Endoscopic and histological patchiness in treated ulcerative colitis

Traditionally, contiguous distribution of inflammation (endoscopic and histological) with rectal involvement is thought to be important in distinguishing ulcerative colitis (UC) from Crohn's disease of the colon. Little long-term data are available that prove whether this rule holds during the course of disease as it is modified by time and treatment. The aim of this study was to investigate the prevalence of endoscopic and histological patchiness and rectal sparing in treated UC over time and to correlate these findings with treatment at the time of endoscopy. Methods : Patients with well-established UC who underwent sequential colonoscopy or flexible sigmoidoscopy with biopsies were included in this study. Patients’ medical records including endoscopy/biopsy reports and clinical status/symptoms/treatment at the time of endoscopy were reviewed retrospectively. Results : A total of 32 patients (14 men, 18 women; median age, 45 yr; median UC duration, 15 yr) underwent 175 sequential endoscopies with biopsies (161 colonoscopies, 14 sigmoidoscopies; median, five endoscopies per patient; range, 3–10). Endoscopic and/or histological patchiness was present in 20 of 175 (11%) sequential endoscopies with biopsies over time from 12 of 32 (38%) patients. Endoscopic and/or histological rectal sparing was present in 27 of 175 (15%) of sequential endoscopies with biopsies over time from 14 of 32 (44%) patients. Seven patients had both patchiness and rectal sparing. Therefore, in 47 (27%) follow-up endoscopies in 19 (59%) patients, there was either patchy disease, rectal sparing, or both sometime during the course of disease with treatment. There was no significant difference in treatment, including steroid use and rectal therapy, between those with patchiness and/or rectal sparing and those without. Conclusions : Contrary to traditional teaching, endoscopic and histological patchiness of inflammation and rectal sparing are common during the course of disease in treated UC and seem to be unrelated to specific therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74642/1/j.1572-0241.1999.01533.x.pd

Campylobacter pylori in Patients with Dyspeptic Symptoms and Endoscopic Evidence of Erosion(s)

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73797/1/j.1572-0241.1989.tb02609.x.pd

Long-Term Follow-Up of Helicobacter pylori Treatment in Non-Ulcer Dyspepsia Patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73344/1/j.1572-0241.1995.tb09422.x.pd

Hypercalcemia during pregnancy: management and outcomes for mother and child (Oct, 10.1007/s12020-021-02615-2, 2021)

Diabetes mellitus: pathophysiological changes and therap

Collagenous Colitis: Histopathology and Clinical Course

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72589/1/j.1572-0241.1997.tb12073.x.pd

Hypercalcemia during pregnancy: management and outcomes for mother and child

Diagnosing and treating hypercalcemia during pregnancy can be challenging due to both the physiological changes in calcium homeostasis and the underlying cause for the hypercalcemia. During pregnancy and lactation there is increased mobilization of calcium in the mother to meet the fetus' calcium requirements. Here we discuss the diagnostic challenges, management, and patient perspective of hypercalcemia during pregnancy in two particular cases and in other rare conditions causing hypercalcemia.Diabetes mellitus: pathophysiological changes and therap

Spinal Cord Ischemia Related to Disc Herniation:Case Report and a Review of the Literature

Symptoms of spinal cord ischemia can mimic myelopathy due to spinal cord compression in the acute phase. Thoracic disc herniation with limited spinal cord compression but rapid progression of neurological symptoms causes a clinical dilemma as to whether emergency decompression should be performed. We report a case of acute progressive myelopathy due to spinal cord ischemia related to thoracic disc herniation initially managed by Th8 laminectomy with reduction of the herniated disc. Repeat imaging showed T2-weighted hyperintensity in the posterior cord. The clinical and radiological course supports posterior spinal artery ischemia. This case illustrates and a review of the literature shows that thoracic disc herniation may be complicated by ischemic myelopathy even in the absence of cord compression