Clinical Journal of Gastroenterology最新文献

Effect of maternal exposure to antibiotics during pregnancy on the neonatal intestinal microbiome and health.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-22 DOI: 10.1007/s12328-024-02088-6

Jun Miyoshi, Tadakazu Hisamatsu

{"title":"Effect of maternal exposure to antibiotics during pregnancy on the neonatal intestinal microbiome and health.","authors":"Jun Miyoshi, Tadakazu Hisamatsu","doi":"10.1007/s12328-024-02088-6","DOIUrl":"https://doi.org/10.1007/s12328-024-02088-6","url":null,"abstract":"Antibiotics are widely used during pregnancy. Recent epidemiological studies suggest that maternal exposure to antibiotics during pregnancy is associated with increased risks of various diseases in offspring; host-microbiome interactions are considered to be involved in pathogenesis, as antibiotic-induced perturbations (dysbiosis) of the maternal microbiome can be transmitted to offspring. We reviewed the current status of antibiotic usage during pregnancy, transmission of maternal antibiotic-induced dysbiosis to offspring, and several diseases in offspring reported to be associated with maternal antibiotic exposure. Antibiotics must be properly used when necessary. While the adverse effect of maternal antibiotic exposure during pregnancy on the health of offspring has been demonstrated by several studies, more robust clinical evidence is necessary to define the best practice for antibiotic use during pregnancy. Epidemiologic studies have limitations in establishing causal links beyond associations; animal studies provide benefits in examining these links, however, microbiomes, gestation courses, and aging vary between host species. Understanding the underlying mechanisms of epidemiologic findings as well as the healthy microbiome during pregnancy and early life in humans would contribute to developing future microbial interventions for restoring antibiotic-induced dysbiosis during pregnancy.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of fruquintinib's efficacy and safety in refractory metastatic colorectal cancer: a systematic review and meta-analysis of phase II and III randomized controlled trials.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-20 DOI: 10.1007/s12328-024-02087-7

Eric Ricardo Yonatan, Rivaldi Ruby, Alver Prasetya, Erlangga Saputra Arifin

{"title":"Evaluation of fruquintinib's efficacy and safety in refractory metastatic colorectal cancer: a systematic review and meta-analysis of phase II and III randomized controlled trials.","authors":"Eric Ricardo Yonatan, Rivaldi Ruby, Alver Prasetya, Erlangga Saputra Arifin","doi":"10.1007/s12328-024-02087-7","DOIUrl":"https://doi.org/10.1007/s12328-024-02087-7","url":null,"abstract":"Background: Metastatic colorectal cancer (mCRC) remains a significant cause of mortality despite advancements in treatments. Fruquintinib, a potent VEGFR inhibitor, has shown promise as an advanced therapy for mCRC. This review evaluates the efficacy and safety of fruquintinib compared to placebo in patients with refractory mCRC, focusing on Phase II and III trials.Method: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed using PubMed, EBSCOHost, ProQuest, and Google Scholar. The analysis of overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety was pooled using hazard ratios (HR) and risk ratios (RR) in RevMan 5.4 software.Results: Three RCTs comprising 1,178 patients were included. Fruquintinib significantly improved OS (HR: 0.66; 95% CI 0.57-0.76) and PFS (HR: 0.30; 95% CI 0.26-0.35) compared to placebo. ORR (RR: 5.91; 95% CI 1.09-32.16) and DCR (RR: 3.83; 95% CI 3.00-4.90) were also higher with fruquintinib. Grade 3 or higher adverse events were more frequent with fruquintinib (RR: 1.31; 95% CI 1.02-1.70). No significant difference was observed in serious adverse events or treatment-related deaths.Conclusion: Fruquintinib significantly improves survival and tumor response in patients with refractory mCRC. While associated with an increased risk of high-grade adverse events, fruquintinib remains a viable and relatively safe treatment option for mCRC patients. Further studies are needed to confirm its efficacy and safety across diverse populations.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Longitudinal analysis of serum intestinal fatty acid-binding protein in a patient with non-occlusive mesenteric ischemia following brachial plexus block-induced hypotension: a case study.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-13 DOI: 10.1007/s12328-024-02081-z

Tatsuo Kanda, Yasuyuki Kawachi, Chie Kitami, Hiroyuki Funaoka, Yoichi Iwafuchi

{"title":"Longitudinal analysis of serum intestinal fatty acid-binding protein in a patient with non-occlusive mesenteric ischemia following brachial plexus block-induced hypotension: a case study.","authors":"Tatsuo Kanda, Yasuyuki Kawachi, Chie Kitami, Hiroyuki Funaoka, Yoichi Iwafuchi","doi":"10.1007/s12328-024-02081-z","DOIUrl":"https://doi.org/10.1007/s12328-024-02081-z","url":null,"abstract":"Intestinal fatty acid-binding protein (I-FABP) is a promising biomarker for small-bowel ischemia including non-occlusive mesenteric ischemia (NOMI). A 75-year-old woman with diabetic nephropathy sustained a distal radius fracture. Two days later, she underwent a brachial plexus block to facilitate orthopedic surgery, which resulted in hypotension. Despite prompt fluid resuscitation and ephedrine administration, the patient developed abdominal pain. Contrast-enhanced computed tomography revealed hepatic portal venous gas, but no direct evidence of small-bowel ischemia. The gastrointestinal surgery team opted for cautious in-hospital observation overnight. Unfortunately, the patient's condition significantly worsened the following day, prompting an urgent laparotomy. Surgery confirmed ileal segment necrosis, macroscopically characterized by a distinctive geographic pattern. Retrospective analysis of stored serum samples using a human enzyme-linked immunosorbent assay demonstrated that I-FABP levels were moderately elevated (7.2 ng/mL) at the initial outpatient visit for the fracture, peaked (17.9 ng/mL) at the clinical onset of NOMI, and returned to normal (0.7 ng/mL) by postoperative day 2. Serum I-FABP levels correlated with the progression of NOMI, showing potential as an early detection marker. However, the longitudinal analysis of serum I-FABP also highlighted significant challenges of this biomarker, including the influence of renal function and the importance of sampling timing.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The efficacy of JAK inhibitors in adult eosinophilic colitis with atopic dermatitis; four cases report.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-12 DOI: 10.1007/s12328-024-02080-0

Hiroshi Matsumto, Momoyo Sasahira, Yasuhito Fujimoto, Shogen Yo, Akiko Shiotani

{"title":"The efficacy of JAK inhibitors in adult eosinophilic colitis with atopic dermatitis; four cases report.","authors":"Hiroshi Matsumto, Momoyo Sasahira, Yasuhito Fujimoto, Shogen Yo, Akiko Shiotani","doi":"10.1007/s12328-024-02080-0","DOIUrl":"https://doi.org/10.1007/s12328-024-02080-0","url":null,"abstract":"We herein present four cases of Eosinophilic colitis (EoC) in adult patients who were successfully treated with a Janus kinase (JAK) inhibitor. Case 1 is a 23-year-old female who was treated with baricitinib (BAR, 4 mg, once a day) for atopic dermatitis (AD). Colonoscopy (CS) initially did not reveal any significant abnormalities. However, she underwent another CS when she underwent a food challenge test involving wheat without baricitinib medication. During this procedure, the CS subsequently leading to her diagnosis of EoC based on eosinophil infiltration. Case 2 is a 26-year-old man whereas Case 3 is a 40-year-old man. Both patients were started on upadacitinib (UPA, 15 mg, once daily) for the treatment of AD. Their abdominal symptoms improved, and colonic histology revealed the disappearance of eosinophils. Case 4, on the other hand, is a 29-year-old woman who was also started on UPA (15 mg, once daily). Her skin lesions and abdominal symptoms also improved within 2 weeks. To the best of our knowledge, this is the first novel clinical observational case report on the efficacy of JAK inhibitors in treating adult patients with both EoC and AD.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of idiopathic portal hypertension with portopulmonary hypertension occurred following splenectomy with a change in portal hemodynamics.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-12 DOI: 10.1007/s12328-024-02072-0

Ryuta Shigefuku, Motoh Iwasa, Kyoko Yoshikawa, Hideaki Tanaka, Yasuyuki Tamai, Akiko Eguchi, Toru Sato, Yoshito Ogihara, Kaoru Dohi, Hayato Nakagawa

{"title":"A rare case of idiopathic portal hypertension with portopulmonary hypertension occurred following splenectomy with a change in portal hemodynamics.","authors":"Ryuta Shigefuku, Motoh Iwasa, Kyoko Yoshikawa, Hideaki Tanaka, Yasuyuki Tamai, Akiko Eguchi, Toru Sato, Yoshito Ogihara, Kaoru Dohi, Hayato Nakagawa","doi":"10.1007/s12328-024-02072-0","DOIUrl":"https://doi.org/10.1007/s12328-024-02072-0","url":null,"abstract":"A 22-year-old female was referred to our hospital due to thrombocytopenia and esophagogastric varices (EGV) [LmF2CbRC1, Lg-c,F1RC0], therefore we performed endoscopic variceal ligation. Dynamic abdominal computed tomography showed giant portosystemic shunts (PSSs) from the left gastric vein to the superior vena cava and splenomegaly despite normal hepatic contour. Blood tests showed thrombocytopenia and hypoalbuminemia, but there were no abnormalities in hepatic function. Retrograde hepatic venography and transjugular liver biopsy were subsequently performed in order to further examine liver pathology. These examinations revealed anastomosis between the right and middle hepatic veins, with no features to suggest cirrhosis, therefore diagnosed as idiopathic portal hypertension. Splenectomy was performed for the treatment of hypersplenism with thrombocytopenia. Nine months after undergoing a splenectomy, the patient consulted a cardiologist due to exertional dyspnea with WHO functional class II. Echocardiography revealed a mild dilatated right ventricle (RV) with an estimated systolic pressure of 55 mmHg, consistent with pulmonary hypertension. Right heart catheterization determined an increased mean pulmonary arterial pressure of 40 mmHg and pulmonary vascular resistance of 7.5 wood units, but a normal pulmonary capillary wedge pressure value of 7 mmHg, resulting in the diagnosis of portopulmonary hypertension (PoPH). Administration of oral macitentan 5 mg/day was initiated. Exertional dyspnea and the findings from right heart catheterization were improved with macitentan 10 mg/day. No report exists of PoPH occurring within one year after splenectomy, however we report here a very rare case in which a splenectomy brought about the onset of PoPH.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Torsion of the wandering spleen with intestinal obstruction.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-12 DOI: 10.1007/s12328-024-02082-y

Nobuhiro Hosoi, Makoto Sohda, Keigo Hara, Hideyuki Saito, Akihiko Sano, Makoto Sakai, Hiroomi Ogawa, Ken Shirabe, Hiroshi Saeki

{"title":"Torsion of the wandering spleen with intestinal obstruction.","authors":"Nobuhiro Hosoi, Makoto Sohda, Keigo Hara, Hideyuki Saito, Akihiko Sano, Makoto Sakai, Hiroomi Ogawa, Ken Shirabe, Hiroshi Saeki","doi":"10.1007/s12328-024-02082-y","DOIUrl":"https://doi.org/10.1007/s12328-024-02082-y","url":null,"abstract":"Wandering spleen is a relatively rare condition and may be complicated by intestinal obstruction or abnormal intestinal rotation. Herein, we report a case where these three conditions appeared concomitantly. An 18-year-old woman with an intellectual disability was admitted to the hospital because of vomiting and fever. The patient's abdomen was distended. Computed tomography revealed a dilated small intestine, a swollen spleen located in the lower abdomen, as well as twisting and swirling of the splenic artery and vein. The patient was diagnosed with torsion of the wandering spleen and emergency surgery was performed. The vascular pedicle was found to be rotated 900° clockwise, and a markedly enlarged spleen was observed in the lower abdomen. When the splenic torsion was released, the pulsation of the splenic artery was well palpated, suggesting that the spleen could be preserved. Additionally, the sigmoid colon to the cecum was not fixed to the retroperitoneum. Dilatation of the small intestine was observed, but there were no findings of intestinal tract necrosis. Splenic torsion is part of the differential diagnosis for acute abdomen. Familiarity with embryology and anatomy is necessary to select the appropriate surgical technique.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intracholecystic papillary neoplasm associated with an invasive carcinoma with cholecystocolonic fistula: a case report.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-12 DOI: 10.1007/s12328-024-02079-7

Tetsushi Azami, Yuichi Takano, Naoki Tamai, Jun Noda, Masataka Yamawaki, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Takafumi Ogawa, Masatsugu Nagahama

{"title":"Intracholecystic papillary neoplasm associated with an invasive carcinoma with cholecystocolonic fistula: a case report.","authors":"Tetsushi Azami, Yuichi Takano, Naoki Tamai, Jun Noda, Masataka Yamawaki, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Takafumi Ogawa, Masatsugu Nagahama","doi":"10.1007/s12328-024-02079-7","DOIUrl":"https://doi.org/10.1007/s12328-024-02079-7","url":null,"abstract":"Intracholecystic papillary neoplasm and cholecystocolonic fistula are both relatively rare diseases. Here, we report a case of a preoperative intracholecystic papillary neoplasm associated with invasive carcinoma and a transverse colonic fistula of the gallbladder. A 79-year-old female patient presented to our hospital with persistent right upper quadrant pain for several months and was suspected to have intracholecystic papillary neoplasm associated with an invasive carcinoma by computed tomography and endoscopic ultrasound. A gallbladder tumor biopsy was pathologically diagnosed as intracholecystic papillary neoplasm. Preoperative cholecystocolonic fistula diagnosis enabled planning not only for cholecystectomy, but also for transverse colon partial resection. Pathological examination of the resected specimen revealed intracholecystic papillary neoplasm associated with an invasive carcinoma with subserosal invasion. No malignant findings were observed in the fistula. This is a rare condition, but the presence or absence of cholecystocolonic fistula should be considered before performing intracholecystic papillary neoplasm surgery.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Amoebic colitis insufficient to metronidazole monotherapy.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-12 DOI: 10.1007/s12328-024-02083-x

Ryosuke Ikeda, Hiroaki Kaneko, Hiroki Sato, Hideyuki Anan, Aya Ikeda, Yoshihiro Goda, Soichiro Sue, Kuniyasu Irie, Shin Maeda

{"title":"Amoebic colitis insufficient to metronidazole monotherapy.","authors":"Ryosuke Ikeda, Hiroaki Kaneko, Hiroki Sato, Hideyuki Anan, Aya Ikeda, Yoshihiro Goda, Soichiro Sue, Kuniyasu Irie, Shin Maeda","doi":"10.1007/s12328-024-02083-x","DOIUrl":"https://doi.org/10.1007/s12328-024-02083-x","url":null,"abstract":"Amoebic colitis is a parasitic gastrointestinal disease caused by Entamoeba histolytica (E. histolytica). In Japan, metronidazole (MNZ) monotherapy is often used and most cases are effective. However, we report a case of MNZ-insufficient amoebic colitis caused by residual cysts. A 73-year-old man had been staying in Southeast Asia for over a decade. He had undergone a screening colonoscopy and ulcerative lesions were observed in the cecum, and a biopsy confirmed amoeba parasites. The patient was treated with MNZ monotherapy. However, he forgot to take the medicine for several days, and the ulcerative lesions persisted. The patient was referred to our facility, and we performed a colonoscopy and confirmed trophozoites. Since we considered that previous treatment failure was due to the low oral dosage, we re-prescribed MNZ. A colonoscopy after 6 months showed that the ulcerative lesions persisted. We clinically diagnosed MNZ-insufficient amoebic colitis caused by residual cysts and prescribed MNZ and paromomycin (PRM) each for 10 days. One year later, no ulcerative lesions were observed. MNZ-insufficient amoebic colitis should be considered, when ulcerative lesions remain after MNZ administration and PRM is effective drug against cysts, and we propose a combination therapy of PRM to MNZ.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cognitive and ataxic adverse events following entrectinib treatment in NTRK1 fusion gene-positive intrahepatic cholangiocarcinoma: a case report.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-07 DOI: 10.1007/s12328-024-02076-w

Kazuya Koyama, Hidetaka Iwamoto, Kenji Takahashi, Tetsuhiro Okada, Hidemasa Kawabata, Yohei Kitano, Hiroki Tanabe, Mikihiro Fujiya, Toshikatsu Okumura, Yusuke Mizukami

引用次数: 0

A case of gastric/duodenal diffuse large B cell lymphoma observed during the administration of tacrolimus/azathioprine for dermatomyositis.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-05 DOI: 10.1007/s12328-024-02077-9

Ayako Yamamoto, Ayumi Ito, Shinichi Nakamura, Tomoaki Higuchi, Masayoshi Harigai, Akihito Shinohara, Tomoko Yamamoto, Yoji Nagashima, Katsutoshi Tokushige

{"title":"A case of gastric/duodenal diffuse large B cell lymphoma observed during the administration of tacrolimus/azathioprine for dermatomyositis.","authors":"Ayako Yamamoto, Ayumi Ito, Shinichi Nakamura, Tomoaki Higuchi, Masayoshi Harigai, Akihito Shinohara, Tomoko Yamamoto, Yoji Nagashima, Katsutoshi Tokushige","doi":"10.1007/s12328-024-02077-9","DOIUrl":"https://doi.org/10.1007/s12328-024-02077-9","url":null,"abstract":"The patient was diagnosed with amyopathic dermatomyositis complicated with interstitial pneumonia (IP) at age 35. She had been treated with prednisolone and maintained on tacrolimus (TAC) + azathioprine (AZA). Eight years later, she experienced epigastric pain, and esophagogastroduodenoscopy (EGD) led to a diagnosis of duodenal ulcer. The pain did not improve, so she visited our hospital, where she presented with malaise, anemia, and weight loss. An EGD revealed submucosal tumor-like protrusions in the anterior and posterior walls of the gastric antrum and punched-out ulcers with auricle-like marginal swelling on the inside of the protrusions. Irregular-shaped punched-out ulcers were also observed in the duodenal bulb. Lymphoma was suspected, and biopsy was performed. Histopathology showed diffuse large, atypical lymphocytes with enlarged nuclei, and immunohistochemical staining revealed CD20-positive cells. Diffuse large B cell lymphoma (DLBCL) was diagnosed, which was considered as lymphomas arising in immune deficiency/dysregulation. After discontinuing TAC + AZA for three months, the gastrointestinal symptoms improved, and on EGD, the duodenal lesions had disappeared, with only a shallow depression covered with regenerated epithelium remaining in the posterior wall of the gastric antrum. Seven months later, the patient underwent follow-up EGD, and the disappearance of lymphoma cells was confirmed histopathologically by biopsy. Repeated and detailed endoscopic examination should be considered in an immunosuppressed patient with treatment-resistant gastric or duodenal ulcers.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0