An uncommon presentation of a common pathogen

Question A 70-year-old woman presented with severe spasmodic abdominal pain, nausea, recurrent vomiting and mild diarrhoea. Two months earlier she underwent autologous stem cell transplantation for stage 2A follicular lymphoma. Her medical history was otherwise unremarkable. Physical examination revealed mild epigastric tenderness. Blood tests showed an elevated lactate dehydrogenase (325 IU/L; normal range 135–214 IU/L) and elevated transaminases (alanine transaminase 126 IU/L; aspartate transaminase 90 IU/L; normal range 10–35 IU/L). Blood cell counts were within the normal range. Ultrasound examination did not detect a cause for the abdominal pain. She was not on immunosuppressive therapy. Subsequently, the patient underwent upper endoscopy that revealed the presence of several protruding, ulcerative gastric lesions (figure 1A). The lesions were detected throughout the stomach while oesophagus and duodenum were spared. Biopsies of the gastric lesions were obtained for histological evaluation (figure 1B) and for microbiological analysis. Following 2 weeks of specific therapy, the gastric...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research

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Gastrointestinal diseases associated with impaired immunity are largely infectious, although an increased incidence of extranodal lymphoma is also found in the context of HIV infection. The range of such infections is related to the role of CD4+ T cells in their eradication. Infections tend to occur with organisms of limited virulence and to be recurrent, and are associated with disseminated infection. The symptoms they produce are usually pain on swallowing, weight loss or diarrhoea. Abdominal pain can be associated with Mycobacterium avium-intracellulare or sclerosis of the bile ducts secondary to infection.
Source: Medicine - Category: Internal Medicine Authors: Tags: Infection Source Type: research
Publication date: February 2019Source: The Lancet Haematology, Volume 6, Issue 2Author(s): Loretta J Nastoupil, Matthew A Lunning, Julie M Vose, Marshall T Schreeder, Tanya Siddiqi, Christopher R Flowers, Jonathon B Cohen, Jan A Burger, William G Wierda, Susan O'Brien, Peter Sportelli, Hari P Miskin, Michelle A Purdom, Michael S Weiss, Nathan H FowlerSummaryBackgroundTherapeutic approaches for B-cell malignancies continue to evolve, especially with regard to combination approaches. We assessed the safety and efficacy of the triplet ublituximab, umbralisib, and ibrutinib in patients with advanced B-cell malignancies.Methods...
Source: The Lancet Haematology - Category: Hematology Source Type: research
Abstract The present study ( Identifier: NCT02221492) was conducted to assess the efficacy and safety of plerixafor for the mobilization and collection of haematopoietic stem cells (HSCs) for autologous transplantation in Japanese non-Hodgkin lymphoma (NHL) patients. In this randomized phase 2 study, patients received granulocyte-colony stimulating factor (G-CSF, filgrastim) 400 µg/m²/day for up to 8 days. Starting on the evening of day 4, patients received, for up to 4 days, either plerixafor (240 µg/kg/day) in the G-CSF+ plerixafor arm (GP arm) or G-CSF alone a...
Source: International Journal of Hematology - Category: Hematology Authors: Tags: Int J Hematol Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs
Rationale: Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal fistula. Patient concerns: Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal fistula and ileac-sigmoid colon fistula. Ultrasound (US) showed small intestinal wall thickened and developm...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We report a case of acute onset of ulcerative colitis (UC) during chemoradiotherapy in a patient with anaplastic lymphoma kinase (ALK)‐positive lung adenocarcinoma. A 46‐year‐old male patient with an abnormal chest shadow was referred to our hospital. He was diagnosed with lung adenocarcinoma, clinical stage T1aN3M0 and stage IIIB. Concurrent chemoradiotherapy was selected for his initial therapy. After two cycles of cisplatin and vinorelbine administration, he experienced persistent diarrhoea and anorexia. Findings of the colonoscopy revealed a pancolitis type of UC. After discontinuation of chemotherapy, oral admin...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
We report the use of PEG-asparaginase along with conventional anthracycline therapy in a 70-year-old woman diagnosed with MEITL, who went into remission and survived for more than one year before succumbing to relapsed disease. PMID: 29062389 [PubMed]
Source: Ecancermedicalscience - Category: Cancer & Oncology Tags: Ecancermedicalscience Source Type: research
A 14-year-old previously healthy adolescent male patient presented at Rady Children's Hospital (San Diego, CA, USA) in July, 2016, with a history of worsening snoring, recurrent nocturnal awakenings, and daytime somnolence over an 8-month period. Notably, the patient was not overweight or obese; by contrast, he had experienced a weight loss of 7 kg during the same time period. He did not complain of nausea, vomiting, diarrhoea, abdominal pain, dysphagia, or anorexia. Physical examination revealed enlarged tonsils (grade 4, with the left tonsil enlarged more than the right) with deviation of the uvula towards the right.
Source: The Lancet Oncology - Category: Cancer & Oncology Authors: Tags: Clinical Picture Source Type: research
CONCLUSIONS: A need exists for empirical research on SM for PPE, diarrhoea, and constipation. Research is needed on the efficacy of self-care strategies in patients with BC, CRC, HL, and NHL. In general, consistency exists across CPGs/EBRs and local guidelines on the assessment and management of common CRTs. PMID: 28069154 [PubMed - in process]
Source: European Journal of Oncology Nursing - Category: Nursing Authors: Tags: Eur J Oncol Nurs Source Type: research
Abstract Celiac disease is induced by the consumption of gluten containing cereals (wheat, spelt, barley, rye). With a prevalence of ~ 1 %, it is the most common non-infectious chronic inflammatory intestinal disease worldwide. It manifests in all age groups, either classically with abdominal pain, diarrhoea and growth failure or weight loss, more commonly with indirect consequences of malabsorption, such as anaemia and osteoporosis, or with associated autoimmune diseases like type 1 diabetes, autoimmune thyroiditis or dermatitis herpetiformis. The pathogenesis of celiac disease is well explo...
Source: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz - Category: Global & Universal Authors: Tags: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz Source Type: research
More News: Diarrhoea | Endoscopy | Gastroenterology | Lymphoma | Microbiology | Oesophagus | Pain | Panendoscopy | Stem Cell Therapy | Stem Cells | Transplants | Ultrasound | Upper Endoscopy