ACG Case Reports Journal最新文献

Doxycycline is an antibiotic frequently used to treat tick-borne diseases. It is known to cause esophageal injury, although gastric injury is less often described. Few cases have been reported of gastrointestinal bleeding secondary to biopsy-proven doxycycline use. In the setting of widespread doxycycline use, it is important to recognize this drug-specific pattern of injury to guide appropriate patient management. This case demonstrates doxycycline-induced gastrointestinal injury and highlights characteristic histological findings.

Gastric squamous cell carcinoma (GSCC) is rare, accounting for less than 1% of gastric malignancies. Due to its rarity, specifics regarding the clinical presentation and risk factors for this malignancy remain uncertain. We describe a rare case of primary GSCC presenting with unstable gastrointestinal bleeding. A 64-year-old woman with a history of vertical band gastroplasty and orthotopic liver transplant for primary biliary cholangitis presented to an outside hospital with melena and hypovolemic shock. Upper endoscopic evaluation was completed revealing an ulcerated, oozing gastric mass within the fundus of the excluded stomach. Biopsies of the mass were consistent with GSCC.

A 29-year-old patient diagnosed with Crohn's disease was proposed to start infliximab (IFX) therapy. During the infusion of the first dose, the patient complained of sudden visual impairment. The ophthalmologic evaluation confirmed a best-corrected visual acuity of 8/10 of the left eye (Snellen Chart). Despite its favorable safety profile, IFX is associated with several paradoxical adverse events. Ocular adverse events represent part of this group of complications. We report a case of a not yet reported paradoxical adverse event during the first administration of IFX. The event manifested as a transitory sudden asymmetric loss of visual acuity.

Rituximab is a monoclonal antibody that targets CD20 on B lymphocytes and is approved for the treatment of multiple hematological and autoimmune disorders. Rituximab may cause gastrointestinal side effects such as colitis, diarrhea, and bowel obstruction or perforation. Infusion-related reactions, such as throat irritation, are, however, not linked to any specific esophageal disease. In this study, we report an extremely rare case of rituximab-induced esophageal ulceration and stricture causing progressive, debilitating dysphagia, highlighting the importance of early recognition and prompt management to prevent long-term morbidity.

Enteroviruses are a common cause of infection in neonates, causing wide spectrum of diseases, including myocarditis, myelitis, meningoencephalitis, hepatitis, and sepsis. The enteroviral hepatitis has rarely been recorded in pediatric populations other than neonates. We report a rare case of self-limiting acute hepatitis in a healthy 3-year-old child affected by hand-foot-and-mouth disease caused by Enterovirus. Providers should be aware of hepatitis prevalence in the Enteroviral infection, and should consider it in the differential diagnosis for acute hepatitis of unknown origin.

Very early-onset inflammatory bowel disease (IBD) has a higher proportion (10%-15%) of monogenic mutations than later onset IBD. With next-generation sequencing (NGS), newer disease-causing mutations are being revealed. We report a 4-year-old girl presenting with chronic bloody diarrhea and failure to thrive, and diagnosed as Crohn's disease. Whole-exome sequencing by NGS revealed a novel pathogenic mutation in mothers against decapentaplegic homolog 7 (SMAD7) gene. She responded to biologics. Monogenic disorders should be suspected in children with very early-onset IBD with poor response to standard immunosuppression, and NGS should be performed. SMAD7 provides a new target for in-depth research for its role in IBD.

Cutaneous Crohn's disease (CD) is a rare manifestation of inflammatory bowel disease characterized by cutaneous lesions that are noncontiguous with gastrointestinal tissue yet share similar histopathologic features with gastrointestinal CD. To our knowledge, there are no published data on the use of guselkumab for cutaneous CD. We discuss a case of concomitant pyoderma gangrenosum and cutaneous CD treated with a novel combination of guselkumab, antimicrobial agents, and corticosteroids.