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Unusual Confluence: Exploring the Association of Biliary Atresia, Wilson Disease, and Iron Overload. 不寻常的汇合：探索胆道闭锁、威尔逊氏病和铁超载的关联。
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-18 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001500
Shivangini Duggal, Samantha Meza-Rodriguez, Saqib Shahid, Marc Zuckerman, Jorge Chiquie Borges
{"title":"Unusual Confluence: Exploring the Association of Biliary Atresia, Wilson Disease, and Iron Overload.","authors":"Shivangini Duggal, Samantha Meza-Rodriguez, Saqib Shahid, Marc Zuckerman, Jorge Chiquie Borges","doi":"10.14309/crj.0000000000001500","DOIUrl":"https://doi.org/10.14309/crj.0000000000001500","url":null,"abstract":"<p><p>The case involves a 33-year-old man with biliary atresia, Wilson disease (WD), and iron overload. Biliary atresia, a cholangiodestructive disease, leads to cirrhosis if untreated. WD, caused by ATP7B gene mutations, results in copper accumulation affecting the liver and brain. Iron overload can be seen in cases of WD and with hereditary hemochromatosis gene mutations. The patient's concurrent presentation of these conditions poses a unique clinical challenge. Elevated iron levels may worsen WD outcomes. A detailed history and physical examination, genetic testing, and close follow-up are crucial. The case highlights the need for increased awareness and vigilant monitoring of patients with overlapping liver diseases.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01500"},"PeriodicalIF":0.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492819","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}
引用次数: 0
Metastatic Small Cell Carcinoma of the Stomach. 胃转移性小细胞癌
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-14 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001540
Mirac Gunay, Celia Leone, Oksana Albayati, Abdalla Mohamed, Nnaemeka Anyadike
{"title":"Metastatic Small Cell Carcinoma of the Stomach.","authors":"Mirac Gunay, Celia Leone, Oksana Albayati, Abdalla Mohamed, Nnaemeka Anyadike","doi":"10.14309/crj.0000000000001540","DOIUrl":"https://doi.org/10.14309/crj.0000000000001540","url":null,"abstract":"<p><p>Primary gastric small cell carcinoma (GSCC) is an extremely rare type of small cell carcinoma. Its aggressive nature with early widespread metastasis and late detection gives it a poor prognosis with overall survival of <12 months. GSCC is a type of neuroendocrine tumor, and because of its histopathological similarity to small cell lung carcinoma (SCLC), treatment regimen of GSCC includes the same chemotherapy agents as SCLC. We report a case of a 57-year-old man who presented with signs of partial gastrointestinal obstruction and was found to have a primary stage IV GSCC with metastasis to the liver.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01540"},"PeriodicalIF":0.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455773","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}
引用次数: 0
A Case of Immune Checkpoint Inhibitor-Induced Duodenitis. 一例免疫检查点抑制剂诱发的十二指肠炎病例
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-14 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001539
Sandra Au, Wei Chen, Iris Vance, Kara Wegermann
{"title":"A Case of Immune Checkpoint Inhibitor-Induced Duodenitis.","authors":"Sandra Au, Wei Chen, Iris Vance, Kara Wegermann","doi":"10.14309/crj.0000000000001539","DOIUrl":"https://doi.org/10.14309/crj.0000000000001539","url":null,"abstract":"<p><p>Immune checkpoint inhibitors improve patient survival in multiple cancers, but immune-related adverse events, including new immunologic conditions arising during therapy, pose a significant challenge. Gastrointestinal immune-related adverse events, although common, exhibit diverse presentations. We present a case of duodenitis resembling celiac disease because of the anti-programmed cell death protein-1 antibody, pembrolizumab. Despite diagnostic uncertainty and therapeutic interventions, including gluten-free diet, symptoms stabilized even with resuming gluten. In addition, endoscopic abnormalities after pembrolizumab therapy have neither progressed nor completely resolved. This case underscores the need for investigation into the pathogenesis of immune checkpoint inhibitor-induced duodenitis, with implications for care of patients on immunotherapies.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01539"},"PeriodicalIF":0.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455771","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}
引用次数: 0
Microvillous Inclusion Disease: An Exceedingly Rare Condition With a New Treatment. 微绒毛包涵体病：一种极为罕见的疾病，一种新的治疗方法。
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-12 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001537
Alexandra Fiedler, Kevin Brittan, Wuttiporn Manatsathit
{"title":"Microvillous Inclusion Disease: An Exceedingly Rare Condition With a New Treatment.","authors":"Alexandra Fiedler, Kevin Brittan, Wuttiporn Manatsathit","doi":"10.14309/crj.0000000000001537","DOIUrl":"https://doi.org/10.14309/crj.0000000000001537","url":null,"abstract":"<p><p>Syndromes characterized by congenital diarrhea, hearing loss, and intrahepatic cholestasis are uncommon and often misdiagnosed as progressive familial intrahepatic cholestasis (PFIC). Recent genetic studies have widened the array of genes linked with cholestatic disorders. Among these, <i>UNC45A</i> has recently been implicated in microvillous inclusion disease (MVID), although only a few cases exist. This case highlights a 20-year-old woman initially diagnosed clinically with PFIC type 1 during childhood. After ileal bypass at age 4 years, she had a resolution of intractable pruritus and cholestasis. Despite remaining symptom-free for over a decade, she returned in adulthood with recurrent cholestatic pruritus. Odevixibat was initiated for presumed PFIC while awaiting additional testing with symptomatic improvement and laboratory normalization. Whole genome sequencing identified novel compound heterozygous mutations in <i>UNC45A</i> and small bowel biopsies confirmed villous atrophy. Odevixibat, currently approved for cholestatic pruritus in PFIC and Alagille syndrome, demonstrates efficacy in managing cholestatic pruritus in MVID.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01537"},"PeriodicalIF":0.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455774","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}
引用次数: 0
Hemorrhagic Cholecystitis Due to Rupture of Underlying Anomalous Duplicated Cystic Arteries. 底层异常双囊动脉破裂导致出血性胆囊炎。
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-11 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001503
Victoria Diaz, George Trad, Sue Boo
{"title":"Hemorrhagic Cholecystitis Due to Rupture of Underlying Anomalous Duplicated Cystic Arteries.","authors":"Victoria Diaz, George Trad, Sue Boo","doi":"10.14309/crj.0000000000001503","DOIUrl":"https://doi.org/10.14309/crj.0000000000001503","url":null,"abstract":"<p><p>Hemorrhagic cholecystitis (HC) is a rare complication that can become rapidly fatal. Patients may present with hematemesis or melena, in addition to other common symptoms of acute cholecystitis. Delay in diagnosing HC postpones early intervention, and patients can quickly decompensate. We present a 33-year-old man with hematemesis and downtrending hemoglobin. Imaging revealed underlying anomalies of duplicate cystic arteries that ruptured, an occurrence never reported in the literature before. Bilateral cystic arteries were embolized successfully. This case demonstrates the importance of early consideration of HC as a differential. Recognition and timely diagnosis prompt urgent intervention, which can reduce morbidity.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01503"},"PeriodicalIF":0.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455772","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}
引用次数: 0
Successful Treatment of Severe Pyoderma Gangrenosum and Ulcerative Colitis With Upadacitinib. 乌达帕替尼成功治疗严重脓皮病和溃疡性结肠炎
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-11 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001531
Sarah Park, Joelle St Pierre, Oluwakemi Onajin, David T Rubin
{"title":"Successful Treatment of Severe Pyoderma Gangrenosum and Ulcerative Colitis With Upadacitinib.","authors":"Sarah Park, Joelle St Pierre, Oluwakemi Onajin, David T Rubin","doi":"10.14309/crj.0000000000001531","DOIUrl":"https://doi.org/10.14309/crj.0000000000001531","url":null,"abstract":"<p><p>Pyoderma gangrenosum (PG) is a rare inflammatory and ulcerative skin disorder that is often associated with an underlying systemic disease, including inflammatory bowel disease. Many treatments used to treat inflammatory bowel disease are also used for the treatment of PG, including systemic therapies, immunomodulators, and tumor necrosis factor-α inhibitors; however, their efficacy in PG is limited. Novel treatments of PG are needed. We report the case of a 62-year-old woman with steroid-refractory PG and concomitant ulcerative colitis successfully treated for both conditions with upadacitinib, a selective Janus kinase inhibitor.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01531"},"PeriodicalIF":0.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485612","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}
引用次数: 0
Secondary Syphilis Can Simultaneously Mimic Cholestatic Liver Injury and Glomerular Nephropathy. 继发性梅毒可同时模拟胆汁淤积性肝损伤和肾小球肾病
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-11 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001538
Rachel Obimah, Omar Martinez-Uribe, James Helzberg, Jane P Gagliardi, Matthew Kappus
{"title":"Secondary Syphilis Can Simultaneously Mimic Cholestatic Liver Injury and Glomerular Nephropathy.","authors":"Rachel Obimah, Omar Martinez-Uribe, James Helzberg, Jane P Gagliardi, Matthew Kappus","doi":"10.14309/crj.0000000000001538","DOIUrl":"https://doi.org/10.14309/crj.0000000000001538","url":null,"abstract":"<p><p>Syphilis, a disease affecting millions, still poses challenges for men who have sex with men in high-income countries and often presents in varying ways. It is exceedingly rare for syphilis to simultaneously cause an acute liver injury and nephropathy. This case describes the concomitant clinical presentation of these abnormalities and also describes a liver injury that mimicked cholestatic disease. Treatment of syphilis led to complete resolution of the liver and kidney injury. This case demonstrates a need to exclude syphilis in patients with high-risk behaviors who present with cholestatic liver injury in atypical fashions.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01538"},"PeriodicalIF":0.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485611","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}
引用次数: 0
Successful Use of Fecal Microbiota Transplantation in Management of Nonobstructive Recurrent Cholangitis Following Total Pancreatectomy and Islet Autotransplant. 成功利用粪便微生物群移植治疗全胰腺切除术和胰岛自体移植后的非梗阻性复发性胆管炎
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-11 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001527
Adam Scott, Alexander Khoruts, Martin L Freeman, Greg Beilman, Karthik Ramanathan, Melena D Bellin, Guru Trikudanathan
{"title":"Successful Use of Fecal Microbiota Transplantation in Management of Nonobstructive Recurrent Cholangitis Following Total Pancreatectomy and Islet Autotransplant.","authors":"Adam Scott, Alexander Khoruts, Martin L Freeman, Greg Beilman, Karthik Ramanathan, Melena D Bellin, Guru Trikudanathan","doi":"10.14309/crj.0000000000001527","DOIUrl":"https://doi.org/10.14309/crj.0000000000001527","url":null,"abstract":"<p><p>Alterations in the gut microbiome have been implicated in various pathologies. Fecal microbiota transplantation (FMT) has been offered as a novel treatment for conditions implicated in the disruption of the gut-microbiota axis. This case report details the successful treatment of recurrent nonobstructive cholangitis following a single FMT application in a patient who had previously undergone a hepatobiliary tract surgical diversion. Cholangitis was suspected secondary to reflux of an altered microbiome into the surgically reanastomosed biliary tract, and FMT was justified based on the history of recurrent <i>Clostridioides difficile</i> infections. This case supports the further evaluation of the utility of FMT as one potential treatment of post hepatobiliary surgical diversion cholangitis.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01527"},"PeriodicalIF":0.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455775","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}
引用次数: 0
Impact of Using Self-Assembling Peptide (PuraStat) on Anastomotic Ulcers-A Multicenter Case Series. 使用自组装肽（PuraStat）对吻合口溃疡的影响--多中心病例系列。
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-10 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001535
Veeral M Oza, Nitish Mittal, Charles Winchester, Yousef Fazel, Amar Manvar, Adam Goodman, Mohit Girotra, Harshit S Khara, Shivangi Kothari, Truptesh H Kothari
{"title":"Impact of Using Self-Assembling Peptide (PuraStat) on Anastomotic Ulcers-A Multicenter Case Series.","authors":"Veeral M Oza, Nitish Mittal, Charles Winchester, Yousef Fazel, Amar Manvar, Adam Goodman, Mohit Girotra, Harshit S Khara, Shivangi Kothari, Truptesh H Kothari","doi":"10.14309/crj.0000000000001535","DOIUrl":"10.14309/crj.0000000000001535","url":null,"abstract":"<p><p>Treatment of anastomotic ulcers, also known as marginal ulcers, is challenging, especially when established techniques have failed. PuraStat is a biocompatible synthetic peptide gel that is indicated for hemostasis of bleeding in the gastrointestinal tract and vascular anastomoses. We aim to evaluate the feasibility of PuraStat in the setting of nonhealing anastomotic ulcers when used alongside standard therapies. This is a multicenter case series of adult patients who had PuraStat applied with a follow-up repeat endoscopy. Nine out of 10 patients showed clinical improvement. We concluded that PuraStat is an effective agent to aid in healing of anastomotic ulcer.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01535"},"PeriodicalIF":0.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399079","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}
引用次数: 0
An Infiltrative Case of Angiosarcoma Causing Portal Hypertension. 引起门静脉高压的血管肉瘤浸润性病例
IF 0.6
ACG Case Reports Journal Pub Date : 2024-10-10 eCollection Date: 2024-10-01 DOI: 10.14309/crj.0000000000001532
Gina Bae, Katie A Dunleavy, Catherine Hagen, Douglas A Simonetto, Manal F Abdelmalek
{"title":"An Infiltrative Case of Angiosarcoma Causing Portal Hypertension.","authors":"Gina Bae, Katie A Dunleavy, Catherine Hagen, Douglas A Simonetto, Manal F Abdelmalek","doi":"10.14309/crj.0000000000001532","DOIUrl":"10.14309/crj.0000000000001532","url":null,"abstract":"<p><p>Hepatic angiosarcoma is a rare and aggressive liver tumor. We report a case study of an 82-year-old elderly gentleman who presented with failure to thrive and ascites. Initially suspected to be cirrhosis, biopsy results eventually concluded angiosarcoma of the liver. Our patient presented with an infiltrative form, rather than distinct masses, which led to portal hypertension and ascites. The variance in symptomatology and radiology presentations make a diagnosis of hepatic angiosarcoma challenging and require a high index of suspicion.</p>","PeriodicalId":7394,"journal":{"name":"ACG Case Reports Journal","volume":"11 10","pages":"e01532"},"PeriodicalIF":0.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399075","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}
引用次数: 0
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