MKSAP: 35-year-old woman is evaluated for intermittent fever
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 35-year-old woman is evaluated for intermittent fever, sweats, fatigue, and dull midchest pain of 2 weeks’ duration. Medical history is significant for liver transplantation 6 months ago for primary biliary cirrhosis; she was seronegative for cytomegalovirus and Epstein-Barr virus, and her donor was positive for both. Results of pretransplant testing for tuberculosis were negative. She received valganciclovir prophylaxis for 3 months after transplantation. Medications are tacrolimus, prednisone, mycophen...
Source: Kevin, M.D. - Medical Weblog - May 12, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Allergies & Immunology Infectious Disease Source Type: blogs

Uncontrollable itching – part II
As we heard the history we stopped, prior to hearing the exam and labs, and developed a differential diagnosis.  With the combination of itching, probable jaundice and pale stools we assume either intrahepatic or extrahepatic obstruction.  Our differential diagnosis with commentary:   Primary biliary cirrhosis – much more common in women then men – but does often present at this age with uncontrollable itching Primary sclerosing cholangitis – no history of ulcerative colitis or diarrhea symptoms, but still possible Gallstone – not all common duct stones cause pain Cholangiocarcinoma – ...
Source: DB's Medical Rants - March 20, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Wheat Belly: Self-Directed Health?
Director chair, film slate and load horn. Here’s a proposal for you: If, by following the Wheat Belly lifestyle, a long list of conditions are reduced or reversed at no risk, almost no cost, reversing even chronic and potentially fatal conditions . . . does that mean that the notion of self-directed health might be on the horizon, i.e., putting control over health back in our own hands? I think it does. No, we will never implant our own defibrillators or take out our own gallbladders. But so many chronic health conditions afflicting modern humans recede that I believe that it is entirely reasonable to start talking a...
Source: Wheat Belly Blog - February 16, 2016 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle arthritis autoimmune diabetes eating disorder gluten grains Inflammation joint Weight Loss Source Type: blogs

Real Mentoring Lessons From the Liver Queen
By MARTIN SAMUELS, MD In 1970 I had the opportunity to spend time at the Royal Free Hospital in London.  One of my professors at The University of Cincinnati College of Medicine, the late Leon Schiff, a renowned liver expert, arranged for me to work under Professor Sheila Sherlock.  I was placed in a laboratory that was investigating the presumed immune basis of primary biliary cirrhosis.  Roy Fox and Frank Dudley, the faculty in the lab, warmly welcomed me and taught me the basics of immunology research.  My first scientific paper in Gut, was based on this work.  But, I was a budding clinician and I was drawn to the ...
Source: The Health Care Blog - June 24, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs

Real Lessons From the Liver Queen
By MARTIN SAMUELS, MD In 1970 I had the opportunity to spend time at the Royal Free Hospital in London.  One of my professors at The University of Cincinnati College of Medicine, the late Leon Schiff, a renowned liver expert, arranged for me to work under Professor Sheila Sherlock.  I was placed in a laboratory that was investigating the presumed immune basis of primary biliary cirrhosis.  Roy Fox and Frank Dudley, the faculty in the lab, warmly welcomed me and taught me the basics of immunology research.  My first scientific paper in Gut, was based on this work.  But, I was a budding clinician and I was drawn to the ...
Source: The Health Care Blog - June 24, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs

Autoimmunity and wheat
Autoimmunity occurs when your own immune system is no longer able to distinguish friend from foe. It means that antibodies, lymphocytes, killer T cells, macrophages and inflammation-mediating proteins can’t tell the difference between, say, the protein of a fungal wall from proteins in your liver or joints. It’s as weird as a mother not recognizing her children, sometimes as tragic as friendly fire. Depending on which tissues in which organs are attacked, the misdirected immune attack of autoimmunity can express itself as autoimmune hepatitis (liver tissue), primary biliary cirrhosis (bile ducts), type 1 dia...
Source: Wheat Belly Blog - December 13, 2013 Category: Cardiology Authors: Dr. Davis Tags: Uncategorized Source Type: blogs

MKSAP: 32-year-old woman with progressive jaundice
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old woman is evaluated for a 10-day history of malaise, right upper quadrant discomfort, and progressive jaundice. She has had no recent travel outside of the United States, does not drink alcohol, and has no recent ingestions of drugs, including acetaminophen or herbal remedies. Up until this time, she has been healthy. She has a history of type 1 diabetes mellitus for which she takes insulin glargine and insulin detemir. She has no other medical problems. On physical examination, temperature is 37.5 Â...
Source: Kevin, M.D. - Medical Weblog - November 9, 2013 Category: Family Physicians Tags: Conditions GI Infectious disease Source Type: blogs

Gliadin: The Universal Human Poison
Autoimmunity is the process describing an immune response waged against our own organs. The complex collection of mechanisms consisting of T and B lymphocytes, antibodies, and others, meant to provide protection against viruses, bacteria, and other body invaders, is misdirected against proteins of the body’s organs, such as liver, pancreas, thyroid, or brain. Autoimmune conditions now affect 8% of the American population–it is increasingly looking like diseases of autoimmunity are out of control. Dr Alessio Fasano was recently awarded the Linus Pauling Award, the highest award from the Institute for Functional...
Source: Wheat Belly Blog - October 7, 2013 Category: Cardiology Authors: Dr. Davis Tags: Autoimmunity Gliadin Source Type: blogs