Advances in Digestive Medicine最新文献

{"title":"Migration of bird feather into bile duct mimicking bile duct stone recurrence: First-ever case report","authors":"Chia-Chang Chen,&nbsp;Yen-Chun Peng,&nbsp;Sheng-Shun Yang,&nbsp;Chun-Fang Tung","doi":"10.1002/aid2.13314","DOIUrl":"10.1002/aid2.13314","url":null,"abstract":"<p>The presence of a bird feather as a foreign object inside the human body has rarely been reported in the literature. A feather can cause severe complications such as neck infection or duodenal perforation. Early recognition and treatment of this condition may prevent associated morbidity and mortality. We report a case of a female patient who had a feather inside her bile duct. The feather caused abdominal pain without acute cholangitis. Fortunately, it was successfully removed before causing severe complications. This is the first-ever case report of the migration of a feather into the common bile duct. A 54-year-old Taiwanese woman had a history of cholecystectomy due to acute calculous cholecystitis 1 year prior to this visit. She had also undergone endoscopic retrograde cholangiopancreatography (ERCP) two times due to acute cholangitis (8 years ago and 1 year ago). Endoscopic papilla sphincterotomy had been performed during ERCP for stone extraction. This time, she visited our clinic due to intermittent epigastric pain for 2 weeks. There were no signs of acute cholangitis. Abdominal computed tomography (CT) did not reveal bile duct stone or foreign bodies. ERCP was arranged for possible hidden stones not detected by CT. To our surprise, we pulled a 5-cm-long bird feather out of her bile duct during ERCP. After successfully removing the feather, she remained free of abdominal pain and other complications during the next 6 months of follow-up at our outpatient clinic. Migration of foreign bodies into the bile duct should be included in the differential diagnosis for unexplained abdominal pain in patients with choledochoduodenal fistula due to previous endoscopic papilla sphincterotomy.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47018682","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":"Gastric amyloidosis associated with multiple myeloma: A rare cause of upper gastrointestinal bleeding","authors":"Huei-Ling Fang,&nbsp;Cheng-Kuan Lin,&nbsp;Yuan-Bin Yu,&nbsp;Min-Hsiang Chang","doi":"10.1002/aid2.13318","DOIUrl":"10.1002/aid2.13318","url":null,"abstract":"<p>Amyloidosis is defined as an excess extracellular deposit of protein fibrils, an associated syndrome with tissue injury and dysfunction. Light chain (AL) amyloidosis is the most common type of systemic amyloidosis. The most frequently involved organs are the kidneys, heart, liver, autonomous nervous system, and gastrointestinal tract. Systemic AL amyloidosis patients often have GI symptoms such as diarrhea and vomiting. Furthermore, asymptomatic gastric amyloid deposits are commonly found in patients with systemic AL amyloidosis. The clinical manifestations, laboratory results, and treatment of an 80-year-old female patient with AL amyloidosis of the gastrointestinal tract in our hospital were summarized. Relevant literatures on the etiology, clinical features, diagnosis, treatment, and prognosis of this disease were reviewed. The patient was referred to upper endoscopy because of melena for weeks. Large areas of irregular thickened gastric folds with overlying ulcers and friable polypoid masses at the fundus were seen, showing amyloid depositions. Further workup revealed that no involvement of other organs. Serum immunoelectrophoresis and bone marrow biopsy confirmed multiple myeloma, which was clinically thought to cause gastric amyloidosis. The patient was treated with melphalan, prednisolone, and thalidomide. After treatment, the melena was improved, the flattening gastric mass and a reduction in the serum kappa light chain level and kappa/lambda ratio were observed. Gastric amyloidosis is rarely seen at upper endoscopy in patients without a previously established diagnosis of myeloma. Early detection of gastrointestinal amyloidosis will ultimately improve the outcomes of patients with the rare disease.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49405770","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":"Efficacy of local-regional treatment plus sorafenib in intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization","authors":"Tzu-Chun Hong,&nbsp;Hong-Ming Tsai,&nbsp;Yih-Jyh Lin,&nbsp;Chiung-Yu Chen,&nbsp;Chiao-Hsiung Chuang,&nbsp;I-Chin Wu,&nbsp;Ting-Tsung Chang,&nbsp;Meng-Zhi Han,&nbsp;Sheng-Hsiang Lin,&nbsp;Shang-Hung Chen,&nbsp;Hao-Chen Wang,&nbsp;Po-Jun Chen,&nbsp;Ming-Tsung Hsieh,&nbsp;Hsueh-Chien Chiang,&nbsp;Chieh-Yen Liu,&nbsp;Hsin-Yu Kuo","doi":"10.1002/aid2.13317","DOIUrl":"10.1002/aid2.13317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Sorafenib treatment is suggested for patients with intermediate-stage hepatocellular carcinoma (HCC) refractory to transarterial chemoembolization (TACE). This study aimed to study if combining local-regional treatment with sorafenib adds benefit to patients who had tumor progression after three sessions of TACE within 12 months. We retrospectively analyzed the treatment outcomes of sorafenib alone and combined treatment of sorafenib and local-regional therapies in intermediate-stage HCC patients after using inverse probability of treatment weighting (IPTW). Forty-nine patients were enrolled; 28 patients were treated with sorafenib alone, whereas 21 patients received TACE or radiofrequency ablation (RFA) in addition to sorafenib. After IPTW, the two groups were well-balanced for most baseline characteristics. The overall response rate (ORR) and disease control rate (DCR) were significantly higher in the sorafenib-combination group than the sorafenib-alone group (ORR: 41.3% vs 10.0%, <i>P</i> = .001; DCR: 44.6% vs 22.1%). The PFS was also significantly longer in the patients of the sorafenib-combination group than the alone group (median 5.3 vs 3.0 months, HR, 0.55; 95% CI, 0.35-0.88). The risk of extrahepatic metastases was significantly lower in the sorafenib-combination group (HR, 0.04; 95% CI, 0.01-0.50). The incidence of adverse events was comparable between sorafenib-combination and sorafenib-alone groups. Loco-regional therapy may be still able to exert additional survival benefit to patients taking sorafenib for TACE-refractory intermediate-stage HCC showing a better PFS and lower risk of extrahepatic metastases without causing significant liver dysfunction. Further investigations to identify patients who will be more likely to benefit from the combination of sorafenib with local-regional therapy are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45670323","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":"Examination of factors related to pathological severity and microperforation in patients undergoing surgery for acute appendicitis","authors":"Naoko Sekiguchi,&nbsp;Jin Matsuyama,&nbsp;Masahiro Koh,&nbsp;Kiyotsugu Iede,&nbsp;Masami Ueda,&nbsp;Yujiro Tsuda,&nbsp;Shinsuke Nakashima,&nbsp;Tsukasa Tanida,&nbsp;Masakazu Ikenaga,&nbsp;Terumasa Yamada","doi":"10.1002/aid2.13311","DOIUrl":"10.1002/aid2.13311","url":null,"abstract":"<p>Patients suffering from appendicitis with severe pathological findings or microperforation have a poor prognosis. Therefore, when selecting treatments, it is critical to clarify the factors related to histopathological severity and the presence of microperforation in cases diagnosed as mild appendicitis. We retrospectively collected data from 357 consecutive patients diagnosed with acute appendicitis based on symptoms such as fever, physical findings, blood tests, and imaging findings who underwent surgery at the Higashiosaka City Medical Center between January 2016 and December 2020. We investigated the predictors of pathological severity and the presence or absence of microperforations. Of the 335 patients, 252 (75%) had clinically mild appendicitis. In the multivariate analysis, diameter of the appendix ≥10.9 mm (<i>P</i> = .0013) and C-reactive protein ≥5.0 mg/dl (<i>P</i> = .0011) were related to gangrenous appendicitis, with odds ratios of 2.67 (95% confidence interval: 1.23-5.80) and 3.88 (95% confidence interval: 1.71-8.77), respectively. On the other hand, the presence of an appendicolith (<i>P</i> = .0083) and duration from onset to surgery ≥2 days (<i>P</i> = .0033) were related to microperforation, with odds ratios of 6.82 (95% confidence interval: 1.64-28.4) and 3.73 (95% confidence interval: 1.21-12.4), respectively. Patients with gangrenous appendicitis or microperforation had higher rates of postoperative complications, including more cases of Clavien-Dindo classification III and longer hospital stays (<i>P</i> &lt; .05). Even in cases of clinically mild appendicitis, there is a possibility of microperforation or gangrenous appendicitis. Therefore, it is essential to carefully select the treatment in cases with more than 2 days after symptom onset, a dilated appendix, and an appendicolith.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44262805","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":"More candidate genes imply how complexity to eliminate the evil","authors":"Jeng-Yih Wu","doi":"10.1002/aid2.13309","DOIUrl":"10.1002/aid2.13309","url":null,"abstract":"<p>Worldwide, colorectal cancer (CRC) is the most lethal and prevalent malignancy and was responsible for nearly 881 000 cancer-related deaths in 2018.<span>¹</span> Despite the pathophysiologic mechanism of CRC being more complex than beyond thought, recent advances in the treatment of CRC provided more strategies, but the results were not satisfactory. In this issue, a study from Lin et al, reported that five STAT3-downstream genes were over-expressed in CRC-derived tumorspheres, including BHLHE40, ATF3, ERRFI1, ITPKA, and S100A14. As expected, the authors found that knockdown of STAT3 diminished the cell viability in HT29 cells in vitro since STAT3 was believed to involve in the initiation of cancer stemness property and progression. Therefore, these STAT3-downstream genes may contribute to cell proliferation and survival.</p><p>For the treatment of CRC, it is more complex. Ideally, the treatment goal is to remove the tumor as completely as possible, either at primary or metastatic sites, which mostly requires surgery. However, surgical intervention is limited to patients with resectable lesions and tolerant to surgery. Otherwise, tumor shrinkage and down-stage by radiotherapy and/or chemotherapy as neoadjuvant or adjuvant treatment are the leading options in the junction of surgically unresectable and intolerable patients. In recent decades, research studies demonstrated combination chemotherapy including FOLFOX (5-FU + OX), FOXFIRI (5-FU + IRI), XELOX or CAPOX (CAP + OX), and CAPIRI (CAP + OX) in CRC patients had prolonged their overall survival (OS) up to 20 months, especially those with metastases.<span>²</span> Nonetheless, the response results of chemotherapy in survival were not satisfactory, therapy targeting the CRC initiation, progression, and migration pathways became approaches to reinforce chemotherapy. In 1995, the first monoclonal antibody targeting EGFR-mediated pathways, named cetuximab, targeted to EGFR with convincing preclinical data were announced.<span>³</span> Combinations of cetuximab with other existing chemotherapies also displayed promising results. The phase III CRYSTAL trial found that cetuximab plus FOLFIRI had better progression control (8.9 vs 8 months, hazard ratio [HR] 0.85; <i>P</i> = .048) than FOLFIRI alone.<span>³</span> Another landmark trials, AVF2107 trial based on antiangiogenic therapy by a humanized IgG monoclonal antibody targeted to VEGF-A, named bevacizumab, for CRC improved both progression-free survival (PFS) and OS in metastatic CRC (RR: 44% vs 34.8%; OS: 20.3 vs 15.6 months; HR: 0.66, <i>P</i> &lt; .001; PFS: 10.6 vs 6.2 months; HR: 0.54; <i>P</i> &lt; .001).<span>⁵</span> Several agents targeting various pathways such as BRAF inhibitor/MEK inhibitor, human epidermal growth factor receptor (HER)2 inhibitor, hepatocyte growth factor (HGF), and the receptor tyrosine kinase known as mesenchymal-epithelial transition factor (c-MET or MET) were","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45361788","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":"Superinfection of other hepatitis viruses on top of chronic hepatitis B: The more, the worse","authors":"Chih-Lin Lin","doi":"10.1002/aid2.13308","DOIUrl":"10.1002/aid2.13308","url":null,"abstract":"<p>Hepatitis B virus (HBV) is one of the most important causes of end-stage liver disease, including cirrhosis and hepatocellular carcinoma worldwide.<span>¹</span> Taiwan is known to be hyperendemic for HBV infection. Although the implementation of nationwide universal hepatitis B vaccination program since 1984 significantly decreased the prevalence of chronic HBV infection from 10.9% to 0.5% in children,<span>²</span> the prevalence of seropositivity of hepatitis B surface antigen (HBsAg) in adults was still up to 13.7% in 2002.<span>³</span> In addition to HBV, Taiwan is also threatened by other hepatitis viruses, including hepatitis A, C, D, and E viruses. Thus, patients with chronic HBV infection coinfected or superinfected with other hepatitis viruses are not uncommon. Among these viral hepatitis, hepatitis C virus (HCV) coinfection in HBV carriers is most common in Asia. Previous studies revealed that patients with HBV and HCV coinfection have a greater risk of developing cirrhosis and hepatocellular carcinoma, leading to a poorer outcome than those with HBV or HCV monoinfection.<span>⁴</span> However, little is known about the clinical manifestations and long-term outcomes of HBV carriers with hepatitis A virus (HAV) and hepatitis D virus (HDV) coinfection or superinfection.</p><p>In this issue of the <i>Advances in Digestive Medicine</i>, Wu et al investigated whether prior exposure of HAV or HDV was associated with adverse long-term outcomes in patients with chronic HBV infection.<span>⁵</span> Compared with HBV carriers without exposure to HAV or HDV, the risk of advanced liver disease increased by more than 10 times in patients with seropositivity of anti-HAV or anti-HDV. Their findings confirmed that the superinfection of other hepatitis virus in patients with chronic HBV infection will aggravate the underlying liver disease. However, several issues were worthy of discussion.</p><p>First, HAV is one of the most common etiologies of acute hepatitis worldwide.<span>⁶</span> Because of poor sanitation and inadequate hygiene, the prevalence of HAV infection was high and most individuals infected with HAV in childhood before 1990 in Taiwan. The annual incidence of HAV infection dramatically decreased after improving sanitation conditions and providing HAV vaccination for high-risk children since 1995.<span>⁷</span> Since then, the seroprevalence of anti-HAV continued to decline in Taiwan. The age-stratified seroprevalence of anti-HAV was lower than 5% in the younger population.<span>⁸</span> In the current study of Wu et al, the anti-HAV seropositive rates were quite low in inactive carriers younger than 60 years old. The most worrisome thing is that the risk of a sudden outbreak of HAV infection in patients with chronic HBV infection may increase in the future. To avoid severe clinical course of HAV superinfection, HAV vaccination is recommended for p","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44520646","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":"2021 Reviewer Acknowledgment","authors":"","doi":"10.1002/aid2.13310","DOIUrl":"10.1002/aid2.13310","url":null,"abstract":"<p>Consistent high-quality of papers published in <i>Advances in Digestive Medicine</i> (AIDM) can only be maintained with the cooperation and dedication of a number of expert referees. The Editors would like to thank all those who have donated the hours necessary to review, evaluate and comment on manuscripts; their conscientious efforts have enabled the journal to maintain its tradition of excellence. We are grateful to the following reviewers for their contributions during 2021.</p><p>Chang, Chun-Chao</p><p>Chang, Chung-Yu</p><p>Chang, Jia-Jang</p><p>Chang, Li-Chun</p><p>Chang, Wei-Lun</p><p>Chen, Chien-Hung</p><p>Chen, Chien-Lin</p><p>Chen, Chih-Yen</p><p>Chen, Jiann-Hwa</p><p>Chen, Ming-Jen</p><p>Chen, Peng-Jen</p><p>Chen, Wen-Chi</p><p>Cheng, Hsiu-Chi</p><p>Cheng, Pin-Nan</p><p>Cheng, Yuan-Lung</p><p>Chiu, Han-Mo</p><p>Chou, Chu-Kuang</p><p>Chou, Jen-Wei</p><p>Chu, Yin-Yi</p><p>Chuah, Seng-Kee</p><p>Chuang, Chiao-Hsiung</p><p>Dai, Chia-Yen</p><p>Fang, Kuan-Chieh</p><p>Han, Ming-Lun</p><p>Hsieh, Ping-Hsin</p><p>Hsieh, Yu-Hsi</p><p>Hsu, Chao-Wei</p><p>Hsu, Ching-Sheng</p><p>Hsu, Ping-I</p><p>Hsu, Yao-Chun</p><p>Huang, Chien-Hao</p><p>Huang, Chung-Feng</p><p>Huang, Hui-Chun</p><p>Huang, Kuo-Hung</p><p>Huang, Yi-Hsiang</p><p>Huang, Tien-Yu</p><p>Hung, Chao-Hung</p><p>Jeng, Wen-Juei</p><p>Kao, Sung-Shuo</p><p>Kao, Wei-Yu</p><p>Kuo, Chao-Hung</p><p>Kuo, Yu-Ting</p><p>Lai, Hsueh-Chou</p><p>Lee, I-Cheng</p><p>Lee, Mei-Hsuan</p><p>Lee, Hsi-Chang</p><p>Li, Chung-Pin</p><p>Liang, Chih-Ming</p><p>Lin, Chih-Lin</p><p>Lin, Chih-Wen</p><p>Lin, Shyr-Yi</p><p>Lin, Hsiang-Hung</p><p>Lin, Tsung-Jung</p><p>Liou, Jyh-Ming</p><p>Lu, Hsiao-Sheng</p><p>Luo, Jiing-Chyuan</p><p>Sheu, Ming-Jen</p><p>Shih, Hsiang-Yao</p><p>Shiu, Sz-Iuan</p><p>Su, Tung-Hung</p><p>Sung, Kai-Feng</p><p>Tai, Wei-Chen</p><p>Tsai, Tzung-Jiun</p><p>Tsay, Feng-Woei</p><p>Tseng, Chih-Wei</p><p>Wang, Chia-Chi</p><p>Wang, Huay-Min</p><p>Wang, Wen-Lun</p><p>Wang, Yen-Po</p><p>Wu, I-Chen</p><p>Wu, Jeng-Yih</p><p>Yan, Sheng-Lei</p><p>Yang, Hung-Chih</p><p>Yang, Tsung-Chieh</p><p>Yeh, Hsing-Jung</p><p>Yen, Hsu-Heng</p><p>Yi, Chih-Hsun</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13310","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42510127","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":"Atezolizumab-associated colitis mimic inflammatory bowel disease: A case report","authors":"Yen-Chun Liu,&nbsp;Cheng-Tang Chiu,&nbsp;Ren-Chin Wu,&nbsp;Chao-Wei Hsu,&nbsp;Chun-Wei Chen,&nbsp;Puo-Hsien Le,&nbsp;Chia-Jung Kuo","doi":"10.1002/aid2.13303","DOIUrl":"10.1002/aid2.13303","url":null,"abstract":"<p>Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that target downregulators of the anticancer immune response. ICIs have revolutionized the treatment of various malignancies. However, many immune-related adverse events have also been described, which mainly occurs when the immune system becomes less suppressed, and affects various organs, including the gastrointestinal tract. We report a case of atezolizumab-associated colitis with clinical and endoscopic follow-ups. The patient was a 72-year-old male diagnosed with advanced squamous cell lung cancer treated with atezolizumab and combination chemotherapy. Two months after atezolizumab therapy, bloody diarrhea and abdominal pain were reported. Initial colonoscopy revealed colonic ulcers with diffuse erythema and loss of vascularity. Histology demonstrated ulcerated mucosa with acute inflammation. Steroids were promptly indicated due to suspicion of immune-related colitis caused by atezolizumab. Follow-up sigmoidoscopy performed 6 weeks after initiating steroid therapy showed improvement of inflammation. Histological findings revealed eroded colonic mucosa with abortive crypts, lymphoplasma, and eosinophil cell infiltration, which mimicked inflammatory bowel disease (IBD). However, there was no colitis relapse after steroid discontinuation. The case demonstrated endoscopic and histological presentations of immune-mediated colitis that mimicked IBD.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44327829","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":"Impact of iron deficiency anemia on quality of life in patients with ulcerative colitis","authors":"Ajay K. Jain,&nbsp;Sandip Vare,&nbsp;Shohini Sircar,&nbsp;Amit D. Joshi,&nbsp;Deepika Jain","doi":"10.1002/aid2.13304","DOIUrl":"10.1002/aid2.13304","url":null,"abstract":"<p>Advances in the last two decades have resulted in better long-term remissions in patients with ulcerative colitis (UC), which is defined as an idiopathic, chronic inflammatory disorder of the colonic mucosa. This better remission has not transformed into a better quality of life. Almost one-third of these patients have mild to moderate anemia, which is one of the main factors leading to decreased quality of life; hence we aimed to determine the prevalence of iron deficiency anemia (IDA) in UC during remission and its impact on the quality of life in this subpopulation. In this prospective study, all consecutive patients of UC in remission for the last 3 months were evaluated for disease activity by Simple Clinical Colitis Activity Index (SCCAI), IDA by blood parameters and quality of life by Short Inflammatory Bowel Disease Questionnaire (SIBDQ). All patients with proven IDA were given oral iron supplements (Ferrous Ascorbate elemental iron 100 mg) for 3 months. Blood parameters, SCCAI, and SIBDQ scores were evaluated at the end of therapy to compare them before iron supplementation. Out of 125 patients of UC seen during the study period, 69 were in remission. IDA was seen in 34 patients (49.27%). Median pre-intervention and postintervention quality of life scores—SIBDQ (4.9 [4.2-5.8] vs 5.4 [5.0-6.1]) and blood parameters [hemoglobin 10.7 (9.8-11.4) g% vs 13.2 (12.8-13.7) g%]—showed significant improvement after iron supplementation. Prevalence of IDA in UC during remission is common (49.27%). Oral iron supplementation improves the quality of life and anemia significantly without increasing disease activity in UC under remission.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48518034","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":"Real-world experience of adalimumab therapy for patients with ulcerative colitis: A single tertiary medical center experience in Central Taiwan","authors":"Hsu-Heng Yen,&nbsp;Yu-Chun Hsu,&nbsp;Chu-Hsuan Kuo,&nbsp;Tsui-Chun Hsu,&nbsp;Yang-Yuan Chen","doi":"10.1002/aid2.13300","DOIUrl":"10.1002/aid2.13300","url":null,"abstract":"<p>There are few studies on the treatment outcomes of adalimumab therapy in Taiwanese patients with ulcerative colitis (UC). A total of 102 patients with ulcerative colitis were identified from the electronic clinical database of the Changhua Christian Hospital. The demographic data and clinical features of the disease pattern of the UC patients receiving adalimumab therapy were retrospectively reviewed. Between January 2015 and June 2020, 18 patients with UC received adalimumab therapy. Due to the absence of a response, 5 of the 18 patients (27.7%) only received the induction therapy. Of the 13 patients who received maintenance adalimumab therapy, four discontinued the therapy: three (23.1%) stopped due to a loss of response, and one (7.7%) stopped due to a cutaneous reaction to adalimumab. Because of Taiwan's 1-year limit on the use of adalimumab, seven patients relapsed and required a second course of therapy. The median period between course completion and relapse was 31 weeks. Two (20%) of the ten patients who finished the first course of therapy did not experience a relapse. The treatment response of patients with UC to adalimumab therapy appears to be comparable to those in previously published Western studies. The majority of patients who responded to adalimumab will relapse following a limited duration of adalimumab therapy in Taiwan.</p>","PeriodicalId":7278,"journal":{"name":"Advances in Digestive Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/aid2.13300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46873095","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}