F. Bouhamou, S. Morabit, S. Berrag, Mouna Tazaourte, F. Rouibaa, A. Aourarh
The management of chronic hepatitis C infection is currently in change. IFN based treatments were the standard therapy, against HCV infection waiting for pending authorization to place the direct acting antivirals on the market. These new direct acting antivirals generic conferred good effectiveness and safety for infected patients. The aim of this study was to characterize the treatment response and tolerance of new generics of DAAs in patients infected with hepatitis C virus. The study was conducted at the gastroenterology I department of the military hospital Mohamed V in Rabat since December 2015. We include all patients infected with HCV: naïf relapsing or non-responsive profiles, all genotypes combined, cirrhotic or not. They all received treatment with the new Moroccan generic of direct acting antivirals. Virological response as well as clinical and biochemical tolerances were achieved. 77 patients with viral hepatitis C were included in the study. The average age of the patients was 61 ± 11 years old. A slight predominance of women noted in 52.8% of cases. Genotype 1 was predominant in 74% of cases. Half of our patients were cirrhotic. The sustained virogical response SVR was of the order of 96.2%. The treatment generally well tolerated in all our patients. The generic of direct acting antivirals promises treatments with shorter treatment times, much higher cure rates, and fewer side effects. Viral eradication leads stabilization or regression of fibrosis.
{"title":"Efficacy and safety of new generic of direct acting antivirals in the treatment of chronic hepatitis C","authors":"F. Bouhamou, S. Morabit, S. Berrag, Mouna Tazaourte, F. Rouibaa, A. Aourarh","doi":"10.15761/GHE.1000195","DOIUrl":"https://doi.org/10.15761/GHE.1000195","url":null,"abstract":"The management of chronic hepatitis C infection is currently in change. IFN based treatments were the standard therapy, against HCV infection waiting for pending authorization to place the direct acting antivirals on the market. These new direct acting antivirals generic conferred good effectiveness and safety for infected patients. The aim of this study was to characterize the treatment response and tolerance of new generics of DAAs in patients infected with hepatitis C virus. The study was conducted at the gastroenterology I department of the military hospital Mohamed V in Rabat since December 2015. We include all patients infected with HCV: naïf relapsing or non-responsive profiles, all genotypes combined, cirrhotic or not. They all received treatment with the new Moroccan generic of direct acting antivirals. Virological response as well as clinical and biochemical tolerances were achieved. 77 patients with viral hepatitis C were included in the study. The average age of the patients was 61 ± 11 years old. A slight predominance of women noted in 52.8% of cases. Genotype 1 was predominant in 74% of cases. Half of our patients were cirrhotic. The sustained virogical response SVR was of the order of 96.2%. The treatment generally well tolerated in all our patients. The generic of direct acting antivirals promises treatments with shorter treatment times, much higher cure rates, and fewer side effects. Viral eradication leads stabilization or regression of fibrosis.","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77561261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frederico S Assirati, Luiz HS Fontes, C. Pagliari, Luciane K Galo, Wellington LF da Silva, Rafaela BB Pinheiro, Claudio L Hashimoto, T. Navarro-Rodriguez
Introduction: Gastroesophageal reflux disease (GERD) is considered one of the most prevalent digestive diseases in Western countries. In many cases, the symptomatic GERD is linked to a normal upper gastrointestinal endoscopy and new endoscopic techniques to identify the abnormalities are need. The high-definition digestive endoscopy coupled with narrow band imaging (NBI) could achieve a more detailed mucosal evaluation, allowing the identification of distal esophageal microerosions. Objectives: To validate the presence of distal esophageal microerosions as found in high-definition endoscopy with NBI and the associative pHmetry, histological, immunohistochemical findings of tissue specimens obtained from esophageal biopsies of patients with typical symptoms of GERD. Methods: A total of 70 participants were enrolled in a prospective, descriptive and cross-sectional study from a gastroenterology outpatient clinic. Endoscopic evaluation was sequentially performed after the pHmetry. Esophageal mucosal biopsies were obtained to perform the histological and immunohistochemical analysis. Results: From 70 participants, 30/70 (42.9%) showed mucosal microerosions. Both, pHmetry and histologic score for esophageal mucosa did not showed difference between participants with or without endoscopic microerosions. The quantitative cellular evaluation by immunohistochemistry of the esophageal mucosa was performed in 56/70 (80%) participants, which 27/56 (48.21%) showed microerosions. Also, no difference occurred between participants with or without endoscopic microerosions regarding total number of cells immunolabelled and number of cells per tissue area. Conclusions: No difference occurred between the groups of participants with typical symptoms of GERD and with or without esophageal microerosions screened by high-definition digestive endoscopy coupled with NBI regarding pHmetric, histological and immunohistochemical analysis.
{"title":"Screening of endoscopic microerosions in non-erosive esophagitis by high-definition digestive endoscopy coupled with narrow-band imaging and microerosions analysis by immunohistochemical, pHmetric and histology","authors":"Frederico S Assirati, Luiz HS Fontes, C. Pagliari, Luciane K Galo, Wellington LF da Silva, Rafaela BB Pinheiro, Claudio L Hashimoto, T. Navarro-Rodriguez","doi":"10.15761/GHE.1000196","DOIUrl":"https://doi.org/10.15761/GHE.1000196","url":null,"abstract":"Introduction: Gastroesophageal reflux disease (GERD) is considered one of the most prevalent digestive diseases in Western countries. In many cases, the symptomatic GERD is linked to a normal upper gastrointestinal endoscopy and new endoscopic techniques to identify the abnormalities are need. The high-definition digestive endoscopy coupled with narrow band imaging (NBI) could achieve a more detailed mucosal evaluation, allowing the identification of distal esophageal microerosions. Objectives: To validate the presence of distal esophageal microerosions as found in high-definition endoscopy with NBI and the associative pHmetry, histological, immunohistochemical findings of tissue specimens obtained from esophageal biopsies of patients with typical symptoms of GERD. Methods: A total of 70 participants were enrolled in a prospective, descriptive and cross-sectional study from a gastroenterology outpatient clinic. Endoscopic evaluation was sequentially performed after the pHmetry. Esophageal mucosal biopsies were obtained to perform the histological and immunohistochemical analysis. Results: From 70 participants, 30/70 (42.9%) showed mucosal microerosions. Both, pHmetry and histologic score for esophageal mucosa did not showed difference between participants with or without endoscopic microerosions. The quantitative cellular evaluation by immunohistochemistry of the esophageal mucosa was performed in 56/70 (80%) participants, which 27/56 (48.21%) showed microerosions. Also, no difference occurred between participants with or without endoscopic microerosions regarding total number of cells immunolabelled and number of cells per tissue area. Conclusions: No difference occurred between the groups of participants with typical symptoms of GERD and with or without esophageal microerosions screened by high-definition digestive endoscopy coupled with NBI regarding pHmetric, histological and immunohistochemical analysis.","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79363611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
All authors do not have any financial or other relationship to disclose. Background For years efforts have been made to improve the quality of colonoscopy. Cap assisted colonoscopy has been shown in some studies to increase the adenoma detec-tion rate (ADR). Full-spectrum colonoscopes (FUSE) with 330°angle of view showed by initial studies a significantly lower adenoma missrate and higher ADR. Subsequent FUSE studies with already high ADR with SFV were unable to confirm these results.
{"title":"Comparison of newer colonoscopy devices with standard forward viewing (SFV) high definition colonoscopies in daily practice","authors":"M. Geyer, Dominik J. Leiner, F. Bannwart","doi":"10.15761/ghe.1000200","DOIUrl":"https://doi.org/10.15761/ghe.1000200","url":null,"abstract":"All authors do not have any financial or other relationship to disclose. Background For years efforts have been made to improve the quality of colonoscopy. Cap assisted colonoscopy has been shown in some studies to increase the adenoma detec-tion rate (ADR). Full-spectrum colonoscopes (FUSE) with 330°angle of view showed by initial studies a significantly lower adenoma missrate and higher ADR. Subsequent FUSE studies with already high ADR with SFV were unable to confirm these results.","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88150660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Received: August 10, 2020; Accepted: August 24, 2020; Published: August 31, 2020 Acute variceal bleeding (AVB) is seen in 50-70% of patients with cirrhosis & portal hypertension (PHT) [1]. Over the passage of time the severity of the variceal bleeding and complications related to it have significantly reduced. This reduction in complications is due to improvement in the clinical management, universal availability of vasopressor drugs, improved endoscopic therapies as well as due to availability of definitive treatment options such as trans jugular intra hepatic porto systemic shunt (TIPS) and liver transplantation. About 10-20% patients presenting with AVB do not respond to the initial management (defined as failure to control bleeding within 48 hrs) and develop re bleeding within 5 days of starting the therapy (after initial control of bleeding), these patients can be defined to have refractory variceal bleeding (Figure 2).
{"title":"Update on the management of refractory variceal bleeding","authors":"K. Jamwal, R. Padhan","doi":"10.15761/GHE.1000209","DOIUrl":"https://doi.org/10.15761/GHE.1000209","url":null,"abstract":"Received: August 10, 2020; Accepted: August 24, 2020; Published: August 31, 2020 Acute variceal bleeding (AVB) is seen in 50-70% of patients with cirrhosis & portal hypertension (PHT) [1]. Over the passage of time the severity of the variceal bleeding and complications related to it have significantly reduced. This reduction in complications is due to improvement in the clinical management, universal availability of vasopressor drugs, improved endoscopic therapies as well as due to availability of definitive treatment options such as trans jugular intra hepatic porto systemic shunt (TIPS) and liver transplantation. About 10-20% patients presenting with AVB do not respond to the initial management (defined as failure to control bleeding within 48 hrs) and develop re bleeding within 5 days of starting the therapy (after initial control of bleeding), these patients can be defined to have refractory variceal bleeding (Figure 2).","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85070233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present an unusual case of a 59 years old female patient with irritable bowel syndrome, and arthritis who underwent a screening colonoscopy. In the rectosigmoid junction a hemorrhagic polypoid mass with a diameter of 1.5 cm (Figure 1), has been detected and been excluded. Histology reveals a solid rectal ulcer characterized by abnormal hyperplastic crypts, dense mixed type inflammatory infiltrates of the lamina propria and ulceration on its surface.
{"title":"Solid rectal ulcer syndrome: An unusual case presentation","authors":"N. Chrysanthos, P. Alexandrou, A. Lazaris","doi":"10.15761/GHE.1000198","DOIUrl":"https://doi.org/10.15761/GHE.1000198","url":null,"abstract":"We present an unusual case of a 59 years old female patient with irritable bowel syndrome, and arthritis who underwent a screening colonoscopy. In the rectosigmoid junction a hemorrhagic polypoid mass with a diameter of 1.5 cm (Figure 1), has been detected and been excluded. Histology reveals a solid rectal ulcer characterized by abnormal hyperplastic crypts, dense mixed type inflammatory infiltrates of the lamina propria and ulceration on its surface.","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"281 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75919581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01Epub Date: 2020-10-08DOI: 10.47690/wjghe.2020.3303
M B Sturm, B P Joshi, S R Owens, E J Seibel, T D Wang
Introduction: Indeterminant biliary strictures can be either malignant or benign. Biliary intraepithelial neoplasia (BilIN) is the precursor lesion to cholangiocarcinoma, a deadly bile duct cancer. Current diagnostic methods are limited by inadequate amounts of cells and tissues collected.
Aim: We aim to demonstrate use of fluorescently-labeled peptides specific for EGFR, claudin-1, and ErbB2 to perform multiplexed imaging of biliary neoplasia.
Methods: Formalin fixed and paraffin embedded specimens resected from human biliary strictures were sectioned. A gastrointestinal pathologist used standard criteria to score immunohistochemistry from biliary neoplasia and adjacent normal epithelium from the same specimen. Peptides specific for EGFR, claudin-1, and ErbB2 were fluorescently-labeled with FITC, Cy5, and IRDye800, respectively. The fluorophores were chosen to provide spectral separation to distinguish the individual targets. Immuno fluorescence images were collected using confocal microscopy.
Results: Target expression was validated using immunohistochemistry. Staining was visualized on the surface of biliary duct epithelial cells and not in the stroma. Greater fluorescence intensity was observed for peptide binding to biliary neoplasia by comparison with normal. The mean ratio for neoplasia-to-normal was 1.4, 1.7, and 1.6, respectively, and the average intensities were significantly greater for neoplasia than normal for each peptide. Peptides and antibody binding co-localized with correlation of ρ=0.64, 0.51 and 0.62, respectively.
Conclusions: A panel of fluorescently-labeled peptides can distinguish BilIN and cholangiocarcinoma from normal biliary epithelium, and may be used for multiplexed imaging of indeterminant biliary strictures.
{"title":"Multiplexed Imaging Strategy to Distinguish Indeterminant Biliary Strictures: An <i>Ex Vivo</i> Study.","authors":"M B Sturm, B P Joshi, S R Owens, E J Seibel, T D Wang","doi":"10.47690/wjghe.2020.3303","DOIUrl":"10.47690/wjghe.2020.3303","url":null,"abstract":"<p><strong>Introduction: </strong>Indeterminant biliary strictures can be either malignant or benign. Biliary intraepithelial neoplasia (BilIN) is the precursor lesion to cholangiocarcinoma, a deadly bile duct cancer. Current diagnostic methods are limited by inadequate amounts of cells and tissues collected.</p><p><strong>Aim: </strong>We aim to demonstrate use of fluorescently-labeled peptides specific for EGFR, claudin-1, and ErbB2 to perform multiplexed imaging of biliary neoplasia.</p><p><strong>Methods: </strong>Formalin fixed and paraffin embedded specimens resected from human biliary strictures were sectioned. A gastrointestinal pathologist used standard criteria to score immunohistochemistry from biliary neoplasia and adjacent normal epithelium from the same specimen. Peptides specific for EGFR, claudin-1, and ErbB2 were fluorescently-labeled with FITC, Cy5, and IRDye800, respectively. The fluorophores were chosen to provide spectral separation to distinguish the individual targets. Immuno fluorescence images were collected using confocal microscopy.</p><p><strong>Results: </strong>Target expression was validated using immunohistochemistry. Staining was visualized on the surface of biliary duct epithelial cells and not in the stroma. Greater fluorescence intensity was observed for peptide binding to biliary neoplasia by comparison with normal. The mean ratio for neoplasia-to-normal was 1.4, 1.7, and 1.6, respectively, and the average intensities were significantly greater for neoplasia than normal for each peptide. Peptides and antibody binding co-localized with correlation of ρ=0.64, 0.51 and 0.62, respectively.</p><p><strong>Conclusions: </strong>A panel of fluorescently-labeled peptides can distinguish BilIN and cholangiocarcinoma from normal biliary epithelium, and may be used for multiplexed imaging of indeterminant biliary strictures.</p>","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Özkaya, E. Canda, M. Köse, M. Kağnıcı, E. Sözmen, M. Çoker, S. K. Uçar
Background: Lysosomal acid lipase (LAL) enzyme, is responsible for the hydrolysis of intracellular triacylglycerol and cholesterol esters. We investigate the LAL activity (LAL-A) in patients with hepatic dysfunction and/or dyslipidemia and determine the associated clinical and biochemical parameters. Methods: This prospective, cross-sectional study included 360 children (3 months -18 years; 40 control, and 320 screening patients). Demographic data, major clinical and laboratory findings, LAL-A and possible biomarkers were evaluated. Screening group was divided into two: LAL-A<0.6 nmol/ml/h (Group1); LAL-A ≥ 0.6 nmol/ml/h (Group 2). LAL-A predictive model was evaluated using logistic regression. Results: The mean LAL-A in the screening group (1.43 ± 2.05 (0.03-16.8) nmol/ml/h) was significantly reduced compare to controls (p < 0.001). No LAL deficiency was detected. There was a negative correlation between LAL-A and low-density lipoprotein cholesterol, triglyceride, and alanine aminotransferase (ALT) levels. LAL-A in patients with chronic fatigue (p = 0.002), hepatomegaly (p = 0.013) and splenomegaly (p = 0.001) were significantly lower compare to those without. The median thiobarbituric acid reactive substances, myeloperoxidase, chitotriosidase, hs-CRP, Citokeratin levels in Group 1 were higher compare to the controls (p < 0.005). Conclusions: LAL-A was reduced in paediatric patients with dyslipidemia and/or elevated transaminase. Our final multivariable predictive model for reduced LAL-A included: ALT, triglyceride, and hepatomegaly. *Correspondence to: Sema Kalkan Uçar, Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Bornova, Izmir, Turkey, Tel: 90.232.390.1037, E-mail: semakalkan@hotmail.com
{"title":"Lysosomal acid lipase activity in children with dyslipidemia and hepatic dysfunction","authors":"B. Özkaya, E. Canda, M. Köse, M. Kağnıcı, E. Sözmen, M. Çoker, S. K. Uçar","doi":"10.15761/GHE.1000205","DOIUrl":"https://doi.org/10.15761/GHE.1000205","url":null,"abstract":"Background: Lysosomal acid lipase (LAL) enzyme, is responsible for the hydrolysis of intracellular triacylglycerol and cholesterol esters. We investigate the LAL activity (LAL-A) in patients with hepatic dysfunction and/or dyslipidemia and determine the associated clinical and biochemical parameters. Methods: This prospective, cross-sectional study included 360 children (3 months -18 years; 40 control, and 320 screening patients). Demographic data, major clinical and laboratory findings, LAL-A and possible biomarkers were evaluated. Screening group was divided into two: LAL-A<0.6 nmol/ml/h (Group1); LAL-A ≥ 0.6 nmol/ml/h (Group 2). LAL-A predictive model was evaluated using logistic regression. Results: The mean LAL-A in the screening group (1.43 ± 2.05 (0.03-16.8) nmol/ml/h) was significantly reduced compare to controls (p < 0.001). No LAL deficiency was detected. There was a negative correlation between LAL-A and low-density lipoprotein cholesterol, triglyceride, and alanine aminotransferase (ALT) levels. LAL-A in patients with chronic fatigue (p = 0.002), hepatomegaly (p = 0.013) and splenomegaly (p = 0.001) were significantly lower compare to those without. The median thiobarbituric acid reactive substances, myeloperoxidase, chitotriosidase, hs-CRP, Citokeratin levels in Group 1 were higher compare to the controls (p < 0.005). Conclusions: LAL-A was reduced in paediatric patients with dyslipidemia and/or elevated transaminase. Our final multivariable predictive model for reduced LAL-A included: ALT, triglyceride, and hepatomegaly. *Correspondence to: Sema Kalkan Uçar, Department of Pediatrics, Division of Metabolism and Nutrition, Ege University Medical Faculty, Bornova, Izmir, Turkey, Tel: 90.232.390.1037, E-mail: semakalkan@hotmail.com","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83675407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
El Mountassir M, Borahma M, Benelbarhdadi I, Lagdali N, Ajana Fz
{"title":"Difficult common bile duct stones: Case series and literature review","authors":"El Mountassir M, Borahma M, Benelbarhdadi I, Lagdali N, Ajana Fz","doi":"10.15761/ghe.1000214","DOIUrl":"https://doi.org/10.15761/ghe.1000214","url":null,"abstract":"","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72531768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Refractory coeliac disease (RCD) is defined by persistent or recurrent malabsorptive symptoms and villous atrophy despite strict adherence to a gluten-free diet (GFD) for at least 6–12 months in the absence of other causes of non-responsive treated coeliac disease and overt malignancy. Symptoms are often severe and require additional therapeutic intervention besides a GFD. RCD can be classified as type 1 which usually improves after treatment with a combination of aggressive nutritional support, adherence to a GFD, and alternative pharmacological therapies. By contrast, clinical response to alternative therapies in RCD type 2 is less certain and the prognosis is poor. Severe complications such as ulcerative jejunitis and enteropathy-associated T cell lymphoma may occur in a subgroup of patients with RCD. The aim of this article is to describe the profile of patients with RCD, their management, and their evolution in a series of 284 patients with celiac disease. *Correspondence to: Ghita Bennani, Department of Diseases of the Digestive System, Medicine C, CHU IBN SINA-Souissi Med University, V-Rabat, Morocco, Tel: +212 5376-76464; E-mail: ghita_med5@yahoo.fr
难治性乳糜泻(RCD)定义为持续或反复出现吸收不良症状和绒毛萎缩，尽管严格坚持无麸质饮食(GFD)至少6-12个月，但没有其他原因导致治疗无反应的乳糜泻和明显的恶性肿瘤。症状通常很严重，除GFD外，还需要额外的治疗干预。RCD可归类为1型，通常在积极的营养支持、坚持GFD和替代药物治疗的组合治疗后改善。相比之下，RCD 2型患者对替代疗法的临床反应不太确定，预后较差。严重的并发症，如溃疡性空肠炎和肠病相关T细胞淋巴瘤可能发生在RCD患者亚组中。本文的目的是描述284例乳糜泻患者的RCD的概况，他们的管理和他们的演变。*通讯:Ghita Bennani，消化系统疾病科，医学C, CHU IBN SINA-Souissi医科大学，摩洛哥拉巴特，电话:+212 5376-76464;电子邮件:ghita_med5@yahoo.fr
{"title":"Refractory coeliac disease: About five cases","authors":"G. Bennani, A. Jahid, I. Benelberhdadi, F. Ajana","doi":"10.15761/GHE.1000201","DOIUrl":"https://doi.org/10.15761/GHE.1000201","url":null,"abstract":"Refractory coeliac disease (RCD) is defined by persistent or recurrent malabsorptive symptoms and villous atrophy despite strict adherence to a gluten-free diet (GFD) for at least 6–12 months in the absence of other causes of non-responsive treated coeliac disease and overt malignancy. Symptoms are often severe and require additional therapeutic intervention besides a GFD. RCD can be classified as type 1 which usually improves after treatment with a combination of aggressive nutritional support, adherence to a GFD, and alternative pharmacological therapies. By contrast, clinical response to alternative therapies in RCD type 2 is less certain and the prognosis is poor. Severe complications such as ulcerative jejunitis and enteropathy-associated T cell lymphoma may occur in a subgroup of patients with RCD. The aim of this article is to describe the profile of patients with RCD, their management, and their evolution in a series of 284 patients with celiac disease. *Correspondence to: Ghita Bennani, Department of Diseases of the Digestive System, Medicine C, CHU IBN SINA-Souissi Med University, V-Rabat, Morocco, Tel: +212 5376-76464; E-mail: ghita_med5@yahoo.fr","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75361392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steve M D’Souza, Lindsey B Cundra, Byung S Yoo, Parth J. Parekh, David A Johnson
{"title":"Microbiome and gastroesophageal disease: Pathogenesis and implications for therapy","authors":"Steve M D’Souza, Lindsey B Cundra, Byung S Yoo, Parth J. Parekh, David A Johnson","doi":"10.15761/ghe.1000199","DOIUrl":"https://doi.org/10.15761/ghe.1000199","url":null,"abstract":"","PeriodicalId":93828,"journal":{"name":"World journal of gastroenterology, hepatology and endoscopy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81401522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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