Abstract:
:Increasing numbers of active tuberculosis in Germany were recorded in the last years. Thus, also extrapulmonary manifestations of tuberculosis gain clinical significance as differential diagnoses, especially when a metastatic tumor disease is suspected. We report the case of a 77-year-old male patient who presented with unilateral leg pain and B symptoms. Further investigations revealed an osteolytic mass in the sacrum as well as CT-morphological findings consistent with metastatic gastric cancer. However, transgastric biopsies showed necrotising granuloma with giant cells leading to molecular and cultural detection of Mycobacterium tuberculosis instead of suspected neoplastic tissue. A nine-month treatment regimen for suspected disseminated tuberculosis with bone involvement was initiated according to national guidelines. Clinical and radiological follow up examinations after treatment completion showed complete remission. :Bei zuletzt stabiler nach in den Jahren davor steigender Inzidenz der aktiven Tuberkuloseerkrankung in Deutschland sind zunehmend auch extrapulmonale Manifestationen von differenzialdiagnostischer Bedeutung. Insbesondere bei Verdacht auf eine metastasierte Tumorerkrankung kommt die Tuberkulose differenzialdiagnostisch in Betracht. Wir berichten über einen 77-jährigen Patienten, der sich mit einseitigen Beinschmerzen und B-Symptomatik vorstellte. Neben einer osteolytischen Sakralwirbelkörper(SWK)-1-Läsion ergab sich bildgebend der Verdacht auf ein metastasiertes Magenkarzinom. In den gewonnenen Biopsien zeigten sich nekrotisierende Granulome mit Riesenzellen, im Verlauf gelang der kulturelle und molekularbiologische Nachweis von Mycobacterium tuberculosis anstelle neoplastischen Gewebes. Nach Sicherung einer disseminierten Tuberkulose mit ossärer Beteiligung erfolgte eine antibiotische Therapie nach nationalen Leitlinien über insgesamt neun Monate. Klinisch und radiologisch zeigte sich in der Abschlussuntersuchung nach Therapieende eine Regredienz der Befunde im Sinne einer definitiven Heilung.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Voit FM,Abdelhafez M,Rothe K,Slotta-Huspenina J,Gaa J,Schmid RM,Spinner CDdoi
10.1055/a-1030-4781subject
Has Abstractpub_date
2019-12-01 00:00:00pages
1487-1492issue
12eissn
0044-2771issn
1439-7803journal_volume
57pub_type
杂志文章abstract::Cholestasis is a combination of defined clinical, paraclinical and morphological findings of which icterus is the direct symptom. It is the consequence of the delay or detention of the bile flow. By means of light microscopy different changes can be observed in hepatic tissue: formation of biliary thrombi, intracellul...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::A patient with multiple hamartoma syndrome or Cowden's disease with multiple gastrointestinal polyps and malignant melanoma is presented. The syndrome is characterized by hamartomatous tumors of the skin, fibrocystic disease of the breasts, gastrointestinal polyps and disease of the thyroid gland such as goiter and ad...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::Since 1977, 15 patients have undergone surgery for Zenker's diverticula at the University of Würzburg Department of Surgery. We were able to follow up 6 of them after an average of 4 years (5 months to 10.5 years). Preoperative manometric findings available on one patient revealed markedly impaired coordination betwee...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::The phenomenon of the spontaneous parietal cell sensitivity not induced by drugs is described in a number of gastric diseases. Different parietal cell sensitivity can be assumed. 1. when there is a shift in the dose response curve between the aid output and continuous intravenous application of a stimulant, 2. when th...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1981-07-01 00:00:00
abstract::The existence of tight junctions between epithelial cells has been known for over 100 years, but their exact functions remained elusive until recently. The present paper summarizes the newest knowledge about morphology, molecular components and regulation of tight junctions. In the chapter about morphology the criteri...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1997-03-01 00:00:00
abstract::There are three major goals in the prophylaxis and treatment of upper gastrointestinal bleeding in portal hypertensive patients: prophylaxis of the first bleeding episode, therapy of active bleeding and prophylaxis of recurrent bleeding. Several therapeutic options are available: non-selective beta-blockers are the tr...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2004-813909
更新日期:2005-01-01 00:00:00
abstract::Gastrointestinal stromal tumours (GIST) occur mostly as sporadic solitary lesions involving the tubular GI tract and are only rarely associated with other benign or malignant neoplasms or occur as part of a multi-neoplastic disease as in the setting of Carney's triad and von Recklinghausen's disease. We analysed a tot...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2005-858378
更新日期:2005-09-01 00:00:00
abstract::In a randomized, endoscopically controlled double-blind trial the effectiveness of a twice daily dose of the prostaglandin E2-analogue enprostil was compared with pirenzepine given to 97 ambulatory patients with duodenal ulcers. Under 35 micrograms b.i.d. enprostil the ulcer healing rates after 2, 4 and 6 weeks averag...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-05-01 00:00:00
abstract::In Western societies roughly 50% of all cases of liver cirrhosis are related to alcohol abuse. The oxidative metabolite of ethanol, acetaldehyde, often in conjunction with viral or metabolic liver disease, is implicated as the major cause for liver fibrogenesis. Acetaldehyde damages cell membranes, initiates lipid per...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::Currently, evidence-based medicine is subject of a controversial discussion. This review is focused on the different types of evidence in clinical medicine and elaborates the history and context of evidence-based medicine. Evidence-based medicine insists that the theoretical plausibility of a therapeutical concept alo...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 历史文章,杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::In 20 patients suffering from advanced chronic active hepatitis, type B or NANB, the therapeutic effect of cyclosporin A was studied. 15 of these patients already showed cirrhotic transformations and partial liver dysfunctions. In 15 cases an unsuccessful pretreatment with glucocorticoids and/or azathioprine had been ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract:AIM:The objective of this study was to assess the efficacy and safety of the phytopharmacon STW 5 versus metoclopramide in functional dyspepsia. METHODS:A retrolective, epidemiological cohort study with parallel groups in 23 randomised centres where both drugs were used routinely was performed. The main outcome variab...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-2007-963357
更新日期:2007-10-01 00:00:00
abstract::To localize transcriptional active cis elements and to study the effect of a single base transition at -86 derived from a patient (PS) with an inherited severe form of hypertriglyceridemia a reporter gene transfection assay with apo C-II promoter fragments was performed. Sequences from -170 to -140, -140 to -59 and -5...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::Diabetes and pancreatic cancer are known to be associated. The relative risk for pancreatic carcinoma is dependent on the time after onset of diabetes. Diabetes in patients with pancreatic carcinoma is frequently of recent onset and partially caused by the tumor. Diabetes in a patient without obesity, no family histor...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Contrast harmonic imaging significantly increases the detectability of liver lesions which are invisible on conventional B-mode sonography. With the introduction of contrast agents, which can be visualized at low mechanical index (low-MI), continuous real time observation of liver lesions under cont...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2004-812712
更新日期:2004-04-01 00:00:00
abstract::Patients with hepatocellular carcinoma (HCC) in cirrhosis have an increased risk for postoperative complications including liver failure. However, there is some evidence that the use of laparoscopy markedly decreases this risk. Patients Between 2010 - 2015, a total of 21 laparoscopic liver resections were performed fo...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0043-100021
更新日期:2017-05-01 00:00:00
abstract:AIM: To investigate feasibility and outcome the novel and favorable option of an endoscopic ultrasonography(EUS)-guided antegrade or even retrograde gall stone extraction via a transhepatic route in patients (pats.) with no option for the usual gold standard, ERCP. MATERIAL/METHODS: All consecutive pats. with cholangi...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/a-1250-8834
更新日期:2020-11-01 00:00:00
abstract::Over the last years several case reports and articles have been published suggesting that a new form of chronic pancreatitis has been diagnosed and named autoimmune pancreatitis. The present overview scrutinizes the proposed evidence in the light of the current literature and aims to prove whether autoimmune pancreati...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-19642
更新日期:2002-01-01 00:00:00
abstract::In the last decade, innovative ultrasound technology has become the primary imaging method in Gastroenterology. Compared to other imaging techniques (e. g., computed tomography and magnetic resonance imaging), conventional ultrasound images have the disadvantage of a restricted field-of-view (width), thus producing im...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-36153
更新日期:2002-12-01 00:00:00
abstract::We describe a 52-year-old woman who presented with severe diarrhea, nausea, intermittent abdominal pain and weight loss of 18 kg within ten months. Jejunal and duodenal ulcers were detected by endoscopy and multiple biopsies revealed villous atrophy of the jejunum. However, neither gliadin nor endomysium antibodies we...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract::The spontaneous course of the galactosamine-hepatitis in the guinea-pig (750 and 1000 mg/kg GalN iv respectively) is characterized by a terminal hypoglycemia together with hypothermia and arterial hypotension fifty-nine hours on average after GalN-application. Preventing hypoglycemia and hypothermia by continuous intr...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract::The CCK- and secretin stimulated pancreatic volume, bicarbonate and enzyme secretion was investigated before and during fasting for 20 days in 12 obese subjects. Pancreatic function tests were performed at the start of the fasting period and on the 10th and 20th day. In an additional and comparable group of 8 obese pa...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::The term oral tolerance (OT) describes the antigen-specific suppression of immune responses following the feeding of the antigen. While some common features with other forms of induction of systemic tolerance have been disclosed, OT can be distinguished by certain immunologic characteristics. Thus, work in experimenta...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1999-02-01 00:00:00
abstract::Diagnosis of oesophageal motility disorders has been well established for many years now, although circadian gastrointestinal motility is still purely understood. So far, high-resolution manometry (HRM) is only available for short-term measurement in clinical practice to evaluate simultaneous pressure conditions throu...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0042-105653
更新日期:2016-09-01 00:00:00
abstract::Probiotics are defined as living micro-organisms which, when administered in large amounts, confer a health benefit on the host. The use of probiotics in the therapy of infectious bowel diseases as well as maintaining remission of ulcerative colitis and in pouchitis is evidence-based. Also, in several studies proof co...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,meta分析
doi:10.1055/s-2004-813934
更新日期:2005-05-01 00:00:00
abstract::This report presents a female patient suffering from chronic diarrhea, who developed palpable purpura on the lower extremities 8 weeks after onset of the gastrointestinal symptoms. Biopsies obtained from the colon and skin showed leukocytoclastic vasculitis. Possible triggers or underlying diseases could not be found,...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0032-1325470
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Radiation enteritis is a severe problem in patients receiving irradiation of the abdomen or pelvis in the course of cancer treatment. Nevertheless, there is a lack of standardised strategies for medical prevention and therapy. MATERIALS AND METHODS:A PubMed based literature search was performed to address t...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1027150
更新日期:2008-05-01 00:00:00
abstract::To assess the opinions of referring physicians on the contents of endoscopy reports, 150 consecutive endoscopy reports were accompanied by a questionnaire. Of these, 102 reports were returned: response was 68%. Almost half of the reports were considered not fully satisfactory. However, endoscopy reports may be improve...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract::We report on a 56-year-old caucasian female, 154 cm, 38 kg, who was admitted to the hospital in extremely poor, cachectic condition with pretibial edemas, ascites and pleural effusion with a history of severe watery diarrhea up to 15 times daily. The patient's history with permanent meteorism, recurrent episodes of wa...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1999-12-01 00:00:00
abstract::We conducted a retrospective study in 112 chronic alcoholics in order to evaluate the incidence of simultaneous damage of both pancreas and liver. In all patients, an endoscopic retrograde pancreaticography (ERP) and a liver biopsy were performed. 65 patients had alterations of the pancreatic ducts compatible with the...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00