Abstract:
:We recently treated a patient with adult-onset Still's disease who developed macrophage activation syndrome (MAS) secondary to disseminated histoplasmosis while being treated with adalimumab. The gastroenterology service was consulted early, before diagnosis, as the patient presented with elevated liver enzymes and disseminated intravascular coagulation. MAS is an exaggerated immune response that can develop as a primary condition or secondary to infections, drugs and various diseases, resulting in liver dysfunction, encephalopathy, pancytopenia and disseminated intravascular coagulation. The development of MAS has also been reported in patients with inflammatory bowel disease and post-liver transplantation and has been triggered by medications used by gastroenterologists, particularly sulfasalazine and anti-tumor necrosis factor biologic modifiers. Therefore, we present a review on etiology, pathogenesis, clinical and laboratory features, and treatment of MAS with a focus on gastrointestinal aspects and presentations. MAS is a life threatening condition with a high mortality rate if untreated. Therefore it is important to recognize this condition early. As these patients may occasionally present to gastroenterologists we hope this review will increase awareness of this rare, but serious syndrome.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Jayakar BA,Hashkes PJdoi
10.1097/MCG.0b013e3181f6015fsubject
Has Abstractpub_date
2011-03-01 00:00:00pages
210-4issue
3eissn
0192-0790issn
1539-2031journal_volume
45pub_type
杂志文章,评审abstract:BACKGROUND:Spiral enteroscopy (SE) has emerged as a new alternative for deep intubation of the small intestine. SE is most often used to evaluate abnormal findings on capsule endoscopy (CE). OBJECTIVE:Investigate the ability of SE to reproduce abnormal findings detected on preceding CE. DESIGN:Prospective study. SET...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181eeb74b
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The impact of methicillin-resistant Staphylococcus aureus (MRSA) colonization of percutaneous endoscopic gastrostomy (PEG) sites on morbidity and mortality is uncertain. AIM:We investigated the impact of known prior MRSA colonization on the incidence of symptomatic PEG site wound infection and mortality. M...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/01.mcg.0000210096.44123.b6
更新日期:2006-04-01 00:00:00
abstract::A 24-year-old man with addisonian pernicious anemia, adult celiac disease and selective IgA deficiency is presented to emphasize the differential diagnosis of vitamin B12 deficient megaloblastic anemia in association with small intestinal mucosal abnormalities and the relationships between immunoglobulin deficiency, p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198606000-00016
更新日期:1986-06-01 00:00:00
abstract::The existence of four genotypes of hepatitis C virus (HCV)--types 1a, 1b, 2a, and 2b--has been suggested based on variations in nucleotide sequences of the core region. The aim of this study was to investigate the prevalence of HCV genotypes in chronic type C liver disease in Taiwan and correlate distinct genotypes to...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199510000-00014
更新日期:1995-10-01 00:00:00
abstract::Myopericarditis is a rare but important manifestation of inflammatory bowel disease. It can be the sole or one of several extracolonic manifestations of either ulcerative colitis or Crohn's disease. Because of the therapeutic implications, we report a patient with ulcerative colitis associated with myopericarditis, wi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198109000-00011
更新日期:1981-09-01 00:00:00
abstract::Two unusual cases of liquid caustic ingestion that resulted in gangrene of the duodenum and adjacent colon, and burns of the esophagus, stomach, and pancreas are presented. The routine evaluation of the oropharynx, esophagus, and stomach after liquid caustic ingestion can seriously underestimate the extent of injury t...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199412000-00009
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:An association between Helicobacter pylori infection and colorectal neoplasia has been reported in cross-sectional studies. GOALS:We examined the association between H. pylori infection and the development of advanced colorectal neoplasia (AN) in a screening cohort. STUDY:We identified 3753 adults, who und...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001273
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Abnormal pancreatic function tests have been reported to precede the imaging findings of chronic pancreatitis. Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) is increasingly accepted as the primary imaging modality for the detection of structural changes of early mild...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31812f4ef5
更新日期:2008-09-01 00:00:00
abstract:GOAL:To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD). BACKGROUND:IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbio...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/MCG.0000000000000772
更新日期:2018-02-01 00:00:00
abstract::We studied the levels of serum hepatitis C virus (HCV)-RNA, the HCV genotype before interferon therapy, and the kinetics of serum HCV-RNA at the initial stages of therapy to determine their utility in predicting the therapeutic efficacy of interferon in 44 patients with chronic hepatitis C infection. We also looked at...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199710000-00009
更新日期:1997-10-01 00:00:00
abstract::Forty cases of nongangrenous ischemic colitis were studied to find the different clinical features between stricturing form and transient form. Clinical and laboratory findings were compared between two groups, 15 cases of stricturing form and 25 of transient form, which were diagnosed by follow-up barium enema radiog...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198612000-00009
更新日期:1986-12-01 00:00:00
abstract::Progressive systemic sclerosis (PSS) causes smooth muscle atrophy and fibrosis of the distal two-thirds of the esophagus. Motility studies show reduced-amplitude or absent peristaltic contractions in this region and normal or decreased lower esophageal sphincter pressure. Patients complain of dysphagia, heartburn, and...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/01.mcg.0000225549.19127.90
更新日期:2006-10-01 00:00:00
abstract::A fifty-year-old woman with abdominal pain, diarrhea, and weight loss ultimately required exploratory laparotomy. The entire small intestine was extensively infiltrated by poorly differentiated adenocarcinoma; mesenteric lymph nodes and surrounding omentum were involved, but no extragastrointestinal tumor was found. A...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198804000-00023
更新日期:1988-04-01 00:00:00
abstract::An unusual case of malignant pancreatic composite tumor with both components of acinar cell tumor (ACT) and islet cell tumor (ICT) was investigated histologically, immunohistochemically, and ultrastructurally. The pancreatic tumor with central cyst formation was found on computerized tomographic examination of a 72-ye...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200009000-00020
更新日期:2000-09-01 00:00:00
abstract::Etiology of inflammatory bowel disease (IBD) is not yet completely understood, but it is hypothesized that a disruption of the immune tolerance to gut microbiota, due to several potential factors like an abnormal gut microbiota composition and activity, may lead to IBD occurrence. Manipulation of the intestinal microb...
journal_title:Journal of clinical gastroenterology
pub_type:
doi:10.1097/MCG.0000000000001095
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND/AIMS:The aim of this exploratory trial was to establish if the probiotic Bifidobacterium natren life start (NLS) strain strain may affect the clinical course and pathophysiological features of patients with untreated celiac disease (CD). Positive findings would be helpful in directing future studies. METHOD...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,随机对照试验
doi:10.1097/MCG.0b013e31827759ac
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Hypertriglyceridemia has been positively associated with the risk of acute pancreatitis (AP), but whether increased triglyceride (TG) levels are associated with the severity of AP remains unknown. To this, a meta-analysis was conducted to assess the effect of elevated serum TG on the prognosis of AP. METHOD...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/MCG.0000000000000846
更新日期:2017-08-01 00:00:00
abstract::A 41-year-old white man with a 2-year history of irritable bowel syndrome (IBS) was referred for psychological treatment. At the time of assessment he was being treated with Metamucil and Darvocet N-100s with little success. A detailed psychosocial assessment indicated several areas for cognitive-behavioral interventi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198704000-00020
更新日期:1987-04-01 00:00:00
abstract::The human large intestine harbors a complex microbiota containing many hundreds of different bacterial species. Although structure/function relationships between different components of the microbiota are unclear, this complex multicellular entity plays an important role in maintaining homeostasis in the body. Many of...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e31822fecfe
更新日期:2011-11-01 00:00:00
abstract::Helicobacter pylori antibody testing is accurate for diagnosing untreated patients. Rapid serum testing is as accurate as formal enzyme-linked immunosorbent assay (ELISA) testing. As whole blood fingerstick tests may become the diagnostic method of choice if they are of similar accuracy, 51 patients were studied who h...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199807000-00010
更新日期:1998-07-01 00:00:00
abstract::This review discusses gastrointestinal manifestations of parathyroid diseases. Parathyroid hormone is the primary regulator of calcium physiology. Hypoparathyroidism can be idiopathic, hereditary, or secondary to surgery in the neck. Hyperparathyroidism is usually from adenomas or hyperplasia. Hypoparathyroidism is as...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MCG.0b013e3181cd9d4c
更新日期:2010-08-01 00:00:00
abstract::Acid-reducing drugs can cause increased growth of microbes, including fungus, because of high gastric pH. Our purpose was to evaluate the occurrence of mycotic infection in patients with duodenal ulcer on anti-ulcer therapy and to compare the effects of cimetidine, famotidine, and omeprazole. Eighty patients with duod...
journal_title:Journal of clinical gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004836-199607000-00003
更新日期:1996-07-01 00:00:00
abstract:GOALS:To determine postpartum hepatitis B virus (HBV) laboratory testing rates and identify factors associated with a lack of follow-up testing in Massachusetts. BACKGROUND:Screening for HBV infection in pregnant women is standard of care. Guidelines recommend that patients with chronic HBV have ongoing care and labor...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000530
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Although sessile serrated adenomas (SSAs) may represent a separate and important pathway for colorectal cancer (CRC), little is known about the risk factors for these lesions. Molecular abnormalities such as BRAF have been observed in SSA and smokers. Our hypothesis is that smoking may be associated with the...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e318207f3cf
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Management of diverticular disease (DD) remains a point of debate. GOALS:To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. STUDY:Twelve questions were aimed at the diagnosis, treatment, an...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000645
更新日期:2016-10-01 00:00:00
abstract::Two cases of Cruveilhier-Baumgarten syndrome not clinically evident and without esophageal varices in patients with liver cirrhosis and portal hypertension are presented. The diagnosis was made by real-time ultrasonography, which showed echographic caput medusae with large afferent umbilical veins and efferent inferio...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1989-06-01 00:00:00
abstract::Physicians sometimes forget nongastrointestinal causes of abdominal pain. Yet, abdominal pain was the major complaint of three patients with ureteropelvic junction obstruction (UPJ). Definitive diagnosis can be made either by a "hydration" intravenous pyelogram or by an intravenous pyelogram during an attack. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-197912000-00011
更新日期:1979-12-01 00:00:00
abstract::Hepatic iron deposition is common in patients with chronic hepatitis C (HCV) and may play a role in progression of liver disease. This pilot study examines the relationship between hepatic iron concentration (HIC) and histologic progression over time in patients with HCV. HIC was retrospectively measured in 14 patient...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200311000-00012
更新日期:2003-11-01 00:00:00
abstract::Lower gastrointestinal bleeding colonic varices is infrequent. We report a patient in whom the diagnosis was made by angiography and in whom portosystemic shunt has been helpful. We believe that the treatment of choice for colonic varices is portosystemic shunt, as attempts at resection, judged by the reports in the l...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198502000-00011
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:The implications of the Rome III recommendations to change the irritable bowel syndrome (IBS) subtype criteria for stool pattern are unknown. AIM:(1) Determine the level of agreement between Rome II and Rome III subtypes and (2) compare the behaviors of Rome II and Rome III subtypes over time. METHODS:Fema...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31815bd749
更新日期:2009-03-01 00:00:00