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Ammer‐Herrmenau C, Hamm J, Neesse A. Autoimmune pancreatitis-New evidence for clinical management strategies. United European Gastroenterol J 2024; 12:279-280. [PMID: 38271283 PMCID: PMC11017752 DOI: 10.1002/ueg2.12537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Affiliation(s)
- C. Ammer‐Herrmenau
- Department of Gastroenterology, Gastrointestinal Oncology and EndocrinologyUniversity Medical Center GoettingenGoettingenGermany
| | - J. Hamm
- Department of Gastroenterology, Gastrointestinal Oncology and EndocrinologyUniversity Medical Center GoettingenGoettingenGermany
| | - A. Neesse
- Department of Gastroenterology, Gastrointestinal Oncology and EndocrinologyUniversity Medical Center GoettingenGoettingenGermany
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Alhammami QS. Analysis of the Accuracy of Magnetic Resonance Enterography for the Detection of Active Inflammation and Disease Activity in Patients With Crohn's Disease: A Single-Center Experience in Najran, Saudi Arabia. Cureus 2024; 16:e52674. [PMID: 38380222 PMCID: PMC10877208 DOI: 10.7759/cureus.52674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Magnetic resonance enterography (MRE) is a non-invasive diagnostic imaging modality that has been used for the detection of active inflammation and disease activity in patients with Crohn's disease. However, its diagnostic accuracy in the Najran population has not been well-studied. STUDY AIM This study aimed to assess the diagnostic accuracy of MRE in detecting active inflammation and disease activity in patients with Crohn's disease in the Najran population. METHODS The study included 51 patients with Crohn's disease, and their demographic, clinical, radiological, laboratory, and endoscopic data were analyzed. RESULTS The results showed that MRE findings, such as the radiological score for active inflammation and the presence of extra-intestinal manifestations, were significantly associated with the final diagnosis of active inflammation. Furthermore, the timing of MRE in relation to symptom activity and the indication for performing MRE were significantly associated with the final diagnosis. The study findings demonstrate the potential of MRE as a valuable tool for diagnosing and assessing disease activity in Crohn's disease patients in the Najran population.
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Hmidi A, Bel Hadj Kacem L, Sellami R, Ksentini M, Znaidi N. Primary colonic MALT lymphoma associated with Crohn's disease: Case report and review of the literature. Clin Case Rep 2023; 11:e7381. [PMID: 37251745 PMCID: PMC10213708 DOI: 10.1002/ccr3.7381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/04/2023] [Accepted: 05/05/2023] [Indexed: 05/31/2023] Open
Abstract
Key Clinical Message To date, the pathogenic mechanisms of the association between Crohn's disease and MALT lymphoma are ambiguous and yet remain to be elucidated. The publication of other cases illustrating this rare association would be interesting to properly plan therapeutic strategies and to better understand the pathogenesis and the prognosis of this association. Abstract Crohn's disease is a progressive disease, with increasing incidence, that leads to bowel damage and disability. Primary colonic MALT lymphoma is a low-grade B lymphoma, representing only 2.5% of all MALT lymphomas. The pathogenesis of these two cancers is still not clearly elucidated and their association is rare. To our knowledge, only two cases have illustrated synchronous Crohn's disease and MALT lymphoma. The possible role of Crohn's disease as a precursor of MALT lymphoma is still debated; some studies proposed that immunosuppressive drugs used in Crohn's disease are involved in the lymphomagenesis of MALT lymphoma. Other studies supposed no relation between these two neoplasms.We present a rare case of association between Crohn's disease and primary colonic MALT lymphoma in an elderly female patient who had not received any immunosuppressive therapy. The patient presented with chronic diarrhea, epigastric pain, and weight loss. A colonoscopy with biopsies was performed. The histopathologic examination concluded with the diagnosis of not only Crohn's disease but also MALT lymphoma. This discovery of MALT lymphoma was incidental. We highlight the clinical and histopathological features, and we discuss the association between Crohn's disease and MALT lymphoma, which may provide additional information about pathogenic mechanisms.
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Affiliation(s)
- Amira Hmidi
- Department of PathologyHospital Charles NicolleTunisTunisia
| | | | - Rym Sellami
- Department of PathologyRegional Hospital of ZaghouanZaghouanTunisia
| | | | - Nadia Znaidi
- Department of PathologyHospital Charles NicolleTunisTunisia
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4
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Konturek PC. [Gut microbiota and chronic inflammatory bowel disease]. MMW Fortschr Med 2022; 164:12-15. [PMID: 35831743 DOI: 10.1007/s15006-022-1230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intestinal dysbiosis remains the focus of research into the pathogenesis of chronic inflammatory bowel disease (IBD). The potential role of gut microbiota in the development of IBD includes interaction with the host genome and immune system, as well as various environmental factors, diet, drugs, industrialization, etc. Other organs are negatively affected by intestinal dysbiosis via gut-brain axis. The composition of microbiota and its metabolic activity has a significant impact on the effectiveness of anti-inflammatory therapies. Microbiome-based treatment for IBD includes the use of diet, antibiotics, pre-, pro- and synbiotics, and faecal transplantation (FMT). The development of effective therapies for IBD patients will only be possible once the interactions between the microbiota and its metabolites and the host immune system are better understood.
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Affiliation(s)
- Peter C Konturek
- ChA/Klinik für Innere Med. II/Saalfeld, Thüringen-Kliniken "Georgius Agricola" GmbH, Rainweg 68, 7318, Saalfeld, Deutschland.
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Schmidt M, Kühnert M, Kuschel B, Kehl S, Schäfer-Graf UM. Care of Women with Chronic Inflammatory Bowel Disease (Chronic IBD) During Pregnancy: Recommendations of the Obstetrics and Prenatal Medicine Working Group of the DGGG. Geburtshilfe Frauenheilkd 2021; 81:1348-1353. [PMID: 34899047 PMCID: PMC8654510 DOI: 10.1055/a-1429-2742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 03/10/2021] [Indexed: 11/25/2022] Open
Abstract
The incidence of chronic inflammatory bowel disease (chronic IBD) in persons of reproductive age is high. Chronic IBD does not typically lead to impaired fertility. Nevertheless, the percentage of women suffering from chronic IBD who have children is lower than that of the general population, due to self-imposed childlessness. Providing women with open, unbiased information and, if necessary, helping them to overcome baseless fears should therefore be an essential part of preconception counseling. With the exception of methotrexate, most standard drugs can and should be continued during pregnancy. If the pregnancy occurs during an inactive phase of disease, the rate of complications in pregnancy should, in principle, not be higher than normal. Nevertheless, pregnant women with chronic IBD are classed as high-risk pregnancies. Organ screening in accordance with DEGUM II criteria should be carried out in every case, and women must be monitored for the potential development
of placental insufficiency. Any flare-ups which occur during pregnancy should be treated in full. Vaginal delivery can be considered if there is no perianal manifestation of disease; however, the individual risk must be carefully weighed up.
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Affiliation(s)
- Markus Schmidt
- Klinik für Frauenheilkunde und Geburtshilfe, Sanakliniken Duisburg, Duisburg, Germany
| | - Maritta Kühnert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Marburg, Marburg, Germany
| | - Bettina Kuschel
- Klinik und Poliklinik für Frauenheilkunde, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Sven Kehl
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
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Barnig C, Bezema T, Calder PC, Charloux A, Frossard N, Garssen J, Haworth O, Dilevskaya K, Levi-Schaffer F, Lonsdorfer E, Wauben M, Kraneveld AD, Te Velde AA. Activation of Resolution Pathways to Prevent and Fight Chronic Inflammation: Lessons From Asthma and Inflammatory Bowel Disease. Front Immunol 2019; 10:1699. [PMID: 31396220 PMCID: PMC6664683 DOI: 10.3389/fimmu.2019.01699] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 07/08/2019] [Indexed: 12/15/2022] Open
Abstract
Formerly considered as a passive process, the resolution of acute inflammation is now recognized as an active host response, with a cascade of coordinated cellular and molecular events that promotes termination of the inflammatory response and initiates tissue repair and healing. In a state of immune fitness, the resolution of inflammation is contained in time and space enabling the restoration of tissue homeostasis. There is increasing evidence that poor and/or inappropriate resolution of inflammation participates in the pathogenesis of chronic inflammatory diseases, extending in time the actions of pro-inflammatory mechanisms, and responsible in the long run for excessive tissue damage and pathology. In this review, we will focus on how resolution can be the target for therapy in "Th1/Th17 cell-driven" immune diseases and "Th2 cell-driven" immune diseases, with inflammatory bowel diseases (IBD) and asthma, as relevant examples. We describe the main cells and mediators stimulating the resolution of inflammation and discuss how pharmacological and dietary interventions but also life style factors, physical and psychological conditions, might influence the resolution phase. A better understanding of the impact of endogenous and exogenous factors on the resolution of inflammation might open a whole area in the development of personalized therapies in non-resolving chronic inflammatory diseases.
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Affiliation(s)
- Cindy Barnig
- Department of Chest Disease, Strasbourg University Hospital, Strasbourg, France.,Equipe d'accueil 3072, University of Strasbourg, Strasbourg, France
| | | | - Philip C Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Anne Charloux
- Department of Chest Disease, Strasbourg University Hospital, Strasbourg, France.,Equipe d'accueil 3072, University of Strasbourg, Strasbourg, France
| | - Nelly Frossard
- UMR 7200 CNRS/Université de Strasbourg, Laboratoire d'Innovation Thérapeutique and LabEx MEDALIS, Faculté de Pharmacie, Strasbourg, France
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Nutricia Research, Utrecht, Netherlands
| | - Oliver Haworth
- Biochemical Pharmacology, William Harvey Research Institute, Bart's School of Medicine and Queen Mary University of London, London, United Kingdom
| | - Ksenia Dilevskaya
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Francesca Levi-Schaffer
- Pharmacology and Experimental Therapeutics Unit, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Evelyne Lonsdorfer
- Department of Chest Disease, Strasbourg University Hospital, Strasbourg, France.,Equipe d'accueil 3072, University of Strasbourg, Strasbourg, France
| | - Marca Wauben
- Department of Biochemistry & Cell Biology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Aletta D Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Anje A Te Velde
- Amsterdam UMC, Tytgat Institute for Liver and Intestinal Research, University of Amsterdam, AGEM, Amsterdam, Netherlands
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Abstract
RATIONALE There is evidence that parasitic helminths can ameliorate colitis in animal models and humans. Although infections with Hymenolepis sp. are clinically benign, the immunomodulatory interactions between host and parasite are largely unknown. PATIENT CONCERNS In this study we examined the intestinal mucosa of an adult asymptomatic patient harboring adult and larval dwarf tapeworms (Hymenolepis nana) who underwent surgery for an unrelated reason. INTERVENTIONS Routine histology and immunohistochemistry were performed to characterize the host's response to the parasite. Parasitic DNA was sequenced to identify the tapeworm species. DIAGNOSES Morphological and immunohistochemical studies showed a nearly complete absence of an anti-parasite host immune response. The outer surface of the parasite also showed prominent cross-reactivity with various tested leukocyte antigens. Our findings closely resemble experimentally obtained data from the H. diminuta-infected rat at the state of persistent colonization. OUTCOMES Cross-reactivity of parasite-borne molecules with anti-human-leukocyte antibodies indicates a potential functional role in active modulation of the host's immune response. LESSIONS We believe that better understanding of the host-cestode interaction will certainly extend our knowledge on auto-aggressive disorders such as inflammatory bowel disease and might provide potential treatment options.
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Affiliation(s)
- Juergen Hench
- Institute of Pathology, Cantonal Hospital Baselland, Liestal
- Department of Neuropathology, Institute of Pathology, University Hospital Basel, Basel
| | - Gieri Cathomas
- Institute of Pathology, Cantonal Hospital Baselland, Liestal
| | - Matthias S. Dettmer
- Institute of Pathology, Cantonal Hospital Baselland, Liestal
- Institute of Pathology, University of Bern, Bern, Switzerland
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Abstract
Ulcerative colitis is an immunologic disorder of the intestine which involves the mucosa and sometimes the submucosa. It has a chronic relapsing course, affects the colon and occasionally the terminal ileum. This so called backwash ileitis is overall very rare and of limited clinical importance. Usually the inflammation starts in the rectum and may extend in a proximal and continuous fashion to the rest of the colon. Symptoms consist of frequent loose bloody stools, cramps and weight loss. It is important and frequently neglected that patients especially (but not exclusively) with a limited degree of colonic involvement up to the splenic flexure are treated topically with mesalamine and budesonid or hydrocortisone by suppository, enema or foam. In case of more severe colitis oral mesalamine, systemic corticosteroids and other immunosupressors should be added to the therapy.
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Affiliation(s)
- Laura Roose
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Jaya D'cunja
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Luc Biedermann
- 2 Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich
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Sassenberg K, Greving H. Internet Searching About Disease Elicits a Positive Perception of Own Health When Severity of Illness Is High: A Longitudinal Questionnaire Study. J Med Internet Res 2016; 18:e56. [PMID: 26944335 PMCID: PMC4799430 DOI: 10.2196/jmir.5140] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 12/07/2015] [Accepted: 01/17/2016] [Indexed: 12/16/2022] Open
Abstract
Background The Internet is one of the primary sources for health information. However, in research, the effects of Internet use on the perception of one’s own health have not received much attention so far. Objective This study tested how Internet use for acquiring health information and severity of illness influence patients with a chronic disease with regard to the perception of their own health. Negative psychological states are known to lead to preferential processing of positive information. In particular, the self-directed nature of Internet use provides room for such biases. Therefore, we predicted that patients experiencing negative health states more frequently, due to more frequent episodes of a chronic illness, will gain a more positive perception of their health if they use the Internet frequently to gain health information, but not if they use the Internet rarely. This effect was not expected for other sources of information. Methods A longitudinal questionnaire study with two measurement points—with a 7-month time lag—tested the hypothesis in a sample of patients with chronic inflammatory bowel disease (n=208). This study assessed patients’ frequency of Internet use, their participation in online social support groups, their use of other sources of health information, and several indicators of the participants’ perceptions of their own health. A structure equation model (SEM) was used to test the predictions separately for Internet searches and other sources of information. Results Data analysis supported the prediction; the interaction between frequency of health-related information searches and frequency of episodes at the first measurement point (T1) was related to participants’ positive perceptions of their own health at the second measurement point (T2) (B=.10, SE=.04, P=.02) above and beyond the perceptions of their own health at T1. When participants used the Internet relatively rarely (-1 SD), there was no relationship between frequency of episodes and positive perceptions of their own health (B=-.11, SE=.14, t203=-0.82, P=.41). In contrast, when participants used the Internet relatively often (+1 SD), the more frequently they had those episodes the more positive were the perceptions of their own health (B=.36, SE=.15, t203=2.43, P=.02). Additional SEM analyses revealed that this effect occurs exclusively when information is searched for on the Internet, but not when other sources of information are consulted, nor when online social support groups are joined. Conclusions The results of this study suggest that patients might process information from the Internet selectively, in an unbalanced, biased fashion, with the formation of a self-serving (ie, positive) perception of own health. At the same time, this bias contributes to the ability of patients to cope psychologically with their disease.
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Affiliation(s)
- Kai Sassenberg
- Leibniz-Institut für Wissensmedien, Social Processes Lab, Tübingen, Germany.
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