Revista Espanola De Enfermedades Digestivas最新文献

{"title":"Plasma protein glycosylation: a biomarker for predicting metabolic dysfunction-associated steatotic liver disease in inflammatory bowel disease.","authors":"Sandra García-Mateo, Samuel Jesús Martínez-Domínguez, Carla Jerusalén Gargallo-Puyuelo, Beatriz Gallego, Erika Alfambra, María Aso, Nuria Amigó, Neus Martínez-Micaelo, Josep Ribalta, Montse Guardiola, Javier Martínez-García, Pedro M Baptista, Fernando Gomollón","doi":"10.17235/reed.2025.11575/2025","DOIUrl":"10.17235/reed.2025.11575/2025","url":null,"abstract":"<p><strong>Background: </strong>plasma glycoproteins, influenced by systemic inflammatory conditions, hold promise as biomarkers for metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with inflammatory bowel disease (IBD).</p><p><strong>Purpose: </strong>to explore the potential of these glycoproteins to identify and predict the course of MASLD in IBD patients.</p><p><strong>Methods: </strong>an ambispective study was conducted involving patients with (cases) and without (controls) IBD. Of 947 IBD patients screened for inclusion in the study, 100 were selected (cases): 50 with IBD and MASLD and 50 without MASLD. Each IBD patient was matched with four controls without IBD. Additionally, each IBD patient was followed for a median of 25 (interquartile range [IQR]: 22-28) months. Plasma samples were analyzed using nuclear magnetic resonance spectroscopy, examining the glycoproteins (Glyc-B, Glyc-F, and Glyc-A).</p><p><strong>Results: </strong>glycoprotein concentrations were significantly higher in the IBD group (p < 0.001), with IBD patients exhibiting MASLD showing the highest levels of glycoproteins compared to those without MASLD and the control group (p < 0.001). Concerning MASLD outcomes, all Glyc-B (p = 0.032), Glyc-F (p = 0.007) and Glyc-A (p = 0.006) showed significant associations with the persistence of hypertransaminasemia at the end of the monitoring period, Glyc B (p = 0.033) with the persistence of lower high density lipoprotein cholesterol, all glycoprotein groups (p < 0.001) with hypertriglyceridemia; and Glyc A (p = 0.015) and Glyc B (p = 0.009) with the development of impaired fasting glucose during follow-up.</p><p><strong>Conclusions: </strong>plasma glycoproteins emerge as a promising biomarker for the presence of MASLD in IBD patients.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"556-564"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyshidrotic eczema associated with upadacitinib use: a paradoxical adverse event or serendipity?","authors":"Gisela Piñero, María Puig, Míriam Mañosa Círia, Eugeni Domenech","doi":"10.17235/reed.2026.11807/2025","DOIUrl":"10.17235/reed.2026.11807/2025","url":null,"abstract":"<p><p>We report the case of a 39-year-old man with long-standing ileocolonic Crohn's disease, with a history of prior ileocecal resection and secondary loss of response to infliximab and ustekinumab, who initiated treatment with upadacitinib (UPA) 45 mg/day due to severe clinical, biochemical, and endoscopic recurrence. The patient achieved a rapid clinical response with normalization of inflammatory biomarkers. Two weeks after UPA initiation, he developed pruritic vesicular lesions on the palms and fingers, which were diagnosed as de novo dyshidrotic eczema by an expert dermatologist. The cutaneous manifestation was mild to moderate and resolved rapidly with topical corticosteroids, without the need to discontinue UPA. Crohn's disease remained in clinical and biochemical remission after 9 months of follow-up. Possible immunological mechanisms underlying this paradoxical reaction are discussed, including selective JAK1 inhibition-related immune imbalance, with disruption of the Th1/Th2 axis, altered IL-4 and IL-13 signaling, and a potential predominance of Th1/Th17 responses. Although UPA has been exceptionally used as a therapeutic option for refractory dyshidrotic eczema, and this condition has been reported as an infrequent adverse event in pivotal ulcerative colitis trials, this case likely represents the first report of upadacitinib-induced dyshidrotic eczema in Crohn's disease.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"595-596"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous multiple early gastric cancer with Schistosoma japonicum eggs.","authors":"Caixia Yao, Youhong Cao, Chen Yuan","doi":"10.17235/reed.2026.11862/2026","DOIUrl":"10.17235/reed.2026.11862/2026","url":null,"abstract":"<p><p>Mostly, Schistosoma japonicum preferred living in mesenteric veins and oviposit rather than the highly acidic environment in the stomach. Herein, we described a rare case of synchronous multiple early gastric cancer with Schistosoma japonicum eggs.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"599"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blown-out myotomy as a cause of symptomatic recurrence after peroral endoscopic myotomy: endoscopic management.","authors":"Mónica Ayude Galego, Sara Campos Cancela, Alberto Iglesias Doallo, Iago Gavín Piña, Luisa de Castro Parga, José Ignacio Rodríguez Prada, Antonio Rodríguez D Jesús","doi":"10.17235/reed.2026.11852/2026","DOIUrl":"10.17235/reed.2026.11852/2026","url":null,"abstract":"<p><p>Blown-out myotomy (BOM) is an uncommon complication following surgical or endoscopic myotomy, associated with food retention and recurrent symptoms. We report a 58-year-old man with type III achalasia who developed dysphagia and regurgitation after peroral endoscopic myotomy (POEM). Endoscopy and imaging revealed a pseudodiverticulum at the previously treated site, consistent with BOM. The patient was successfully treated with an anterior myotomy, achieving complete and sustained symptom resolution. This case highlights the importance of considering BOM in patients with recurrent symptoms after myotomy and supports endoscopic management as a safe and effective option.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"596-597"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reading the glycome in MASLD: at the crossroads of metabolism and inflammation.","authors":"Javier Crespo, Paula Iruzubieta","doi":"10.17235/reed.2026.12254/2026","DOIUrl":"10.17235/reed.2026.12254/2026","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as the hepatic expression of a broader cardiometabolic and inflammatory disorder. In this context, circulating glycoprotein signals may provide information beyond conventional assessment of steatosis and fibrosis risk. García-Mateo et al. evaluated plasma Glyc-A, Glyc-B and Glyc-F using nuclear magnetic resonance in patients with inflammatory bowel disease (IBD), with and without MASLD, and in matched controls. Glycoprotein concentrations showed a progressive increase from controls to IBD and were highest when IBD and MASLD coexisted, while Glyc-B and Glyc-F remained independently associated with MASLD after adjustment for relevant metabolic variables. These findings should not yet be interpreted as establishing new clinical biomarkers. Rather, they raise a more fundamental question: what biological information is captured by circulating glycoprotein signals? Glyc-A, Glyc-B and Glyc-F represent composite spectroscopic signals influenced by acute-phase proteins, systemic inflammation, metabolic dysfunction and, potentially, disease-specific glycan changes. Their interpretation is therefore particularly relevant in IBD, where immune-mediated inflammation may modify the metabolic and hepatic phenotype. Emerging transcriptomic and glycomic data suggest that MASLD arising in different inflammatory contexts may not be biologically identical, despite a similar clinical classification. The current evidence supports the biological plausibility of glycoprotein profiling but not yet its routine clinical use. Future studies should determine the relative contribution of systemic inflammation, adiposity, insulin resistance, dyslipidaemia and liver injury to these signals; establish their relationship with clinically relevant liver phenotypes, particularly fibrosis; and demonstrate incremental value beyond established non-invasive tools. Learning to interpret the glycome may ultimately prove more informative than simply measuring it.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":"118 ","pages":"552-555"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An extreme megaesophagus causing lung collapse.","authors":"Ivo Mendes, Francisco Vara-Luiz, João Mirinha Luz, Gonçalo Nunes","doi":"10.17235/reed.2024.10866/2024","DOIUrl":"10.17235/reed.2024.10866/2024","url":null,"abstract":"<p><p>An 83-year-old male with long-term dysphagia and weight loss was admitted due to an acute ST-elevation myocardial infarction. During hospitalization he developed hematemesis requiring several red blood cell transfusions. An upper endoscopy was attempted being interrupted due to esophageal high-volume stasis. Despite remaining fasting for several days and naso-esophageal tube drainage, three additional upper endoscopies still revealed non-removable solid food stasis in a markedly dilated esophagus and bleeding from severe underlying esophagitis. A thoracic CT confirmed an aberrant and massive esophageal dilation with 110x100mm and large food impaction leading to almost complete right lung atelectasis and respiratory failure. A narrow esophagogastric junction and no apparent associated obstructive lesions were also observed on CT scan. Based on clinical symptoms and radiologic findings a presumptive diagnosis of achalasia was considered although it could not be confirmed through esophageal manometry. Parenteral nutrition was started. Nevertheless, the patient died a few days later from aspiration pneumonia.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"589-590"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pancreatitis associated with periampullary hamartomatous polyp in Peutz-Jeghers syndrome.","authors":"Edson Kenzo Mizushima, Augusto Ricken Siqueira, Luis Carlos Anflor, Luiz Felipe Peres Giesta","doi":"10.17235/reed.2026.11826/2026","DOIUrl":"https://doi.org/10.17235/reed.2026.11826/2026","url":null,"abstract":"<p><p>We report the case of an 11-year-old girl with Peutz-Jeghers syndrome (PJS) and a history of bilateral oophorectomy for a sex cord-stromal tumor, who presented with acute abdominal pain, nausea, and vomiting. Laboratory findings indicated acute pancreatitis, and imaging revealed pancreatic enlargement with a large lobulated polypoid lesion (6.2 × 3.8 cm) in the periampullary duodenum, causing biliary and pancreatic ductal dilatation without gallstones. Upper endoscopy confirmed the lesion, and surgical duodenotomy with polypectomy and cholecystectomy was performed. Histopathological analysis identified a hamartomatous polyp consistent with PJS. No other etiologies for pancreatitis were found. This case highlights a rare but clinically significant complication of PJS, where a periampullary hamartomatous polyp caused obstructive pancreatitis. Accurate diagnosis through imaging and endoscopy, followed by surgical intervention, led to complete resolution of symptoms and stable follow-up.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":"118 10","pages":"594-595"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: dual advanced therapy in inflammatory bowel disease. Why, when and how?","authors":"Rodrigo Quera, Paulina Núñez, Gonzalo Pizarro, Francisca Carvajal, Lilian Flores","doi":"10.17235/reed.2025.11678/2025","DOIUrl":"10.17235/reed.2025.11678/2025","url":null,"abstract":"<p><p>Dual targeted therapy, which involves the combination of two biological agents and/or small molecules, is an emerging treatment option for patients with difficult-to-manage inflammatory bowel disease (IBD), who present with extraintestinal manifestations or have associated immune-mediated diseases. Prospective studies and randomized controlled trials will be essential to better define its efficacy and safety in the personalized management of inflammatory bowel disease.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"600-601"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual partners: a rare cause of small bowel bulges and a common cause of anemia.","authors":"Ana Isabel Ferreira, Sofia Xavier, Bruno Rosa, José Cotter","doi":"10.17235/reed.2024.10846/2024","DOIUrl":"10.17235/reed.2024.10846/2024","url":null,"abstract":"<p><p>A 67-year-old female, without prior medical history, presented to the emergency department due to dizziness and asthenia, where iron deficiency anemia, without visible blood loss, was identified. A previous abdominal computed tomography revealed intestinal pneumatosis of the proximal jejunum and right colon. The upper endoscopy showed non-atrophic gastritis associated with H.pylori infection, which was treated, and the colonoscopy revealed right colic pneumatosis, without other alterations. A small bowel capsule endoscopy was performed, revealing bulging areas of the intestinal wall, lymphangiectasias and angioectasias, in the proximal small bowel. A single balloon assisted anterograde enteroscopy reached the proximal jejunum, showing several areas of bulging with endoscopically normal mucosa, compatible with intestinal pneumatosis. In 3 bulging areas, there were multiple lymphangiectasias and friable punctate angioectasias, which were treated with argon-plasma coagulation and through-the-scope clip with haemostatic success. The procedure was uneventful. After 6 months of follow-up, the patient was asymptomatic, without anemia or iron deficiency.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"586-588"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of existing predictive scores of response in patients with moderately active ulcerative colitis treated with oral corticosteroids.","authors":"Gisela Piñero, Jordina Llaó, Mercè Navarro-Llavat, Orlando García-Bosch, Margalida Calafat, Jesús Castro, Míriam Mañosa, Eugeni Domènech","doi":"10.17235/reed.2025.11584/2025","DOIUrl":"10.17235/reed.2025.11584/2025","url":null,"abstract":"<p><strong>Background: </strong>the prediction of response to corticosteroids in ulcerative colitis (UC) might allow early introduction of advanced therapies. Predictive scores have been proposed for severe UC, but their performance in moderate flares is unknown.</p><p><strong>Aim: </strong>to evaluate the performance of established indexes to predict early corticosteroid response in moderately active UC patients treated with oral prednisone and identify baseline predictors of response.</p><p><strong>Methods: </strong>data from two prospective clinical studies in patients with moderate UC treated with oral prednisone were analyzed. All patients underwent a colonoscopy before starting corticosteroids and clinical and biological assessments at baseline and after seven days. Non-response was defined as the persistence of rectal bleeding in > 50 % of bowel movements and > 3 additional bowel movements from baseline after seven days of therapy or if rescue therapy was prescribed. Albumin, C-Reactive Protein, and Endoscopy Score (ACE), Degree of Ulcerative Colitis Burden of Luminal Inflammation (DUBLIN), and C-reactive protein/albumin ratio (CAR) scores were calculated.</p><p><strong>Results: </strong>among 94 patients (51 % extensive colitis), 44 achieved clinical remission and 16 were classified as non-responders at day 7. Most patients met high-risk scores for the DUBLIN score, 17 % for CAR index, whereas only one patient met the high-risk ACE score. No index reliably predicted non-response. In the univariate analysis, younger age at baseline (p = 0.04) and shorter disease duration at admission (p = 0.012) were the only variables associated with lack of response.</p><p><strong>Conclusions: </strong>the existing clinical-biological scores developed for therapeutic response in severe UC lack predictive accuracy for moderate UC flares treated with oral corticosteroids. Novel, tailored prediction tools are needed in this clinical setting.</p>","PeriodicalId":21342,"journal":{"name":"Revista Espanola De Enfermedades Digestivas","volume":" ","pages":"565-571"},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}