Thymic stromal lymphopoietin levels are increased in patients with celiac disease

Thymic stromal lymphopoietin (TSLP) is a cytokine produced by epithelial cells in the lungs, skin and intestinal mucosa, and is involved in several physiological and pathological processes. In this study, we evaluated serum TSLP levels in patients with celiac disease (CD). The prospective study was conducted at a gastroenterology outpatient clinic between March 2018 and August 2018. Eighty-nine participants aged between 18 and 75 years were classified into following groups: 22 patients with newly diagnosed CD; 20 patients with CD who were compliant with a gluten-free diet (GFD); 32 patients with CD who were not compliant with a GFD; and 15 healthy controls. Demographic characteristics, disease duration, and selected biochemical and hematologic parameters were recorded and compared between groups. Median serum TSLP levels were 1193.65 pg/mL (range: 480.1–1547.1) in newly diagnosed CD patients, 110.25 pg/mL (range: 60.3–216.7) in CD patients who were compliant with a GFD, 113.1 pg/mL (range: 76.3–303.4) in CD patients who were not compliant with a GFD, and 57 pg/mL (range: 49–67.8) in healthy controls. Overall, there was a significant difference in serum TSLP levels between groups (p = 0.001). Patients with newly diagnosed CD had the highest serum TSLP levels. There was no significant difference in serum TSLP levels between patients with CD who were or were not compliant with a GFD. TSLP appears to be involved in the pathogenesis of CD. Further studies are required to determine if the TSLP signaling pathway can be used in the treatment of CD

Doxycycline-induced esophagitis: Report of two cases and review of the literature

Although it is not so frequent in medical literature, drug-induced esophageal injury is important, because of its possible complications. Here, we reported two patients with ulcerative esophagitis secondary to doxycycline use. Both patients applied to outpatient clinic with retrosternal pain, odynofagia and dysphagia. Symptoms had been developed after three days of doxicycline treatment in the first patient, and after two days in the second patient. Upper gastrointestinal endoscopy revealed ulcers in patient 1 at the upper 1/3 segment of esophagus and in patient 2 at the middle 1/3 segment of esophagus. Based on the endoscopic findings, the patients were diagnosed as drug-induced esophageal injury resulting from doxycycline treatments. Doxycycline treatments were stopped and lansoprazole and sucralfate was started.

Foreign bodies in gastrointestinal tract

Objective: Ingested foreign bodies in gastrointestinal tract are a common event which can cause serious morbidity and mortality in the children and adult population. For this reason, early diagnosis and treatment are crucial for preventing these life threatening complications. In this study, we aimed to analyze the characteristics of the patients with upper gastrointestinal foreign bodies that were treated in our department. Methods: Patients diagnosed with upper gastrointestinal foreign bodies who were admitted to our hospital between February 2010 and August2013 were evaluated retrospectively. The data regarding their age, gender, clinical profile, type and localization of the esophageal foreign body, performed endoscopic procedure and initial symptoms of the patients were noted and analyzed statistically. Results: Thirty-eight patients with a diagnosis of gastrointestinal foreign body were included in this study. Of these patients, 21 were male and 17 were female. The youngest patient was 17 years old and the oldest patient was 79 years old. Most of the foreign bodies (%55.3) detected in the stomach. Food waste and metallic objects in 21 and 16 patients respectively. The most common complaint was dysphagia (%50). After endoscopic intervention three of the patients were directed to surgery. Conclusion: Early recognition and treatment of gastrointestinal foreign bodies is important as their complications are life threatening. The best method of removal of foreign bodies is controversial. Early management with upper gastrointestinal endoscopy is the most efficient and safe treatment method in current conditions

A rare cause of diarrhea: Eosinophilic gastroenteritis

Eosinophilic gastroenteritis (EG) is a rare disease that is characterized by an eosinophil-driven inflammation of the digestive tract, presenting with gastrointestinal symptoms. In this report, a case of EG in an elderly man who presented with diarrhea was presented.A 68-year-old man admitted to hospital due to diarrhea, nausea, abdominal pain, and weight loss started two weeks ago. Hypereosinophilia were determined. Serum immunoglobulin E level was high. Stool examinations for intestinal parasites were negative. Biopsies were taken from esophagus, stomach, duodenum during upper and lower gastrointestinal endoscopies. Histopathological assessement showed an intense edema, eosinophilic and increased lymphoplasmasitic infiltration in lamina propria. Increased eosinophil count seen in bone-marrow biopsy, atypical cell was not seen. Eosinophilic gastroenteritis was considered and, ketotifen 2 mg/day and methylprednisolone 1 mg/kg/day were started. His symptoms were improved.Gastrointestinal symptoms of EG are nonspecific. The increase of eosinophilic cells in the circulating blood can suggest the possibility of EG. Definite diagnosis is made by histopathological assessment. Glucucorticoid therapy is the mainstay and is effective in the treatment of EG. However, the antihistamines are also used solely or combined with glucocorticoids

Serum Interleukin-35 And Pentraxin-3 Levels In Patients With Mild Acute Pancreatitis

Introduction Interleukin-35 (IL-35) is a newly defined potent anti-inflammatory cytokine that is predominantly produced by regulatory T cells, and pentraxin-3 belongs to the acute-phase proteins. Aim To measure the serum IL-35 and pentraxin-3 levels in the early phase of mild acute pancreatitis (AP). Material and methods Eighty-three patients with mild AP and 30 healthy controls were included in the study. The serum levels of IL-35 and pentraxin-3 were measured by enzyme-linked immunosorbent assay upon admission and at the 48th hour after diagnosis. Results The mean value of serum IL-35 levels in patients with mild acute pancreatitis at admission was 5.91 ng/ml (4.21–7.90) and was significantly lower than those in healthy controls (25.53 ng/ml (12.79–54.73, p 0.05). Also there was no significant difference between the mean value at admission and the mean value at 48-hour, 6.75 ng/ml (4.74–9.06, p > 0.05). Conclusions Interleukin-35 can be used in diagnosis and follow-up in patients with mild AP.PubMedWoSScopu

The short-term effects of Helicobacter pylori eradication on symptoms of functional dyspepsia

Objectives: Helicobacter pylori (H.pylori) infection is major etiologic factor of chronic active gastritis and peptic ulcer disease. Functional dyspepsia (FD) is defined as “persistent or recurrent abdominal pain or discomfort centered in the upper abdomen in patient who has no definite structural or biochemical explanation of their symptoms. It is uncertain whether treatment of H.pylori infection relieves symptoms in patients with FD. We searched short term effects of H.pylori eradication for symptoms in patients with FD.Material and method: We enrolled patients with dyspeptic symptoms which were diagnosed FD and satisfied en-rollment criteria of trial. Endoscopic biopsy was taken from each patient during upper gastrointestinal endoscopy. H.pylori infected patients were assigned to seven days of treatment with 30 mgr of lansoprozole twice daily, 1000 mg of amoksisilin twice daily, and 500 mg levofloxacin once daily. Patients were assessed whether treatment was suc-cessful or not by 14C urea breathe test after 6-8 week. Also pretreatment and post treatment symptom scores were questioned.Results: There were 99 female and 68 male patients. After treatment 114 patients (68%) was negative for H. pylori, 53 patients (32%) remained positive. Mean of age and proportion of sex was similar in H.pylori (+) and (-) groups. While 111 (97.4%) of H.pylori (-) patients’ symptom scores decreased, 38 (71.7%) of H.pylori (+) patients’ scores de-creased. There was significant differences between two groups (p=0.001).Conclusion: Eradication of H.pylori relieves the symptoms of functional dyspepsia. New trials for long term effect of H.pylori eradication on symptoms must be conducted in future

The efficacy of levofloxacin-based triple therapy for first-line Helicobacter pylori eradication

Standard triple therapy composed of a proton pump inhibitor, clarithromycin and amoxicillin has been widely preferred for H. pylori eradication in Turkey and World. Alternative therapies are currently under investigation because of an increase in clarithromycin resistance. The aim of this study was to evaluate the efficacy of a levoflox-acin-containing triple therapy.Materials and methods: The study was carried out in 81 H. pylori-infected patients (52 female, 29 male) with nonul-cer dyspepsia. The mean age was found 46.3 ± 13.9. Treatment was indicated with lansoprazol 30 mg b.d., amoxicil-lin 1 g b.d., and levofloxacin 500 mg daily for 7 days. H. pylori status was rechecked by (14)C urea breath test 6-8 weeks after the end of therapy.Results: Totally 81 patients could complete the treatment and follow-up protocol. Effectiveness was 68%. The distrib-tions of age, gender and smoking were similar between eradicated and non-eradicated groups (p > 0.05).Conclusion: Seven-day levofloxacin based triple therapy is not very effective in the first-line treatment of H. pylori in-fection. The new treatment modalities should be investigated

The Relationship between Helicobacter pylori and Beta-2 Microglobulin in Humans

H. pylori is related to various gastrointestinal diseases. β2 Microglobulin (β2M) is an intrinsic element of major histocompatibility complex (MHC I). Serum β2M level may increase in inflammatory states. The aim of current study is to evaluate the relationship between β2M and H. pylori bearing CagA strains. Methods. H. pylori status was determined by histopathology of samples taken from stomach. CagA status and β2M level were measured from blood samples of patients. Eradication therapy was administered to the patients with H. pylori infection. β2 Microglobulin levels were measured before and after treatment. Results. 35 (29.2%) H. pylori(−) patients and 85 (70.8%) H. pylori (+) patients were included in the study. There were 52 (43.3%) patients with CagA negative and 33 (27.5%) patients with CagA positive H. pylori infection. The mean serum β2M level was 1.83 mg/L in H. pylori (−) group, 1.76 mg/L in H. pylori (+) CagA (−) group, and 1.93 mg/L in H. pylori and CagA (+) group (P>0.05). Serum β2M levels (1.82 versus 1.64 mg/L P<0.05) were decreased after eradication. Conclusion. H. pylori and CagA status did not affect β2M level. Relationship between low grade systematic inflammation and H. pylori should be investigated to find out new predictors for diseases associated with inflammation