Abstract:
:Infliximab is efficacious for refractory Crohn's disease, but delayed hypersensitivity reactions preclude retreatment for patients experiencing this complication. We report the results of four patients offered enrollment in an open label trial of thalidomide as "salvage" therapy for their refractory disease. Two patients with active fistulous disease and two with lumenal disease received open-label thalidomide 200 mg every night and were evaluated monthly at the University of Chicago Clinical Research Center for 12 weeks. Before administration, patients signed an informed consent form discussing the potential risks of thalidomide use. Female patients of child-bearing age underwent serum pregnancy testing every 4 weeks. Response was defined as an absolute decrease in Crohn's Disease Activity Index (CDAI) by 100 points or improvement in two of three clinical parameters for fistulous disease. A patient with a single perirectal fistula had complete closure by 4 weeks, the other had noticeable improvement of five perianal fistulae at 4 weeks and complete closure by 12 weeks. One lumenal patient had a CDAI decrease of 250 points in 4 weeks. The fourth patient withdrew secondary to sedation after only a week of therapy. Two patients (one fistula, one lumenal) continued thalidomide past the 3-month study period and remained in remission at 5 and 7 months. Side effects reported were sedation (four of four patients), hypertension (one of four), and peripheral neuropathy (one of four). Thalidomide appears to be a safe and effective alternative for short-term healing in patients who develop infliximab-induced delayed hypersensitivity reaction and may be an alternative strategy for those at risk.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Kane S,Stone LJ,Ehrenpreis Edoi
10.1097/00004836-200208000-00006subject
Has Abstractpub_date
2002-08-01 00:00:00pages
149-50issue
2eissn
0192-0790issn
1539-2031journal_volume
35pub_type
临床试验,杂志文章abstract::Sjogren syndrome (SS) is an autoimmune disease that affects exocrine glands and therefore may affect the gastrointestinal system, from the mouth, esophagus, and bowel to the liver and pancreas. Oral involvement in SS is mainly characterized by dryness, with a wide spectrum of symptoms, from mild-to-severe xerostomia w...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3182329d9c
更新日期:2012-01-01 00:00:00
abstract::In this manuscript, a short review is provided of the basic principles of screening, emphasizing some of the methodologic problems attendant on any screening test, in short, a "screening primer." My analysis of the "core" data supporting efforts to screen for colorectal cancer leads to the conclusion that the utility ...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:
更新日期:1983-06-01 00:00:00
abstract::In two patients, treatment of amebic dysentery was followed (despite the disappearance of the infecting organism) by an illness with the clinical, pathological, and radiological characteristics of nonspecific ulcerative colitis. Their case histories indicate that in addition to persistent or recurrent amebic infection...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198306000-00004
更新日期:1983-06-01 00:00:00
abstract:GOALS:To review the published experience with acute pancreatitis in childhood. STUDY:Computerized search of the English medical literature since 1965 using MEDLINE. RESULTS:Details of 589 patients were reviewed. Mean age was 9.2 +/- 2.4 years (range: 1 week to 21 years). Male to female ratio was 1.2. Etiologies inclu...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200308000-00015
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Fundic gland polyps (FGPs) are now the most common gastric polyp encountered by endoscopists. However, they have minimal clinical significance. If they could be reliably predicted by endoscopic features, it might prevent the need for and cost of biopsy. GOALS:To determine the positive predictive value of en...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200305000-00007
更新日期:2003-05-01 00:00:00
abstract::Patients who are hepatitis B surface antigen (HBsAg) positive are at risk for hepatitis flare when receiving cytotoxic or immunosuppressive therapy. It has been reported that as high as 50% of HBsAg-positive individuals who undergo chemotherapy develop elevation of liver transaminases. According to current Association...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181945942
更新日期:2009-05-01 00:00:00
abstract::Aminosalicylates are of proven benefit in maintaining medically induced remissions of both ulcerative colitis and Crohn's disease. Even rectal 5-aminosalicylic acid has been found to be useful in maintaining long-term remissions of distal ulcerative colitis. Particularly noteworthy is the demonstrated efficacy of oral...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199503000-00009
更新日期:1995-03-01 00:00:00
abstract::Among the factors involved in the pathogenesis of gastric ulcer, the reduced clearing capacity of the stomach seems to play an important role. On this basis, cisapride, which improves gastrointestinal motility, enhances gastric emptying, and prevents duodenogastric reflux, may be effective in the treatment of the gast...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199307000-00003
更新日期:1993-07-01 00:00:00
abstract:GOALS:The authors aimed to characterize older adults' intentions for future surveillance colonoscopy, knowledge of polyps, and predictors of colonoscopy plans. BACKGROUND:Guidelines recommend that the decision to continue or stop surveillance colonoscopy in older adults with colon polyps be "individualized." Although ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001401
更新日期:2020-07-29 00:00:00
abstract::Aortoesophageal fistula is a rare cause of massive gastrointestinal hemorrhage, and may occur as a sequela to prosthetic replacement of the thoracic aorta. Esophageal compression necrosis with leakage of microorganisms into the proximal suture line is probably central to pathogenesis. Like the more common aortoduodena...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198412000-00009
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Women with irritable bowel syndrome (IBS) frequently report chronic pelvic pain, however, it is still unanswered whether these are truly separate entities. IBS negatively impacts on quality of life, but the impact of IBS on sexual function is not clear. GOALS:We aimed to (1) describe the impact of IBS on se...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181d7a368
更新日期:2010-11-01 00:00:00
abstract::In a prospective series of 284 upper gastrointestinal (GI) endoscopies, outcome was evaluated by a cost-benefit analysis. Two-thirds of the endoscopies had a negative result, or a diagnosis was found which was not worth the costs of the endoscopy. The overall diagnostic gain of 284 endoscopies, however, outweighed the...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198204000-00003
更新日期:1982-04-01 00:00:00
abstract::To determine whether the urease-based CLOtest or low-dose 14C urea breath test can predict severity of gastritis or the presence of peptic ulcers, we studied 84 patients presenting for upper endoscopy. Antral biopsies were obtained for histologic analysis and CLOtesting, and urea breath testing was performed. The time...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199709000-00003
更新日期:1997-09-01 00:00:00
abstract::Identical twins presented as sexagenarians with heartburn, regurgitation, and dysphagia; each had a Barrett esophagus remarkably similar to the other. This instance suggests a hereditary influence upon the development of mucosal dysplasia in some patients with this condition. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198306000-00011
更新日期:1983-06-01 00:00:00
abstract::Mycosis fungoides is a cutaneous T-cell lymphoma that can disseminate to multiple organs. We report a patient who presented with obstructive jaundice caused by isolated involvement of the extrahepatic biliary tree by mycosis fungoides. Initially, endoscopic examinations and biopsies of the biliary tree and liver faile...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199901000-00015
更新日期:1999-01-01 00:00:00
abstract::Gastroesophageal reflux disease (GERD) is recognized to be present in 10-20% of cases of chronic cough. Proving that it is the cause of the cough is more difficult. This problem is illustrated by way of a case report demonstrating that GERD can still be the cause, even when the patient is unresponsive to conventional ...
journal_title:Journal of clinical gastroenterology
pub_type: 社论,评审
doi:10.1097/00004836-199604000-00002
更新日期:1996-04-01 00:00:00
abstract::Adhesive tape wound around the shaft of an upper GI endoscope serves as a simple method to dilate upper GI strictures under endoscopic control. This technique avoids the need for guidewires and fluoroscopy. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198506000-00005
更新日期:1985-06-01 00:00:00
abstract::We report a case of Klebsiella pneumoniae peritonitis after endoscopic sclerotherapy and discuss its pathogenesis and risk factors. We also review previous cases in the literature and make recommendations for prophylactic therapy. Endoscopists should be aware of peritonitis as a possible complication of endoscopic scl...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199212000-00013
更新日期:1992-12-01 00:00:00
abstract::The role of psychosocial factors in peptic ulcer remains controversial. We have investigated the relationship between socioeconomic status, concrete stressors, and ulcers in a longitudinally followed, population-based cohort, taking confounding risk factors into account. A total of 6,928 adults completed the Alameda C...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199510000-00004
更新日期:1995-10-01 00:00:00
abstract::The intensity of diagnostic workup of patients with human immunodeficiency virus (HIV)-related chronic diarrhea is controversial. In the ideal setting in which an enteric pathogen is detected with minimal evaluation (stool tests) and in which specific treatment clears the diarrhea, eradicates the pathogen, and improve...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-199304000-00018
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Guidelines for chronic hepatitis C virus (HCV) management have recommended that a liver biopsy be repeated at 3-year intervals for HIV/HCV-coinfected patients and 5-year intervals for those with HCV monoinfection to assess fibrosis progression. However, it is unclear if patients are willing to repeat this pr...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318266fe70
更新日期:2013-05-01 00:00:00
abstract::One hundred forty-six consecutive specimens of excised bowel from patients with Crohn's disease were studied to determine the relationships between strictures, sinuses, and "fissures." A significant coincidence of sinuses and strictures was observed and sinuses tended to arise proximal to the point of maximal strictur...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198610000-00024
更新日期:1986-10-01 00:00:00
abstract::Lansoprazole is the first proton pump inhibitor developed in Japan. We studied the clinical efficacy of lansoprazole 30 mg q.d. on peptic ulcers and the subsequent relapse rates. The endoscopic healing rate of gastric ulcers (n = 86) after 8 weeks of treatment and duodenal ulcers (n = 52) after 6 weeks of treatment we...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章
doi:10.1097/00004836-199506002-00022
更新日期:1995-01-01 00:00:00
abstract::We sought to define the risk of bleeding after percutaneous aspiration liver biopsy in patients with low platelet counts but otherwise normal clotting factors. Eighty-seven patients underwent liver biopsy using the Menghini 1-second technique with either a 1.6-mm or a 1.2-mm needle. Bleeding occurred in three out of 1...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198210000-00011
更新日期:1982-10-01 00:00:00
abstract::Hypertriglyceridemia (HTG) is a rare cause of pancreatitis. Pancreatitis secondary to HTG, presents typically as an episode of acute pancreatitis (AP) or recurrent AP, rarely as chronic pancreatitis. A serum triglyceride (TG) level of more than 1,000 to 2,000 mg/dL in patients with type I, IV, or V hyperlipidemia (Fre...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200301000-00016
更新日期:2003-01-01 00:00:00
abstract::In the current COVID-19 pandemic, there has been concern regarding the use of ibuprofen and other nonsteroidal anti-inflammatory agents by COVID-19 infected patients. Aminosalicylates (5-ASAs) are structurally similar and have anti-inflammatory functions that resemble those of nonsteroidal anti-inflammatory agents. Si...
journal_title:Journal of clinical gastroenterology
pub_type: 评论,杂志文章
doi:10.1097/MCG.0000000000001371
更新日期:2020-08-01 00:00:00
abstract::A 36-year-old male patient, after 3 months' treatment with fluvastatin 40 mg/d for hypercholesterolemia, presented with acute pancreatitis. The pancreatitis was mild, and the patient settled on medical treatment. Other causes of the disease were ruled out. Some months later, the patient reintroduced fluvastatin on his...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200211000-00010
更新日期:2002-11-01 00:00:00
abstract:GOALS:We determined yearly rates of upper and lower gastrointestinal (GI) hospitalizations in Quebec, Canada and compared the 1-year readmission and mortality risks among those discharged from lower versus upper GI hospitalizations. BACKGROUND:The burden of serious upper and lower GI events is substantial. STUDY:Demo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318282a1d7
更新日期:2013-08-01 00:00:00
abstract::Sclerosing cholangitis may be a cause of refractory pain in patients infected with the human immunodeficiency virus. We performed celiac plexus block in three such patients with sever pain from sclerosing cholangitis and a poor response to conventional analgesia. The pain had been centered in the epigastrium and/or up...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199607000-00013
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:The presence of laryngopharyngeal reflux disease is controversial when abnormal sensation of the laryngopharynx is felt without heartburn. GOALS:The aims of this study were to investigate the relationship between abnormal sensation of the laryngopharynx and gastroesophageal reflux, and to elucidate the path...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318167b8b5
更新日期:2009-03-01 00:00:00