Zapalenie osierdzia i mięśnia sercowego — niecodzienna pozajelitowa manifestacja wrzodziejącego zapalenia jelita grubego

Ulcerative colitis (UC) is an example of inflammatory bowel disease that can be manifested by extraintestinal complications including cardiac disorders. The most commonly reported — pericarditis — occurs in 0.23% of all UC patients. The knowledge about the etiology of pericarditis is important to implement accurate therapy. However, the diagnosis is not always clear and can be connected with diagnostic and therapeutic challenges. In this case, we present a myopericarditis in the course of UC exacerbation.Wrzodziejące zapalenie jelita grubego (UC) jest przykładem nieswoistej choroby zapalnej jelit, która może się manifestować objawami pozajelitowymi, w tym objawami ze strony układu sercowo-naczyniowego. Najczęściej stwierdzane zapalenie osierdzia występuje u 0,23% pacjentów z UC. Wiedza na temat etiologii zapalenia osierdzia jest niezbędna do wdrożenia właściwej terapii. Mimo to diagnoza nie zawsze jest łatwa i może być związana z wyzwaniami zarówno w zakresie diagnostyki jak i leczenia. Przedstawiony opis przypadku ilustruje problem zapalenia osierdzia i mięśnia sercowego w przebiegu UC

Alterations in serum levels of selected markers of oxidative imbalance in adult celiac patients with extraintestinal manifestations : pilot study

Oxidative stress is considered to be one of the mechanisms responsible for gluten toxicity, but its role in celiac disease (CD) remains unclear. The aim of the study was to evaluate oxidative imbalance in the pathomechanism of CD by determining the concentrations of nitric oxide (NO) and selected antioxidant parameters. The study involved 197 adult patients: 53 patients with untreated active CD, 92 celiac patients on gluten‑free diet (GFD), and 52 controls. The serum levels of antioxidants (uric acid, bilirubin, ferritin, albumin), celiac antibodies, NO, glutathione peroxidase 3 (GPx3), and vitamin E were measured. A histopathological study of duodenal biopsy was performed. Celiac patients had higher uric acid concentrations than controls (P <0.001). NO levels were higher in patients with active CD than in controls (P <0.01) and were correlated with the degree of mucosal damage ($r^{2}$ = 0.04; P = 0.01). Vitamin E levels were decreased in celiac patients (P <0.01), and GPx3 activity was reduced in patients with active CD compared with controls (P <0.001)

Application of the clustering technique to multiple nutritional factors related to inflammation and disease progression in patients with inflammatory bowel disease

Diet and nutritional status affect intestinal inflammation in patients with inflammatory bowel disease (IBD). The aim of this study was to use a cluster analysis to assess structural similarity between different groups of parameters including short-chain fatty acid (SCFA) levels in stool as well as hematological and inflammatory parameters (such as serum C-reactive protein (CRP) and proinflammatory and anti-inflammatory cytokines). We also assessed similarity between IBD patients in terms of various biochemical features of disease activity and nutritional status. A total of 48 participants were enrolled, including 36 patients with IBD and 12 controls. We identified four main meaningful clusters of parameters. The first cluster included all SCFAs with strong mutual correlations. The second cluster contained red blood cell parameters and albumin levels. The third cluster included proinflammatory parameters such as tumor necrosis factor-α, CRP, platelets, and phosphoric, succinic, and lactic acids. The final cluster revealed an association between zonulin and interleukins IL-10, IL-17, and IL-22. Moreover, we observed an inverse correlation between IL-6 and body mass index. Our findings suggest a link between nutritional status, diet, and inflammatory parameters in patients with IBD, which contribute to a better adjustment of the nutritional treatment

The importance of nutritional aspects in the assessment of inflammation and intestinal barrier in patients with inflammatory bowel disease

Intestinal inflammation in inflammatory bowel disease (IBD) is closely linked to nutrition. This study aimed to evaluate associations between nutritional, inflammatory, and intestinal barrier parameters in patients with IBD. We assessed nutritional status, fecal short-chain fatty acid profile, serum cytokine levels, and mRNA expression of enzymes and tight junction proteins in intestinal biopsies obtained from 35 patients, including 11 patients with inactive IBD, 18 patients with active IBD, and six controls. Patients with active IBD were characterized by hypoalbuminemia, fluctuations in body weight, and restriction of fiber-containing foods. In addition, they had significantly reduced levels of isovaleric acid and tended to have lower levels of butyric, acetic, and propionic acids. Patients with active IBD had higher mRNA expression of peroxisome proliferator-activated receptor γ and inducible nitric oxide synthase, and lower mRNA expression of claudin-2 and zonula occludens-1, compared with patients with inactive IBD. Moreover, patients with a body mass index (BMI) of ≥25 kg/m(2) had higher median tumor necrosis factor-α levels that those with a lower BMI. We comprehensively evaluated inflammatory parameters in relation to IBD activity and nutritional status. The discrepancies between proinflammatory and anti-inflammatory parameters depending on IBD activity may be related to nutritional factors, including diet and abnormal body weight

Effect of long-term proton pump inhibitor therapy on complete blood count parameters and selected trace elements : a pilot study

Introduction: Proton pump inhibitors (PPIs) are widely prescribed for several gastrointestinal conditions, often as long-term therapy. The effects of long-term PPI use have not been fully elucidated. Objectives: We aimed to determine the association between long-term PPI use and complete blood count parameters, particularly red blood cell (RBC) count, white blood cell (WBC) count, and hemoglobin concentrations, as well as serum levels of selected micronutrients such as selenium (Se), iron (Fe), copper (Cu), and zinc (Zn). Patients and methods: We enrolled 37 patients on long-term PPI therapy (mean [SD] age, 57.1 [15.4] years) and 30 healthy controls (mean [SD] age, 39.3 [11.8] years). In each group, complete blood count, and serum Fe levels were performed, and serum Cu, Zn, and Se levels were measured using atomic absorption spectrometry. Results: Red blood cell and WBC counts were lower in the PPI group compared with controls (mean [SD], 4.24 [0.55]×106/μl vs 4.7 [0.4]×106/μl; P <0.001 and 6.13 [1.44]×103/μl vs 7.3 [1.28]×103/μl; P <0.001, respectively). Hemoglobin and serum Fe concentrations were also lower in the PPI group (mean [SD], 12.5 [1.8] g/dl vs 14.3 [0.8] g/dl; P <0.001 and 16.3 [5.4] μmol/l vs 23.4 [2.7] μmol/l; P <0.001, respectively). Serum Zn and Cu concentrations were higher in PPI users than in controls. Conclusions: Long-term PPI therapy may reduce RBC and WBC counts as well as hemoglobin levels, leading to iron deficiency. It may also affect concentrations of some micronutrients, although the underlying mechanism of this association is not fully clear