13 research outputs found
Une endoscopie redoutable [A terrible endoscopy].
International audienceNous exposons ici le cas dâun lymphome intra-vasculaire diagnostiquĂ© sur biopsies duodĂ©nales rĂ©alisĂ©es dans le cadre du bilan dâune altĂ©ration de lâĂ©tat gĂ©nĂ©ral et de douleurs Ă©pigastriques Ă©voluant depuis 3 mois chez un homme de 77 ans. Cette entitĂ© trĂšs rare, appartient au sous-groupe des lymphomes B diffus Ă grandes cellules dans la classification OMS 2008. Il se caractĂ©rise par une localisation quasi exclusive des cellules lymphomateuses dans les capillaires et les vaisseaux de petit calibre. Le pronostic de cette hĂ©mopathie gĂ©nĂ©ralement diagnostiquĂ©e post mortem reste de nos jours trĂšs pĂ©joratif, notamment du fait du retard diagnostic en lien avec le caractĂšre peu spĂ©cifique des symptĂŽmes. LâoriginalitĂ© de notre cas tient Ă son diagnostic prĂ©coce rĂ©alisĂ© sur biopsies duodĂ©nales dans un contexte de douleurs Ă©pigastriques sans anomalie endoscopique, rĂ©vĂ©lant une atteinte viscĂ©rale dissĂ©minĂ©e confirmĂ©e par TEP scanner et myĂ©logramme. Lâatteinte ganglionnaire et lâinfiltration mĂ©dullaire permettent Ă©galement de discuter le sous-type rarissime dit « asiatique »
Small-bowel video capsule endoscopic findings of Cronkhite-Canada syndrome
International audienceCronkhite-Canada syndrome (CCS) is a rare, non-familial disorder characterized by multiple gastrointestinal polyps and ectodermal changes. This article presents the first small-bowel video sequences of CCS using video capsule endoscopy (VCE)
Endoscopic resection of a rectal gastrointestinal stromal tumor using the submucosal tunneling endoscopic resection (STER) technique
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Submucosal dissection of a large colonic angiodysplasia in case of failure of conventional treatment
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The reversion variant (p.Arg90Leu) at the evolutionarily adaptive p.Arg90 site in CELA3B predisposes to chronic pancreatitis
A gainâofâfunction missense variant in the CELA3B gene, p.Arg90Cys (c.268C>T), has recently been reported to cause pancreatitis in an extended pedigree. Herein, we sequenced the CELA3B gene in 644 genetically unexplained French chronic pancreatitis (CP) patients (all unrelated) and 566 controls. No obvious lossâofâfunction variants were identified. None of the six lowâfrequency or common missense variants detected showed significant association with CP. Nor did the aggregate rare/very rare missense variants (nâ=â14) show any significant association with CP. However, p.Arg90Leu (c.269G>T), which was found in four patients but no controls, and affects the same amino acid as p.Arg90Cys, serves to revert p.Arg90 to the human elastase ancestral allele. As p.Arg90Leu has previously been shown to exert a similar functional effect to that of p.Arg90Cys, our findings not only confirm the involvement of CELA3B in the etiology of CP but also pinpoint a new evolutionarily adaptive site in the human genome
NATURAL HISTORY OF PERIANAL CROHNâS DISEASE: LONG-TERM FOLLOW-UP OF A POPULATION-BASED COHORT
International audienceBACKGROUND AND AIMS: The natural history of perianal Crohnâs disease (PCD) remains poorly described and is mainly based on retrospective studies from referral centres. The aim of this study was to assess the incidence, outcomes and predictors of the onset of PCD. METHODS: All incident cases of patients diagnosed with possible CD were prospectively registered from 1994 to 1997 in Brittany, a limited area in France. At diagnosis, the clinical features of perianal disease were recorded. All patient charts were reviewed from the diagnosis to the last clinic visit in 2015. RESULTS: Among the 272 out of 331 incident CD patients followed up, 51 (18.7%) patients had PCD at diagnosis. After a mean follow-up of 12.8 years, 93 (34%) patients developed PCD. The cumulative probabilities of perianal CD occurrence were 22%, 29%, and 32% after 1 year, 5 years, and 10 years, respectively. The cumulative probabilities of anal ulceration were 14%, and 19% after 1 year and 10 years, respectively. Extraintestinal manifestations were associated with the occurrence of anal ulceration. The cumulative probabilities of fistulizing PCD were 11%, 16%, and 19% after 1 year, 5 years, and 10 years, respectively. Extraintestinal manifestations, rectal involvement and anal ulceration were predictors of fistulizing PCD. The cumulative probability of developing anal stricture was 4% after 10 years. CONCLUSIONS: PCD is frequently observed during CD, in approximately one-third of patients. These data underline the need for targeted therapeutic research on primary perianal lesions (proctitis, anal ulceration) to avoid the onset of fistulizing perianal disease