31 research outputs found
A Review of Ophthalmic Complications in Inflammatory Bowel Diseases
No full textInflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are chronic immune-mediated conditions caused by various polygenic and environmental factors. Clinical manifestations of IBD primarily occur in the gastrointestinal tract, but many patients are affected by extraintestinal complications, including eye diseases. Ocular disorders are the third most common extraintestinal manifestation (EIM), following musculoskeletal and mucocutaneous involvement. Episcleritis, frequently occurring in IBD patients, may be associated with exacerbation of the intestinal disease. Uveitis does not correlate with IBD activity but may be related to the presence of other EIMs, particularly erythema nodosum and peripheral arthritis. Early detection and specific therapy of ocular manifestations of IBD are fundamental to avoiding sight-threatening complications. Therefore, ophthalmic evaluation should be performed in all IBD patients. Systemic corticosteroids or immunosuppressants may be inevitable in severe cases to control ocular inflammation. Persistent and relapsing conditions usually respond well to TNF-α-inhibitors. Interdisciplinary cooperation between gastroenterologists and ophthalmologists is fundamental in initiating the appropriate treatment for patients
Guzkowy przerost limfoidalny dwunastnicy u dwojga dzieci z zakażeniem Helicobacter pylori i izolowanym deficytem IgA
No full textEndoscopic Ultrasonography in Children with Eosinophilic Esophagitis—A Review
No full textEndoscopic ultrasonography (EUS) is a diagnostic endoscopy of the upper gastrointestinal tract, during which ultrasound of nearby organs is also performed. It is also possible to perform a fine needle aspiration biopsy. Currently, EUS is performed more frequently in adults. Despite some limitations, this diagnostic method is also more and more often performed in pediatric patients. Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus, which also occurs in children, and leads to irreversible fibrosis of the esophagus wall, if left untreated. Traditional methods of diagnosing and monitoring EoE treatment have significant limitations, and the use of EUS and total esophageal wall thickness (TWT) assessment may bring measurable benefits. Several studies have shown an increased thickening of TWT in EoE in children compared to pediatric patients with gastroesophageal reflux disease, and a decrease in TWT in adults who responded to EoE treatment. These results suggest that EUS and TWT measurement may become an important test in diagnostics, monitoring the effectiveness of therapy, assessing disease progression, and in individualizing the method and duration of EoE treatment also in children
Phacomatoses, genetic testing for personalisation of clinical management (part 2)
No full textVon Hippel-Lindau disease and tuberous sclerosis are rare genetic disorders, which belong to the group of phacomatoses. They involve an increased risk of development of multiple cancers, mostly benign ones, which may undergo malignant transformation. Genetic diagnostic including identification of the pathogenic variant of the VHL and TSC1 and TSC2 genes enables optimisation of patient care and identification of relatives who carry the mutation
Fakomatozy, znaczenie badań genetycznych dla personalizacji postępowania klinicznego (część 1).
No full textGenetycznie uwarunkowane zaburzenia rozwoju tkanek wywodzących się z ekto, endo i mezodermy, powstające na wczesnym etapie życia płodowego zwane fakomatozami stanowią liczną grupę schorzeń predysponujących do rozwoju nowotworów . Wczesna diagnostyka obejmująca identyfikację mutacji oraz ocenę kliniczną umożliwia objęcie pacjentów z potwierdzonym rozpoznaniem wielospecjalistyczną opieką, co poprawia długoterminowe rokowanie oraz wpływa na podwyższenie jakości życia chorych. Do najczęstszych fakomatoz należą: nerwiakowłókniakowatość typu 1 i 2 oraz Schwannomatoza
Etiology of IBD—Is It Still a Mystery?
No full textInflammatory bowel diseases (IBD), including colitis ulcerosa and Crohn’s disease, are chronic diseases of the gastrointestinal tract for which the cause has not been fully understood. However, it is known that the etiology is multifactorial. The multidirectional network of interactions of environmental, microbiological and genetic factors in predisposed persons lead to an excessive and insufficiently inhibited reaction of the immune system, leading to the development of chronic inflammation of the gastrointestinal walls, the consequence of which is the loss of the function that the intestine performs, inter alia, through the process of fibrosis. Detailed knowledge of the pathways leading to chronic inflammation makes it possible to pharmacologically modulate disorders and effectively treatthese diseases. In this review, we described the primary and adaptive immune system response in the gut and the known immune pathogenetic pathways leading to the development of IBD. We also described the process leading to intestinal tissue fibrosis, which is an irreversible consequence of untreated IBD
The Impact of Pentraxin 3 on Crohn’s Disease Phenotype
No full textPentraxin 3 [PTX3] is an acute-phase protein playing an important role in the regulation of the humoral arm of immune response. As one of the molecules from the conservative family of pentraxins, PTX3 is a soluble mediator involved in the transduction of pro-inflammatory signals between immunocompetent cells. Additionally, recognizing damage-associated molecular patterns (DAMPs) during tissue injury mediates wound healing; therefore, its concentration potentially correlates with the severity of fibrosis. The aim of our study was to evaluate the value of the PTX3 measurement as a phenotypic marker of the stenotic form of Crohn’s disease. The research covered 63 patients, 35 with the narrowing type (B2) and 28 with the inflammatory type (B2) of CD. The mean concentrations of PTX3 in the study were as follows: 3.06 ng/mL (95% CI: 1.27–6.99) for the B1 phenotype, 4.89 ng/mL (95% CI: 2.98–13.65) for the B2 phenotype, and 3.04 ng/mL (95% CI: 1.01–4.97) for the control group. PTX3 concentrations reached the highest values in the B2 group and the lowest in the control group. The differences between the B1 and B2 groups were statistically significant at p < 0.001. The presented studies indicate the potential role of PTX3 in the monitoring of tissue remodeling and the development of fibrosis in CD
