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Affiliation(s)
- C Berkelhammer
- Departments of Medicine, Pathology and Surgery, Christ Hospital, University of Illinois, Oak Lawn, Illinois, USA
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Aboud W, Marshall R, Berkelhammer C. Pseudomembranous colitis. Gastrointest Endosc 2000; 52:234. [PMID: 10922098 DOI: 10.1067/mge.2000.107290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Affiliation(s)
- C Berkelhammer
- Departments of Medicine, Gastroenterology and Pathology, Christ Hospital, University of Illinois, Oak Lawn, Illinois, USA
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Abstract
We report a patient with life-threatening refractory sprue who was dependent on high doses of corticosteroids to prevent severe diarrhea, malabsorption, and villous atrophy. Azathioprine allowed tapering of corticosteroids to lower doses, while maintaining remission in histology and in objective measures of malabsorption. Immunosuppressive therapy, however, is not without risks, particularly in patients with associated hypoglobulinemia.
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Affiliation(s)
- A Vaidya
- Department of Gastroenterology, Christ Hospital, University of Illinois, Oak Lawn, 60453, USA
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Abstract
Minocycline can cause various types of hepatotoxicity. We report an 18-year-old male who developed a delayed onset of minocycline-induced cholestatic hepatitis with autoimmune features and neutropenia. He responded to withdrawal of the drug and a short course of corticosteroids. If minocycline is to be administered, then periodic monitoring for hepatoxicity is recommended.
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Affiliation(s)
- G Bhat
- Department of Medicine, Christ Hospital and Medical Center, Oak Lawn, IL 60453, USA
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Berkelhammer C, Wood RJ, Sitrin MD. Inorganic phosphorus reduces hypercalciuria during total parenteral nutrition by enhancing renal tubular calcium absorption. JPEN J Parenter Enteral Nutr 1998; 22:142-6. [PMID: 9586791 DOI: 10.1177/0148607198022003142] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Increasing the inorganic phosphorus content of total parenteral nutrition (TPN) formulas has been shown to decrease TPN-induced hypercalciuria in experimental animals and humans. The mechanism of this effect, however, has been uncertain. METHODS By using a randomized cross-over design, seven patients on cyclic TPN were given otherwise identical formulas providing either 15 or 45 mmol/d of inorganic phosphorus. Urinary calcium excretion, serum ultrafilterable calcium, filtered calcium load, fractional calcium excretion, urinary cyclic adenosine 5'-monophosphate (cAMP), and serum levels of ionized calcium, parathyroid hormone (PTH), and vitamin D metabolites were determined at the end of each study period. RESULTS Urinary calcium excretion was significantly lower when the patients received the higher inorganic phosphorus formula. Increasing the inorganic phosphorus in the TPN formula did not change ultrafilterable calcium or filtered calcium load, but significantly reduced fractional calcium excretion. No differences in serum levels of ionized calcium, PTH, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, or urinary cAMP were observed between treatments. CONCLUSIONS These results demonstrate that increasing the inorganic phosphorus content of the TPN formula decreases urinary calcium excretion by increasing renal tubular calcium resorption. This effect is not due to alterations in the PTH-1,25-dihydroxyvitamin D axis, but likely reflects a direct action of inorganic phosphorus on the renal tubules.
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Affiliation(s)
- C Berkelhammer
- Department of Medicine, The University of Chicago, IL 60637, USA
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Abstract
We describe a patient with an unusual segment of ectopic gastric mucosa in the proximal esophagus. The gastric heterotopia was circumferential and unusually long at 7 cm. It contained benign rugal-type folds, a stricture at the mid-portion of the gastric inlet patch was lined by normal antral-type gastric mucosa but harbored submucosally infiltrating adenocarcinoma. There was no evidence of Helicobacter pylori infection by biopsy or serologic screening. Malignancy, including submucosally infiltrating adenocarcinoma, should be considered in patients with strictures involving ectopic gastric mucosa in the proximal esophagus.
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Affiliation(s)
- C Berkelhammer
- Section of Gastroenterology, Christ Hospital and Medical Center, Oak Lawn, IL 60453, USA
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Berkelhammer C, Ghani A, Walloch J, de Bustros A. Large particle biopsy by the "band-snare" technique. Am J Gastroenterol 1997; 92:2099-103. [PMID: 9362201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- C Berkelhammer
- Department of Internal Medicine, Christ Hospital & Medical Center, Oak Lawn, Illinois 60453, USA
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Abstract
Intussusception is rare in adults. There is little information on the role of colonoscopy in colonic intussusception. We report, to our knowledge, the first adult case of small-bowel lymphoma causing ileocecal intussusception in which the diagnosis was made by colonoscopy. Colonoscopy has a useful role in the diagnosis and management of ileocecal intussusception.
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Affiliation(s)
- C Berkelhammer
- Department of Gastroenterology, Christ Hospital & Medical Center, Oak Lawn, Illinois 60453, USA
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Yedidag A, Zikos D, Spargo B, MacEntee P, Berkelhammer C. Esophageal carcinoma presenting with nephrotic syndrome: association with anti-neutrophil cytoplasmic antibody. Am J Gastroenterol 1997; 92:326-8. [PMID: 9040216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Malignancy is a cause of membranous glomerulonephritis. We report a patient with an otherwise asymptomatic squamous cell carcinoma of the esophagus whose presenting manifestation was membranous glomerulonephritis and nephrotic syndrome. Perinuclear anti-neutrophil cytoplasmic antibody was positive. This is the first reported case of perinuclear anti-neutrophil cytoplasmic antibody associated with paraneoplastic glomerulonephritis and nephrotic syndrome due to esophageal squamous cell carcinoma.
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Affiliation(s)
- A Yedidag
- Department of Gastroenterology, Christ Hospital & Medical Center, Oak Lawn, Illinois 60453, USA
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Berkelhammer C, Janarthan B, Bhagavan M, Schreiber S. Hepatocolic fistula and lower GI bleeding in hepatoma. Am J Gastroenterol 1996; 91:2625-6. [PMID: 8947006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- C Berkelhammer
- Department of Internal Medicine and Pathology, Christ Hospital and Medical Center, Oak Lawn, Illinois 60453, USA
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Abstract
We describe the response to plasma exchange in a woman with extreme gestational hyperlipidemia and severe pancreatitis. Her serum triglyceride reached an astounding level of 21,300 mg/dl-among the highest concentrations ever recorded. Two consecutive plasma exchanges led to a remarkable reduction in triglyceride levels of 73% and 82%, respectively. Plasma viscosity decreased by 50% after the first plasma exchange. This was associated with an equally dramatic and unexpectedly rapid resolution of severe pancreatitis. Plasma exchange can rapidly and safely resolve extreme hyperlipidemia and be associated with prompt resolution of pancreatitis in women with severe gestational hyperlipidemic pancreatitis.
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Affiliation(s)
- P Saravanan
- Department of Internal Medicine, Christ Hospital and Medical Center, Oak Lawn, Illinois, USA
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Berkelhammer C. Helicobacter pylori and ulcer in patients taking NSAIDs. JAMA 1995; 273:376. [PMID: 7823378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
We describe, to our knowledge, the first reported case of nortriptyline-induced fulminant hepatic failure. This tricyclic antidepressant drug was taken by a postmenopausal woman for 64 days before her presentation. The absence of fever, rash, or marked eosinophilia, the predominant zone 3 necrosis with bridging, and the latent period favor a metabolic idiosyncratic reaction. The fatal outcome underscores the importance of recognizing the association and discontinuing the offending agent.
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Affiliation(s)
- C Berkelhammer
- Department of Medicine, Christ Hospital and Medical Center, Oak Lawn, Illinois 60453
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Abstract
We present a case of necrotizing lymphomatous colitis--masquerading as Crohn's disease--that was complicated by spontaneous multiple perforations. This potentially fatal occurrence might have been obviated by earlier immunologic diagnosis.
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Affiliation(s)
- C Berkelhammer
- Department of Medicine (Section of Gastroenterology, Christ Hospital and Medical Center, Oak Lawn, Illinois 60453
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Abstract
We evaluated the efficacy of endoscopically placed biliary stents as treatment for 32 benign postoperative biliary strictures in 29 patients. Five patients also had bile fistulas. Stents were inserted for a mean of 162 days and then removed. ERCPs were obtained before stent insertion and again after removal. Responses were followed and categorized as excellent, good, or poor. Stent insertion was successful in 25 patients (86%), 23 of which have a mean follow-up of 19 months (range, 2 to 42 months) after stent removal. Seventy-four percent had an excellent (48%) or good (26%) response. Early postoperative strictures and fistulas responded favorably. We conclude that benign postoperative biliary strictures can be treated successfully by endoscopic prostheses.
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Affiliation(s)
- C Berkelhammer
- Department of Medicine, Wellesley Hospital, University of Toronto, Ontario, Canada
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Berkelhammer C, Bear RA. A clinical approach to common electrolyte problems: 4. Hypomagnesemia. Can Med Assoc J 1985; 132:360-8. [PMID: 3918779 PMCID: PMC1345822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Magnesium plays a critical role in many cell functions. Hypomagnesemia may occur because of decreased intake or absorption, internal redistribution or increased loss of this element through either renal or nonrenal routes. Manifestations of magnesium deficiency include alterations in calcium, phosphate and potassium homeostasis along with cardiac disorders such as malignant ventricular arrhythmias refractory to conventional therapy, enhanced sensitivity to digoxin and, possibly, coronary artery vasospasm and sudden death. Other features of magnesium deficiency include a host of neuromuscular and neuropsychiatric disorders. In this review we detail mechanisms that may lead to magnesium deficiency, summarize the clinical features of the deficiency and provide a clinical approach to the diagnosis and treatment of this electrolyte disorder.
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Berkelhammer C, Bear RA. A clinical approach to common electrolyte problems: 3. Hypophosphatemia. Can Med Assoc J 1984; 130:17-23. [PMID: 6418367 PMCID: PMC1875686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hypophosphatemia is a common disorder caused by decreased intake, increased loss or transcellular shift of phosphorus. Symptoms of severe hypophosphatemia include reversible depression of myocardial function, acute respiratory failure, coma, rhabdomyolysis, osteomalacia, renal tubular acidosis and hemolysis. This paper discusses common clinical disorders associated with hypophosphatemia and presents an approach to diagnosis and treatment.
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