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-30197393

RESUMO

We performed a retrospective analysis on three patients diagnosed with EGE (eosinophilic gastroenteritis) at our hospital and 90 cases obtained from a case database. The cases' genders, ages, peripheral eosinophils, ascites, endoscopic findings, biopsy findings, diagnostic scores, and rates of glucocorticoid use were evaluated. The gender ratio was 40 males to 53 females, and the median age was 50. 78.5% of cases had peripheral eosinophilia. The prevalence of allergic diseases was 31.2%, and the incidence of ascites was 34.4%. 83.9% of endoscopic findings were positive, and 92.5% of biopsies were positive. The total rate of glucocorticoid use was 77.4%. When both score <5 and age <33 conditions were met, the rate of glucocorticoid use was approximately 30%, meaning it was possible to avoid glucocorticoid use.


Assuntos
Enterite/terapia , Eosinofilia/terapia , Gastrite/terapia , Adulto , Ascite , Enterite/epidemiologia , Eosinofilia/epidemiologia , Feminino , Gastrite/epidemiologia , Gastroenterite , Humanos , Masculino , Estudos Retrospectivos
16.
J Allergy Clin Immunol Pract ; 6(5): 1483-1495, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30201096

RESUMO

The eosinophilic gastrointestinal diseases (EGIDs) represent disorders of the gastrointestinal (GI) tract that result from the local infiltration and aberrant activity of eosinophils and other immune cells. Eosinophilic esophagitis (EoE) is the most well-characterized EGID and is defined by the presence of intraepithelial eosinophils in the esophagus (≥15 eosinophils per high-powered field) and clinical symptoms associated with esophageal dysfunction. The other EGIDs are rare and lack strong data regarding pathogenesis and management. The incidence and prevalence of EoE are increasing, and EoE is now a major cause of upper GI morbidity. Management is multidisciplinary, with collaboration between gastroenterologists, allergists, pathologists, and dieticians, and is aimed at amelioration of symptoms and prevention of long-term complications such as esophageal stricture. Treatment options for EoE include proton pump inhibitors, swallowed topical corticosteroids, and elimination diets. Esophageal dilation is used when esophageal strictures or fibrostenotic changes are present. Additional therapies targeting eosinophils and other mediators of Th2 inflammation are under development and are promising. Treatment options for other EGIDs typically involve corticosteroids or dietary elimination.


Assuntos
Enterite/diagnóstico , Eosinofilia/diagnóstico , Esofagite Eosinofílica/diagnóstico , Eosinófilos/imunologia , Estenose Esofágica/prevenção & controle , Esôfago/imunologia , Gastrite/diagnóstico , Inflamação/imunologia , Mucosa Intestinal/imunologia , Corticosteroides/uso terapêutico , Produtos Biológicos/uso terapêutico , Citocinas/antagonistas & inibidores , Enterite/terapia , Eosinofilia/terapia , Esofagite Eosinofílica/terapia , Esôfago/patologia , Gastrite/terapia , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , Células Th2/imunologia
18.
Zhonghua Er Ke Za Zhi ; 56(7): 500-504, 2018 Jul 02.
Artigo em Chinês | MEDLINE | ID: mdl-29996182

RESUMO

Objective: To summarize the clinical data including manifestations, diagnosis, treatment and prognosis of eosinophilic gastroenteritis (EGE) in children. Methods: A retrospective analysis was performed in 71 patients with pathologically proven EGE at Beijing Children's Hospital Affiliated to Capital Medical University from January 2008 to January 2017. Their clinical manifestations, laboratory and imaging examinations, endoscopic findings, histopathological examinations, and treatment were collected and analyzed. Results: Among 71 EGE cases, 47 (66%) cases were male and 24 (34%) cases were female, and the median age was 9.2 (0.2-16.5) years old. The main clinical manifestations included abdominal pain (76%, 54/71), vomiting (68%, 48/71), anorexia (54%, 38/71), weight loss (38%, 27/71), and diarrhea (37%, 26/71). There were 27 cases (38%) with a history of allergic diseases or family history. The median absolute value of eosinophil in peripheral blood of the 71 patients was 0.4 (0-36.8)×10(9)/L, and 27 cases (38%) showed an increase in eosinophil counts. Serum IgE was measured in 52 patients (104.3 (3.4- 3 000.0)×10(3) U/L), and 30 patients (58%) showed an increase in serum IgE. A large number of eosinophils ((41.0±8.5)/HP) were found in 3 patients' ascites. The endoscopic examination of upper gastrointestinal tract revealed hyperemic edema in 62 cases (87%), plaque in 44 cases (62%), erosion in 17 cases (24%) and ulceration in 16 cases (23%). Histopathologically, in 8 cases (11%) the disease involved both stomach and duodeneum, in 21 cases (30%) involved stomach only, and in 37 cases (52%) involved duodeneum only. In addition, in 6 cases (8%) the disease involved esophagus and in 10 cases (14%) involved colorectum. Microscopically, eosinophil counts averaged 67/HP, 33/HP, 40/HP and 38/HP in esophageal, gastric, duodenal and colorectal mucosa respectively. A total of 34 cases were treated with glucocorticoid, and all these patients had alleviation of symptoms, which occurred within 14.9 days on average, but EGE recurred in 11 cases (32%). Conclusions: The clinical symptoms and endoscopic findings of EGE are diverse and nonspecific. Histopathological examination of gastrointestinal mucosa is particularly important for the diagnosis. Glucocorticoid treatment is effective, but the patients with EGE are prone to relapse.


Assuntos
Enterite , Eosinofilia , Gastrite , Adolescente , Criança , Pré-Escolar , Enterite/complicações , Enterite/diagnóstico , Enterite/terapia , Eosinofilia/complicações , Eosinofilia/diagnóstico , Eosinofilia/terapia , Feminino , Gastrite/complicações , Gastrite/diagnóstico , Gastrite/terapia , Gastroenterite , Humanos , Lactente , Masculino , Estudos Retrospectivos
19.
Nihon Shokakibyo Gakkai Zasshi ; 115(7): 655-661, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-29998988

RESUMO

A 69-year-old Japanese man underwent successful percutaneous endoscopic gastrostomy (PEG) without any intra-procedural adverse event. However, 3 days postoperatively, he presented with melena and bloody discharge from the gastrostomy tube. Computed tomography revealed gastric emphysema, hepatic portal venous gas, portal vein thrombosis, and swelling of the ascending colon. We administered antibiotics and discontinued enteral feeding; this resulted in resolution of gastric emphysema, hepatic portal venous gas, and portal vein thrombosis and an improvement in the swelling of the ascending colon. To the best of our knowledge, till date, only three patients have been reported to develop gastric emphysema and hepatic portal venous gas after PEG. All previously reported patients were treated with antibiotics and/or discontinuation of enteral feeding, exhibiting recovery within 6-14 days. Although the occurrence of gastric emphysema and hepatic portal venous gas after a PEG procedure is rare, conservative management can ensure recovery in such patients.


Assuntos
Tratamento Conservador , Enfisema/terapia , Gastrite/terapia , Idoso , Humanos , Japão , Fígado , Masculino , Veia Porta
20.
J Pediatr Gastroenterol Nutr ; 67(3): 318-321, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29851758

RESUMO

Eosinophilic gastrointestinal disorders are a set of conditions with a wide range of clinical manifestations and treatment modalities. The disorders are suspected to result from an abnormal inflammatory response to allergen (s), and individuals may develop a relapsing or chronic disease, if the allergen is not eliminated. Mechanisms of disease pathogenesis, including the humoral immune response, need to be fully elucidated. A variety of therapies are used, although there is a lack of well-defined randomized, prospective studies. Other therapeutic options are needed as the current treatments have potential concerns; elimination diets may impair a child's quality of life, and corticosteroids have adverse risks with long-term use. We review what is known about nonesophageal eosinophilic gastrointestinal disorders, and discuss research investigations which need to be conducted to facilitate diagnosis and enhance treatment methods.


Assuntos
Enterite/fisiopatologia , Enterite/terapia , Eosinofilia/fisiopatologia , Eosinofilia/terapia , Gastrite/fisiopatologia , Gastrite/terapia , Enterite/diagnóstico , Eosinofilia/diagnóstico , Gastrite/diagnóstico , Humanos
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