Inflammatory bowel disease (IBD) is profoundly associated with extraintestinal manifestations (EIM) that can involve almost every organ in our body. Although the exact etiology of IBD is still poorly understood, it is...Inflammatory bowel disease (IBD) is profoundly associated with extraintestinal manifestations (EIM) that can involve almost every organ in our body. Although the exact etiology of IBD is still poorly understood, it is generally characterized by an overly aggressive inflammatory response in the intestinal mucosa. Renal damage is one of the manifestations encountered in Crohn’s disease (CD) and ulcerative colitis (UC) and it accounts for 4% - 23% of IBD patients. The common renal complications of IBD include: glomerulonephritis, tubulointerstitial nephritis, nephrolithiasis, amyloidosis and iatrogenic complications of IBD treatment. Several hypotheses have emerged to explain the pathogenic mechanisms underlying the prevalence of IBD-induced kidney injuries. The present work aims to elucidate the pathological principles that drive secondary renal injury in individuals with IBD and highlight the currently used therapeutic strategies for evaluating, monitoring and treating kidney complications-related IBD.展开更多
Schistosomiasis is a chronic worm infection caused by a species of trematodes, the Schistosomes. We may distinguish a urinary form from Schistosomes haematobium and an intestinal-hepatosplenic form mainly from Schisto...Schistosomiasis is a chronic worm infection caused by a species of trematodes, the Schistosomes. We may distinguish a urinary form from Schistosomes haematobium and an intestinal-hepatosplenic form mainly from Schistosomes mansonicharacterized by nausea, meteorism, abdominal pain, bloody diarrhea,rectal tenesmus, and hepatosplenomegaly. These infections represent a major health issue in Africa,Asia, and South America, but recently S mansoni has increased its prevalence in other countries, such as Europe countries and USA, due to international travelers and immigrants, with several diagnostic and prevention problems. We report a case of a 24-yearold patient without HIV infection, originated from Ghana, admitted for an afebrile dysenteric syndrome.All microbiologic studies were negative and colonoscopy revealed macroscopic lesions suggestive of a bowel inflammatory chronic disease. Since symptoms became worse, a therapy with mesalazine (2 g/d) was started,depending on the results of a bowel biopsy, but without any resolution. The therapy was stopped after 2 wk when the following result was available: a diagnosis of"intestinal schistosomiasis" was done (two Schistosoma eggs were detected in the colonic mucosa) and this was confirmed by the detection of Schistosoma eggs in the feces. Therapy was therefore changed to praziquantel(40 mg/kg, single dose), a specific anti-parasitic agent,with complete recovery. Schistosomiasis shows some peculiar difficulties in terms of differential diagnosis from the bowel inflammatory chronic disease, as the two disorders may show similar colonoscopic patterns.Since this infection has recently increased its prevalence worldwide, it was considered in the differential diagnosis of our patient with gastrointestinal symptoms.展开更多
文摘Inflammatory bowel disease (IBD) is profoundly associated with extraintestinal manifestations (EIM) that can involve almost every organ in our body. Although the exact etiology of IBD is still poorly understood, it is generally characterized by an overly aggressive inflammatory response in the intestinal mucosa. Renal damage is one of the manifestations encountered in Crohn’s disease (CD) and ulcerative colitis (UC) and it accounts for 4% - 23% of IBD patients. The common renal complications of IBD include: glomerulonephritis, tubulointerstitial nephritis, nephrolithiasis, amyloidosis and iatrogenic complications of IBD treatment. Several hypotheses have emerged to explain the pathogenic mechanisms underlying the prevalence of IBD-induced kidney injuries. The present work aims to elucidate the pathological principles that drive secondary renal injury in individuals with IBD and highlight the currently used therapeutic strategies for evaluating, monitoring and treating kidney complications-related IBD.
文摘Schistosomiasis is a chronic worm infection caused by a species of trematodes, the Schistosomes. We may distinguish a urinary form from Schistosomes haematobium and an intestinal-hepatosplenic form mainly from Schistosomes mansonicharacterized by nausea, meteorism, abdominal pain, bloody diarrhea,rectal tenesmus, and hepatosplenomegaly. These infections represent a major health issue in Africa,Asia, and South America, but recently S mansoni has increased its prevalence in other countries, such as Europe countries and USA, due to international travelers and immigrants, with several diagnostic and prevention problems. We report a case of a 24-yearold patient without HIV infection, originated from Ghana, admitted for an afebrile dysenteric syndrome.All microbiologic studies were negative and colonoscopy revealed macroscopic lesions suggestive of a bowel inflammatory chronic disease. Since symptoms became worse, a therapy with mesalazine (2 g/d) was started,depending on the results of a bowel biopsy, but without any resolution. The therapy was stopped after 2 wk when the following result was available: a diagnosis of"intestinal schistosomiasis" was done (two Schistosoma eggs were detected in the colonic mucosa) and this was confirmed by the detection of Schistosoma eggs in the feces. Therapy was therefore changed to praziquantel(40 mg/kg, single dose), a specific anti-parasitic agent,with complete recovery. Schistosomiasis shows some peculiar difficulties in terms of differential diagnosis from the bowel inflammatory chronic disease, as the two disorders may show similar colonoscopic patterns.Since this infection has recently increased its prevalence worldwide, it was considered in the differential diagnosis of our patient with gastrointestinal symptoms.
