Clinical overlap of multiple sclerosis and autoimmune hepatitis: three cases

Multiple sclerosis (MS) is an autoimmune, inflammatory disease characterized by demyelination and axonal degeneration in the central nervous system. MS is the second major cause of disability following trauma, and is mostly seen between the ages of 20 - 40 years and in women. Autoimmune hepatitis (AH) is a chronic disease characterized by hypergammaglobulinemia, high levels of transaminases, presence of antibodies, and histologically by the necroinflammatory process with interface hepatitis. In AH, the etiological agent of the disease and the cause of liver injury remain unknown. MS may be associated with AH, autoimmune thyroiditis, and type 1 diabetes mellitus (DM). In literature, 8 cases with overlap of MS and AH have been reported. In this report, we present 3 cases which were detected with overlap of MS and AH, and are very rare condition in literature

Peripheral blood levels of cellular and humoral immunity parameters in esophageal and gastric cancer patients

Aim: To evaluate parameters of cellular and humoral immunity in gastric and esophageal cancer patients. Material and methods: In this study, we recruited 40 patients with newly diagnosed esophageal cancer (20 of them) or stomach cancer (20 of them) and 20 healthy individuals of similar age as a control group. In the study and control groups we measured CD3, CD4, CD8, CD19, CD4/CD8 ratio and the ratio of natural killer cells using the flow cytometer device. Results were evaluated with factorial analysis of variance and Duncan test. Results: The CD3 and CD8 ratios were significantly higher in patients with esophageal cancer (p = 0.012, p = 0.003, respectively) and the ratio of NK cells was significantly higher in patients with stomach cancer (p = 0.001) when compared to the control group. The ratio of CD19 was significantly lower in the two cancer groups (p = 0.031). There were no significant differences in the ratio of CD4 and CD4/CD8 between the groups. No correlation between the stage of cancer and the ratio of CD cells was detected. Discussion: In conclusion, understanding of the cancer immunology of esophageal and stomach cancer will provide insight into the pathogenesis of the cancer Therefore, further and extensive cancer immunology studies should be conducted to understand the nature of the upper gastrointestinal tract cancers

Helicobacter pylori infection in amniotic fluid may cause hyperemesis gravidarum

Objectives: Limited data are available from recent trials involving pregnant women to guide Helicobacter pylori infection diagnosis. There are no data about the presence of H. pylori in the amniotic fluid as well. Furthermore, the relation between amniotic fluid H. pylori and hyperemesis gravidarum (HG) has not been characterized yet. Materials and Methods: This is a prospective study conducted after obtaining approval from the Ethics Committee. Pregnant women undergoing amniocentesis were enrolled in the study. The stool antigen test assessed the presence of H. pylori in amniotic fluid. A perinatologist independently performed an amniocentesis. The obtained amniotic liquid was sent to the laboratory to evaluate H. pylori infection by stool H. pylori antigen assay. We determined the rate of H. pylori in amniotic fluid and assessed relations between H. pylori infection and pregnancy outcome, including HG. Results: Between May and September 2017, we enrolled 48 pregnant women who underwent amniocentesis to detect possible fetal malformations. Patients were divided into two groups regarding the HG status. There were significant differences between the groups in terms of H. pylori infection presence. Among them, 28 (58.3%) were found to have a positive H. pylori test in their amniotic fluid. The rate of HG was significantly higher (71.4%) in patients who tested positive for H. pylori in amniocentesis than the H. pylori-negative group (20%), (p<0.001). Conclusions: The study’s main new finding is that presence of H. pylori in the amniotic fluid is possible. Our data suggest that H. pylori-infected amniotic fluid is associated with the experience of past HG. The current study may have important implications for HG detection and help identify patients who would benefit from future preventive strategies. © 2020 Global Research Online. All rights reserved

Syndrome of Inappropriate Secretion of Antidiuretic Hormone Cholestasis and Pericardial Effusion Due to Brucellosis Infection: A Case Report

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is an extremely rare complication of infectious diseases. A rare case of brucellosis complicated by syndrome of inappropriate secretion of antidiuretic hormone (SIADH) cholestasis and pericardial involvement is reported. A 27-year-old woman was admitted for fever, abdominal pain, and scleral icterus. Her medical history revealed no recent use of diuretic agents. In addition to cholestasis and elevated liver enzymes, euvolemic hyponatremia, hypouricemia, low plasma osmolality, and high urinary osmolality were also detected. Surrenal and thyroid tests were also within normal range. Echocardiography revealed minimal pericardial effusion with normal cardiac functions. The final diagnosis was SIADH due to Brucellosis. Hyponatremia, cholestasis, and pericardial disease were resolved with effective antibrucellar treatment with streptomycine and doxycycline. After completing treatment of brucellosis, there was not any more evidence of cholestasis and pericardial fluid

Prevalence of Non Alcoholic Fatty Liver Disease in patients with Parkinson Disease

INTRODUCTION[|]Non alcoholic fatty liver disease (NAFLD) has presented as the most common cause of chronic liver disease in the Western world. Parkinson disease (PD) is the second most common non-demyelinizan neurologic disase and its incidence is steadily increasing in the world. Our study aims to analyze the prevalence of ultrasonography-proven NAFLD among the PD patients. [¤]METHODS[|]A retrospective chart review was performed to identify PD patients who had at least two visits in the Liver Clinic from January 2017 to May 2018. Thus, 124 consecutive patients (the mean age 74,2+-11,9years; 65 female) with PD was longitudinally screened for NAFLD which were diagnosed according to ultrasonographic criteria. Control subjects (65 subjects, mean age was 68+-3.4 years; 35 female) were selected from age-matched eldely subjects. Demographic and laboratory data, concurrent statin use and results of hepatobiliary ultrasonography were collected. Patients with history of chronic liver disase, liver transplant, past alcohol use or not enough data to stage NAFLD were excluded. Data analyzed using Pearson's chi-squared test with the Stata software.[¤]RESULTS[|]Nonalcoholic fatty liver disease prevalence was significantly lower in the PD group than in the age -matched control group (21% vs. 36%, P&lt;0.05). In multiple logistic regression analyses using baseline factors, statin use (P=0.04) and elevated Hb A 1 C (P&lt;0.001), baseline fasting glucose below than 100 mg/dL (P=0.03), and elevated ALT levels (P&lt;0.001) were independently associated with NAFLD.[¤]DISCUSSION AND CONCLUSION[|]While additional studies in large populations are needed to investigate the correlation between PD and NAFLD, further exploration of PD -related metabolic liver disease clinically appears warranted.[¤

SCREENING FOR HEPATITIS B AND C SEROPREVALENCE AND PREVALENCE OF HIV INFECTION AMONG AFGHAN REFUGEES NEWLY ARRIVED IN COASTAL REGION TURKEY IN 2018: A SYSTEMATIC SINGLE-CENTRE ANALYSIS

Introduction: Previous studies showed that refugee status have been associated with various deteriorated effects on human health including higher prevalence of hepatitis B, C and HIV infections. In this study we aim to bridge the gap between Afghan immigrants and naive Turkish population by identifying HBV, HCV and HIV profiles. In addition, a large number of laboratory parameters was collected for all participants, including hematologic and biochemical test results. Materials and Methods: We performed a retrospective review of laboratory records at a tertiary center in Northern Turkey from January 1, 2018, to April 15, 2018. Our population based study comprising hospital data of 403 Afghan refugees and 400 naive Turkish citizens. Results: Afghan refugees had higher anti-HIV seropositivity than Turkish citizens.(p<0.05).There were no difference between the two groups according to HbsAg and anti-HCV seropositivity. Also Afghan refugees had statistically lower ALT levels, higher hemoglobin levels and higher mean TSH level (p<0.05). Mean T4 level did not show significant difference between the two groups. Conclusion: We need further investigations to find out the risk of infections that originated from immigration

Endoscopic retrograde cholangiopancreatography procedures in specific patients: a single-center experience

Endoskopik retrograd kolanjiopankreatografi, gastroenterolojinin en çok komplikasyona sahip işlemlerinden biridir. Klasik işlemin yanında bazı fark-lılıklar gösteren hasta ve hastalıklarda işlemde veya kullanılan malzemelerde bazı değişiklikler yapmak gerekebilmekte, deneyimli merkezlerde bu işlem-ler daha az komplikasyonla yapılabilmektedir. Biz de kendi merkezimizde yaptığımız bazı özellikli endoskopik retrograd kolanjiopankreatografi işlem-lerini sunmayı amaçladıkEndoscopic retrograde cholangiopancreatography is one of the most com-plicated interventions of gastroenterology. In addition to the classical proce-dure, some modifications can be made, for certain patients and diseases, that differ in the treatment modality or materials used, and these procedures can be performed with fewer complications in experienced centers. We aimed to present some specific endoscopic retrograde cholangiopancreatography interventions used in our clinic

Treatment of Crimean-Congo Haemorrhagic Fever by Favipiravir in a Patient with Novel Coronavirus Co-Infection

Introduction: Crimean-Congo haemorrhagic fever (CCHF) is a lethal zoonotic disease caused by an RNA virus that is a member of the Nairovirus genus in the Bunyaviridae family from the arbovirus group. CCHF is transmitted by Hyalomma ticks through direct contact with the blood and other bodily fluids of patients or infected animals.Case description: A 65-year-old man was admitted to the emergency unit with dry cough, myalgia and fever. He was treated with favipiravir. He had disseminated intravascular coagulopathy with thrombocytopenia in the setting of COVID-19 infection. He tested positive for both COVID-19 and CCHF. By the end of the fifth day of treatment, his laboratory parameters and clinical symptoms had normalized.Conclusion: Favipiravir is currently on the market for treating COVID-19 infection worldwide. It has also been used to treat CCHF in laboratory animals. To the best of our knowledge this is the first report of CCHF successfully treated with favipiravir, which could be a key drug for treating human CCHF

Delta hepatitis-related thyroid disease: a unique phenomenon

Introduction: Hepatitis delta virus (HDV) infection is a serious health problem worldwide. Thyroid disturbances represent a major limitation to the efficacy of interferon treatment targeting chronic HDV (C-HDV) infection. Moreover, pre-treatment thyroid diseases may be influenced by interferon therapy. Despite this, the characteristic features of the thyroid diseases in C-HDV patients remain poorly characterised