JGH Open最新文献

{"title":"Risk of Pseudogallstones and Biliary Complications in Rehabilitation Patients Administered Ceftriaxone: A Retrospective Study","authors":"Hidehiro Kamezaki,&nbsp;Terunao Iwanaga,&nbsp;Takahiro Maeda,&nbsp;Junichi Senoo,&nbsp;Hiroshi Ohyama,&nbsp;Naoya Kato,&nbsp;Nobuyuki Sugiura","doi":"10.1002/jgh3.70214","DOIUrl":"https://doi.org/10.1002/jgh3.70214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to evaluate the risk of pseudogallstones and biliary tract infections after ceftriaxone administration in patients undergoing rehabilitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This retrospective observational study was conducted from October 2016 to May 2022. During this period, 41 patients with gastrointestinal and hepatobiliary conditions were transferred from a rehabilitation hospital to an acute care facility. Of these, 22 patients were diagnosed with biliary tract infections, and they were included in the study. Data collection focused on patient demographics, antibiotic history, incidence of pseudogallstones, and related biliary complications. The median patient age was 83.5 years, with 45.5% male and 54.5% female patients. The primary reasons for rehabilitation included orthopedic and neurological diseases. A history of antibiotic administration was noted in 63.6% of patients, with 18.2% developing pseudogallstones after ceftriaxone administration. Individual case studies highlighted acute cholangitis and biliary sludge formation following ceftriaxone therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified a significant incidence of pseudogallstones and biliary complications associated with ceftriaxone administration, particularly in elderly patients, patients with immobility, and those with renal impairment. By using ceftriaxone in appropriate patients, the number of patients with biliary tract infections transferred from rehabilitation hospitals to acute-care hospitals can be reduced by 18.2%, thereby improving patient outcomes in rehabilitation settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Double-Blind, Placebo-Controlled Trial of Artesunate and Curcumin in Patients With Crohn's Disease: A Pilot Study","authors":"Devinder Kumar,&nbsp;Uday C Ghoshal,&nbsp;Vamika Mansi Saigal,&nbsp;Moni Chaudhary,&nbsp;Shikha Sahu,&nbsp;Vishruti Pandya,&nbsp;Ujjala Ghoshal","doi":"10.1002/jgh3.70211","DOIUrl":"https://doi.org/10.1002/jgh3.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Less than half of all patients with Crohn's disease remain in remission with long-term use of azathioprine. Our aim was to assess the efficacy of Artesunate and Curcumin in maintaining remission in patients with Crohn's disease, who had ongoing evidence of disease activity despite taking azathioprine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with Crohn's disease being treated with azathioprine for at least 3 months but still had mild to moderate Crohn's disease (CDAI 150–450) were included. Patients were randomized into four blocks of 10 patients each in a 2 × 2 factorial design to receive artesunate 200 mg PO daily for 2 weeks and/or curcumin 200 mg PO daily for 3 months or placebo. Harvey–Bradshaw Index, CDAI, and fecal calprotectin were measured at baseline, 1 week, 1 month, 3 months, and 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty patients were recruited and randomized into the study. Both Artesunate and Curcumin were well tolerated with no adverse effects. The Harvey–Bradshaw Index statistically differed across the treatment groups at 6 months (<i>p</i> = 0.047), there were no significant group differences in the post hoc pairwise analysis. The differences in CDAI from baseline to 6 months were statistically significant in Artesunate + Curcumin (<i>p</i> = 0.0098) and Curcumin + Placebo (<i>p</i> = 0.0431) groups. Similarly, statistically significant differences were observed between Baseline and 6 months for the Harvey–Bradshaw Index in the Artesunate + Curcumin (<i>p</i> = 0.0070) and Curcumin + Placebo (<i>p</i> = 0.0138) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A combination of artesunate and curcumin in patients with ongoing inflammatory activity appears to be effective as measured by CDAI and Harvey–Bradshaw Index.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Stress, Vagal Nerve Stimulation and Disease Activity on Circulating Cytokines, Quantified by an Ultrasensitive Technique, in Ulcerative Colitis: A Pilot Study","authors":"Tamara Mogilevski,&nbsp;Melinda Y. Hardy,&nbsp;Kazuya Takahashi,&nbsp;Rebecca Smith,&nbsp;Anke L. Nguyen,&nbsp;Adam Farmer,&nbsp;James O. Lindsay,&nbsp;Jason A. Tye-Din,&nbsp;Qasim Aziz,&nbsp;Peter R. Gibson","doi":"10.1002/jgh3.70206","DOIUrl":"https://doi.org/10.1002/jgh3.70206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The utility of circulating cytokine concentrations in ulcerative colitis is limited due to poor assay sensitivity. We aimed to examine the relationship of circulating cytokine concentrations, when measured by ultrasensitive detection, to disease activity, response to induction therapy, and physiological stimuli associated with mucosal injurious events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Plasma was obtained from adult patients with ulcerative colitis in whom disease activity was assessed; before/after induction therapy; and before/after acute psychological stress and cervical transcutaneous vagal nerve/sham stimulation. Cytokines were measured using an ultrasensitive electrochemiluminescence-based multiplex assay. For stress/vagal-stimulation studies, epithelial injury was quantified by plasma concentrations of intestinal-type fatty acid-binding protein.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 12 patients in remission, 15 with mild-moderately active disease and 6 with severe colitis, concentrations of interleukin-17, IL10, interferon-<b>γ</b>, interleukin-8 and interleukin-6, but not tumor necrosis factor-α or interleukin-12p70, significantly reflected disease activity. In five patients in whom clinical remission was achieved with induction therapy, only interleukin-12p70 changed with a median increase of 65 (IQR 42–303)% (<i>p</i> = 0.006), with no consistent changes in the 10 not in remission. Vagal nerve stimulation had no effect on cytokine concentrations, but, following stress, interleukin-12p70 increased by 37 (13–60)% compared with a reduction of 29 (3–55)% following sham stimulation (<i>p</i> = 0.012), an effect that mirrored that of epithelial injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multiple cytokines were detected at sub-pg/mL levels and many showed relationships to disease activity in patients with ulcerative colitis. Effects exerted by interventions associated with epithelial injury were consistently detected by changes in interleukin-12p70 concentrations, but not other cytokines.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry: ACTRN12621000168853 and ANZCTR 12620000569909 [Ultrasound studies]; ClinicalTrials.gov identifier: NCT03908073</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal Neuroendocrine Tumor With Non-Atypical Mucous Cell Glands: A Case Report","authors":"Akira Ishikawa,&nbsp;Hidenori Tanaka,&nbsp;Ken Yamashita,&nbsp;Shiro Oka,&nbsp;Shinji Mii","doi":"10.1002/jgh3.70208","DOIUrl":"https://doi.org/10.1002/jgh3.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neuroendocrine neoplasms (NENs) of rectal origin containing non-neuroendocrine components are extremely rare. Additionally, there have been no previous reports of NENs accompanied by nonmalignant components. Herein, we report a case of an NEN accompanied by mucous cell glands that could not be regarded as a carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A Japanese woman in her 30s underwent a colonoscopy that revealed a yellowish submucosal tumor-like protrusion in the rectum. Endoscopic findings suggested a high possibility of NEN; therefore, endoscopic mucosal resection was performed. Histopathologically, it was found that tumor cells had invaded beyond the muscularis mucosa into the submucosa. The tumor predominantly consisted of neuroendocrine tumor (NET) components with mucous cell glands observed in 5% of the tumor. The mucous cell glands were Periodic acid-Schiff-positive and immunohistochemically positive for CK20, whereas synaptophysin, CD56, and chromogranin A were negative. Based on the above findings, the pathological diagnosis was NET G1 with mucous cell glands.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first reported case worldwide. Further discussion is needed to address the atypical nature of the glandular component and explore the differences and similarities with entities such as mixed neuroendocrine–non-NENs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 7","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbohydrate-Deficient Transferrin Evaluation Over Time Has Usefulness for Confirming Sobriety of Alcohol Rehabilitation Program Patients","authors":"Noriyo Yamashiki,&nbsp;Miki Murata,&nbsp;Shunichiro Ikeda,&nbsp;Kazushi Sugimoto,&nbsp;Akiko Eguchi,&nbsp;Motoh Iwasa,&nbsp;Saeko Nagao,&nbsp;Kanehiko Suwa,&nbsp;Toshihito Seki,&nbsp;Makoto Naganuma","doi":"10.1002/jgh3.70185","DOIUrl":"https://doi.org/10.1002/jgh3.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For treating severe alcohol-related liver disease (ALD), abstinence from alcohol is essential. Because underreporting can occur, abstinence biomarkers are necessary during hepatology outpatient service. This study assesses whether serial changes of the serum carbohydrate-deficient transferrin to transferrin ratio (%CDT) reflect patient abstinence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively investigated serial %CDT measurements and laboratory data from two outpatient settings: patients in an alcohol rehabilitation program (A), and ALD patients at a hepatology clinic (H) who attempted abstinence with self-diary monitoring. Using group A data, correlation coefficients were determined between the number of days from the last drink (abstinence days) and laboratory data. Linear approximation was applied for significant coefficients. Using these results, %CDT was validated for group H.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group A data were 223 data samples from 55 cases with abstinence days. Four (7%) were diagnosed as having cirrhosis. Eighteen patients continued abstinence over 30 days. %CDT (<i>Rho</i> = −0.50, <i>p</i> &lt; 0.001) and GGT (<i>Rho</i> = −0.34, <i>p</i> &lt; 0.01) were negatively correlated with abstinence days. For %CDT, negative linear approximation was maintained with the number of days (<i>y</i> = 2.01–0.004 <i>x</i>).</p>\u0000 \u0000 <p>Group H data were 18 cases, of which 12 (66%) were diagnosed as cirrhosis cases. Seven patients reported continued abstinence for 8 weeks, during which time %CDT values dropped significantly. The group H %CDT was higher than the group A %CDT, perhaps because of severer liver disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The %CDT trend assessment is useful to support continued, multi-month self-reported abstinence from alcohol, but it must be interpreted carefully in severe liver disorder cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144323648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Evidence of Association Between Gastroesophageal Reflux Disease and Hypertensive Disorders in Pregnancy","authors":"Qiong Li,&nbsp;Yajing Pang,&nbsp;Chaoyan Yue,&nbsp;Chenyang Zhao,&nbsp;Dongzhu Lei,&nbsp;Jin Zhou","doi":"10.1002/jgh3.70176","DOIUrl":"https://doi.org/10.1002/jgh3.70176","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between gastroesophageal reflux disease (GERD) and hypertensive disorders in pregnancy (HDP) is unclear. A bidirectional Mendelian randomization (MR) analysis was conducted to investigate the causal association between GERD and HDP using the public databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four methods were applied in our MR analysis, including the inverse variance weighting (IVW), MR–Egger, weighted median, and weighted mode. A series of sensitivity analyses were conducted to affirm the stability and reliability of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>IVW analysis showed a potential causal association between GERD and pre-eclampsia (PE) (OR = 1.20, <i>p</i> = 0.048), as well as gestational hypertension (GH) (OR = 1.26, <i>p</i> = 0.008). The other three methods, including MR–Egger, weighted median, and weighted mode, yielded consistent results. Heterogeneity existed between GERD and PE (<i>p</i> &lt; 0.05), as well as GH (<i>p</i> &lt; 0.05) in sensitivity analyses. However, there was no pleiotropy in MR analysis results (<i>p</i> &gt; 0.05). Leave-one-out analysis indicated that none of the SNPs had a potential impact on IVW results. In the reverse MR analysis, there is no causal effect of HDP on GERD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results demonstrated that GERD exhibited a causal relationship with a high risk of HDP, which contributed to the ongoing discourse of GERD in the etiology of HDP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small-Bowel Capsule Endoscopy in Immune-Mediated Enterocolitis: A Case Series of Four Patients","authors":"Masayuki Orikasa,&nbsp;Tomoyoshi Shibuya,&nbsp;Hirotaka Ishino,&nbsp;Masashi Omori,&nbsp;Rina Odakura,&nbsp;Masao Koma,&nbsp;Kentaro Ito,&nbsp;Takafumi Maruyama,&nbsp;Kei Nomura,&nbsp;Dai Ishikawa,&nbsp;Mariko Hojo,&nbsp;Akihito Nagahara","doi":"10.1002/jgh3.70201","DOIUrl":"https://doi.org/10.1002/jgh3.70201","url":null,"abstract":"<p>Immune checkpoint inhibitors (ICIs) have emerged as a cornerstone of cancer immunotherapy but are associated with immune-mediated adverse events (imAEs), including gastrointestinal toxicities. Among these, enteritis is a less common but clinically significant complication. However, small intestinal involvement remains under-recognized, and endoscopic findings are not well characterized. We report four cases of imAE enteritis in which small-bowel capsule endoscopy (SBCE) was performed. SBCE revealed variable mucosal abnormalities, including villous atrophy, aphthous ulcers, and extensive erosions; in one case, deep circumferential ulcers with stricture were observed. While one patient responded to corticosteroids, the other three required escalation to biologic therapy due to steroid-refractory disease. These findings suggest that SBCE may play a valuable role in assessing disease extent and predicting treatment responsiveness in imAE enteritis. Early utilization of SBCE could facilitate timely therapeutic decision-making in affected patients.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Prognostic Factors of Acute Hepatitis Among Pediatric Patients: A Cross-Sectional Study","authors":"Neda Ezoddin,&nbsp;Fateme Ziamanesh,&nbsp;Alireza Ramandi,&nbsp;Pejman Rohani,&nbsp;MohammadHassan Sohouli,&nbsp;Hosein Alimadadi","doi":"10.1002/jgh3.70164","DOIUrl":"https://doi.org/10.1002/jgh3.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early identification of acute hepatitis etiology and specific management is crucial for reducing morbidity and mortality. Therefore, this study aims to investigate the prognostic factors of acute hepatitis in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted on children with diagnosis of acute hepatitis According to the criteria of ESPHAGAN, admitted to the Children's Hospital from March 2018 to March 2023. Data were analyzed using SPSS statistical software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 164 patients with acute hepatitis were included, comprising 78 patients with acute liver failure and 86 patients without acute liver failure. Viral infections were identified as the most common etiology of acute hepatitis and were significantly more prevalent in patients without acute liver failure. Wilson's disease was significantly more prevalent in patients with acute liver failure. All patients with viral etiology recovered. Among the 24 patients with Wilson's disease, 14 (58.3%) underwent transplantation, 4 (16.6%) were deceased, and 6 (25%) survived without transplantation. Patients with other etiologies did not experience any mortality, with only 13.8% undergoing transplantation due to autoimmune causes. Low albumin (&lt; 2.5), prolonged PT (&gt; 22), elevated INR (&gt; 3), encephalopathy, low phosphorus (&lt; 3), and a duration of more than 7 days between symptom onset and hospitalization significantly increased the risk of mortality or need for transplantation in patients with acute liver disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Albumin levels, PT, INR, encephalopathy, phosphorus levels, and the duration between symptom onset and hospitalization are significant prognostic factors for acute hepatitis in pediatric patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cemiplimab-Induced Colitis Causing Hypovolemic Shock: A Case Report and Literature Review","authors":"Saeed S. Graham,&nbsp;Kena J. Lemu,&nbsp;Victoria Mofopefoluwa Thomas,&nbsp;Stanley O. Oghoghorie,&nbsp;Abdulazeez R. Swaiti,&nbsp;Jinye Liu,&nbsp;Alina Faheem","doi":"10.1002/jgh3.70198","DOIUrl":"https://doi.org/10.1002/jgh3.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The use of immune checkpoint inhibitors (ICI), such as Cemiplimab, has become prevalent in oncology, providing significant anti-tumor effects. However, these agents can induce severe gastrointestinal inflammation, which may be potentially life-threatening. This case report details an instance of Cemiplimab-induced colitis resulting in hypovolemic shock in a patient with cutaneous squamous cell carcinoma (cSCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>An 83-year-old male veteran with a complex history of scalp squamous cell carcinoma, treated initially with excision and radiation, experienced recurrence necessitating Cemiplimab therapy. One year post-initiation, the patient presented with severe diarrhea, leading to hypovolemic shock and acute renal failure. Initial tests ruled out infectious causes. Endoscopic evaluation revealed inflammatory mucosal changes in the sigmoid colon, and histopathology confirmed active colitis. The patient responded well to high-dose prednisone, with rapid improvement in symptoms, leading to a transfer to a lower level of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cemiplimab, approved for advanced cSCC, fulfills a crucial therapeutic need but is associated with immune-related adverse events, including severe colitis. Management of such cases requires early endoscopy and corticosteroid therapy, which can significantly improve outcomes. This report underscores the importance of vigilant monitoring for gastrointestinal symptoms in patients undergoing ICI therapy and prompt intervention to mitigate severe complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus Statement on Metabolic Dysfunction-Associated Steatotic Liver Disease in Children and Adolescents From the Joint TASL-TSPGHAN Expert Committee","authors":"Yu-Cheng Lin,&nbsp;Fang-Min Liao,&nbsp;Hsun-Ching Chao,&nbsp;An-Chyi Chen,&nbsp;Yung-Ming Jeng,&nbsp;Chieh-Chung Lin,&nbsp;Mao-Meng Tiao,&nbsp;Yao-Jong Yang,&nbsp;Chun-Yan Yeung,&nbsp;Huey-Ling Chen,&nbsp;Yen-Hsuan Ni","doi":"10.1002/jgh3.70137","DOIUrl":"https://doi.org/10.1002/jgh3.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition in children and adolescents, driven by the global rise in pediatric obesity. In this consensus statement by the Taiwan Association for the Study of the Liver (TASL) and the Taiwan Society of Pediatric Gastroenterology, Hepatology, and Nutrition (TSPGHAN), we highlight the unique clinical challenges in diagnosing and managing this condition in Asian children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This consensus was developed by expert members of TASL and TSPGHAN through a comprehensive review of current literature and clinical practice. Key topics included prevalence, screening policies, diagnostic criteria, disease characteristics, and management strategies relevant to pediatric MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We emphasize the rising prevalence of pediatric MASLD, which correlates strongly with obesity but often remains underdiagnosed due to the lack of screening policy for at-risk individuals and variations in diagnostic criteria. This review also discusses the distinct natural history and histopathological features of pediatric MASLD, underscoring the critical need for a greater understanding of its long-term outcomes. Currently, liver enzymes and ultrasonography are commonly used for screening and diagnosis, though these methods have limitations. The diagnostic imaging and novel non-invasive biomarkers specifically tailored for pediatric MASLD are in urgent need. Clinical management continues to rely on lifestyle interventions, with no pharmacological treatments currently approved for pediatric MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Effective management of pediatric MASLD requires a comprehensive approach to risk assessment, early detection, and intervention, tailored to the disease's unique pathophysiology in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}