Analysis of cases with tuberculous peritonitis: A single-center experience

Background/Aims: Tuberculous peritonitis (TP) is a rare form of tuberculosis and is caused by peritoneal involvement with Mycobacterium tuberculosis. A distinctive correlation exists between socioeconomic state and disease prevalence. We aimed to evaluate the clinical, laboratory, and radiological findings of patients with TP. Materials and Methods: We conducted a retrospective study in patients with peritoneal tuberculosis from January 2004 to October 2008 at Yuzuncu Yil University Medical School Education and Research Hospital. During this time, the data of 21 patients (17 females) with TP were reviewed. Results: Fever, abdominal pain, and anorexia were the most common symptoms. An analysis of ascites showed lymphocyte predominance and low albumin gradient in all patients. Patients with TP had a median ascites adenosine deaminase (ADA) level of 139 U/L (range, 25 to 303U/L). Peritoneal involvement (wet peritonitis) was seen in all the cases. Following 6-month administration of combined anti-TBC treatment, mean serum CA-125 levels were within the normal range among patients who had previously higher serum CA-125 level. Mortality rate in the total cases was 4.6%. Conclusion: Peritoneal tuberculosis should be considered in the differential diagnosis of exudative ascites in eastern Turkey. A high level of suspicion is required, especially in high-risk populations living in rural areas. ADA seems to be a sufficient, safe, and inexpensive method to perform the diagnosis of peritoneal tuberculosis. Serum CA-125 levels may play a key role to support the diagnosis as well as disease management of TP

Preoperative Serum Il-6 Levels: Clinical Importance In Gastric Carcinoma With Lymph Node Metastasis

Aim: The interleukin-6 (IL-6) pathway is one of the mechanisms that link inflammation and angiogenesis. The purpose of this study was to investigate the preoperative serum levels of IL-6 in gastric carcinoma with lymph node metastasis, and to correlate them with disease status. Method: A total of 100 patients who underwent gastrectomy were enrolled in this study. Serum levels of IL-6 were assessed enzyme linked immunosorbent assay (ELISA). Histological findings included tumor size, depth of tumor invasion, lymph node (LN) metastasis, and TNM stage. Result: Increases in cancer invasion and staging are generally associated with increases in preoperative serum IL-6 levels. IL-6 levels were correlated with invasion depth (p<0.001), LN metastasis (p<0.001), and TNM stage. The presence of peritoneal seeding metastasis is associated with IL-6 levels (p<0.001). Conclusion: Preoperative serum IL-6 levels might be markers of tumor invasion, LN metastasis, and TNM stage. These results suggest that IL-6 levels are potential molecular markers that predict lymphatic involvement in gastric carcinoma

Human infection with Dicrocoelium dendriticum in Turkey

Human dicrocoeliosis is reported sporadically in various parts of the world. We report a case in a 21-year-old male, who had right upper abdominal pain, weight loss, and chronic relapsing watery diarrhea three to four times daily for four weeks. The patient had abdominal tenderness to palpation in the right upper quadrant. Alkaline phosphatase, alanine aminotransferase, and serum immunoglobulin E levels were slightly elevated; all other biochemical and hematological findings were in their normal ranges. The duodenal biopsy samples were normal and an abdominal ultrasonography showed no biliary or hepatic abnormality. Stool microscopy revealed numerous eggs of Dicrocoelium dendriticum. As pseudoparasitosis can result from eating raw, infected animal liver, the patient was given a liver-free diet for three days, to rule out that possibility. Subsequent stool examinations showed eggs in each of the samples indicating that the infection was genuine. The patient was treated with triclabendazole 10 mg/kg in a single dose. Four weeks later, no parasite eggs were detected in the microscopic examination of the stool samples. The patient got better gradually and the symptoms disappeared. Physicians should keep in mind parasitic diseases such as the rarely encountered dicrocoeliosis