Endoscopic and video capsule endoscopic observation of Yersinia enterocolitis

A woman in her late 20s suffered from epigastralgia following lower abdominal pain with diarrhea. Kampo medicine relieved the complaints, but the pain recurred a month later. She had immigrated from Vietnam to Japan 6 months before the onset of the abdominal pain. Blood test findings were almost within normal limits, except for mild C-reactive protein elevation and positive Helicobacter pylori antibody findings. Colonoscopy revealed an edematous cobblestone-like appearance at the end of the ileum with irregular ulceration mimicking Crohn's disease. Video capsule endoscopy was performed to detect lesions in the small intestine and demonstrated irregular ileal ulcer, reminiscent of Crohn's disease. A biopsy performed during colonoscopy demonstrated granulomatous inflammation with a moderate accumulation of plasma cells and mononuclear cells. The bacterial culture of the biopsy specimen proved the growth of Yersinia enterocolitica. Levofloxacin 500 mg for 7 days rapidly relieved abdominal pain. Yersinia enterocolitis is rare in developed countries, but as a differential diagnosis for Crohn's disease, it is important to treat. This is the first case report of the video capsule endoscopy findings of Yersinia enterocolitis. Video capsule endoscopy can help to confirm the spread of the lesions of Yersinia enterocolitis.

Effects of intratracheal pretreatment with yttrium chloride (YCl3) on inflammatory responses of the rat lung following intratracheal instillation of YCl3

We investigated pulmonary clearance of yttrium (Y) and acute lung injury following intratracheal instillation (i.t.) of yttrium chloride (YCl3) in saline- or YCl3-pretreated rats (30 days before the second challenge). About 67% of the initial dose of Y remained in the lung even 31 days after the i.t. treatment. The pretreatment with YCl3 significantly reduced i.t.-YCl3-induced increases in biochemical inflammatory indicators in bronchoalveolar lavage fluid (BALF), such as lactate dehydrogenase, beta-glucuronidase, and alkaline phosphatase activities and protein concentration, while the pretreatment increased the number of polymorphonuclear leukocyte (PMN) in BALF. These results suggest that the augmentation of PMN infiltration does not play an important role, if any, in i.t. YCl3-induced increases in biochemical indicators in BALF. The reduction of the increases in those biochemical inflammatory indicators may be due, at least in part, to the increase of manganese-superoxide dismutase (Mn-SOD) activity in the lung tissue, because the lung Mn-SOD activity in the YCl3-pretreated group was two times higher than that of the saline-pretreated group.