Volume 69 - 2006 - Fasc.3 - Case reports
Mesalazine interstitial nephritis presenting as colitis ulcerosa exacerbation
Mesalazine is the first line treatment in paediatric inflammato- ry bowel disease (IBD). There are several reports in literature about nephrotoxicity (1/150 treated patients), from renal insuffi- ciency to reversible nephritis. It is currently advised to follow cre- atinin in patients treated with mesalazine during the first 5 years of treatment ; however this may reveal the problem too late. As demonstrated in this paediatric case, a high degree of clinical sus- picion is needed to diagnose the side effects before irreversible kid- ney damage occurs. Since the treatment of IBD exacerbation and mesalazine induced interstitial nephritis is based upon steroids, delayed diagnosis of the latter is at risk. (Acta gastroenterol. belg., 2006, 69, 276-277).
Focal fatty liver sparing lesion presenting as a “pseudotumor" : case report
We are reporting our experience of a case of "focal fatty liver sparing lesion" in a 24-year-old patient, without any evident pre- disposing factors for fatty infiltration of the liver. Fatty liver infil- tration was sparing the posterior part of liver segment VI, defin- ing an area which was mimicking a lesion on US and CT. Fatty liver infiltration is usually diffuse but may be patchy or localized. Occasionally, focal areas of normal parenchyma in an otherwise diffuse fatty liver may simulate mass lesions. Typically, these "pseudolesions" appear as echo-poor areas against a background of bright echoes due to fatty infiltration and may pose a difficult diagnostic problem. We present this case and discuss the investi- gation process in order to differentiate this lesion from a hepatic tumor. (Acta gastroenterol. belg., 2006, 69, 278-281).
Fluoroscopically guided endoluminal balloon dilation of esophageal stricture due to dystrophic epidermolysis bullosa in two sisters
Dystrophic epidermolysis bullosa is an inherited disorder with frequent oesophageal stricture formation. There is no satisfactory medical treatment of dysphagia however ; endoluminal balloon dilation is a novel method with satisfactory results. Intrafamilial cases of dystrophic epidermolysis bullosa manifest variable clini- cal presentations. We report two sisters with dystrophic epider- molysis bullosa simultaneously presenting with dysphagia. Fluoroscopically guided endoscopic balloon dilation revealed almost complete resolution of dysphagia in both patients. Our cases represented a striking similarity in their clinical picture and response to treatment. Balloon dilation in these cases is a safe and effective approach. (Acta gastroenterol. belg., 2006, 69, 282-284).
Hepatoid adenocarcinoma of the stomach : report of five cases and review of the literature
We report on a rare hepatoid adenocarcinoma of the stomach producing alpha-fetoprotein (AFP) in five cases. Definitive fea- tures included an aggressive, invasive, and rapidly progressing neoplasm showing areas morphologically comparable to those of hepatocellular carcinomas. All patients had multiple metastases to lymph nodes and/or liver. The serum AFP level of the patients was between 83-87.900 ng/ml. Two subtotal and one palliative gastrec- tomy was performed. A short duration of chemotherapy was administered only in two patients. The length of survival averaged 4.7 months. Our experience together with what has been reported in literature suggest that the course of hepatoid adenocarcinoma of the stomach is more aggressive than an ordinary adenocarcino- ma and that from a diagnostic point of view distinction from an adenocarcinoma may be accomplished histochemically and by measuring serum AFP levels. (Acta gastroenterol. belg., 2006, 69, 285-292).
Mesalazine interstitial nephritis presenting as colitis ulcerosa exacerbation
Mesalazine is the first line treatment in paediatric inflammato- ry bowel disease (IBD). There are several reports in the literature about nephrotoxicity (1/150 treated patients), from renal insuffi- ciency to reversible nephritis. It is currently advised to follow cre- atinin in patients treated with mesalazine during the first 5 years of treatment ; however this may reveal the problem too late. As demonstrated in this paediatric case, a high degree of clinical sus- picion is needed to diagnose the side effects before irreversible kid- ney damage occurs. Since the treatment of IBD exacerbation and mesalazine induced interstitial nephritis is based upon steroids, delayed diagnosis of the latter is at risk. (Acta gastroenterol. belg., 2006, 69, 321-322).
Focal fatty liver sparing lesion presenting as a “pseudotumour" : case report
Fluoroscopically guided endoluminal balloon dilation of oesophageal stricture due to dystrophic epidermolysis bullosa in two sisters
Dystrophic epidermolysis bullosa is an inherited disorder with frequent oesophageal stricture formation. There is no satisfactory medical treatment of dysphagia however ; endoluminal balloon dilation is a novel method with satisfactory results. Intrafamilial cases of dystrophic epidermolysis bullosa manifest variable clini- cal presentations. We report two sisters with dystrophic epider- molysis bullosa simultaneously presenting with dysphagia. Fluoroscopically guided endoscopic balloon dilation revealed almost complete resolution of dysphagia in both patients. Our cases represented a striking similarity in their clinical picture and response to treatment. Balloon dilation in these cases is a safe and effective approach. (Acta gastroenterol. belg., 2006, 69, 327-329).
Hepatoid adenocarcinoma of the stomach : report of five cases and review of the literature
We report on a rare hepatoid adenocarcinoma of the stomach producing alpha-fetoprotein (AFP) in five cases. Definitive fea- tures included an aggressive, invasive, and rapidly progressing neoplasm showing areas morphologically comparable to those of hepatocellular carcinomas. All patients had multiple metastases to lymph nodes and/or liver. The serum AFP level of the patients was between 83-87.900 ng/ml. Two subtotal and one palliative gastrec- tomy was performed. A short duration of chemotherapy was administered only in two patients. The length of survival averaged 4.7 months. Our experience together with what has been reported in literature suggest that the course of hepatoid adenocarcinoma of the stomach is more aggressive than an ordinary adenocarcino- ma and that from a diagnostic point of view distinction from an adenocarcinoma may be accomplished histochemically and by measuring serum AFP levels. (Acta gastroenterol. belg., 2006, 69, 330-337).
