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ABSTRACT 3 Whipple's disease in a man of North African descent : case report and brief review of the literature.
ABSTRACT 1 Adverse effects of bevacizumab in metastatic colorectal cancer: a case report and literature review. Willems E, George C, D'Hondt M, et al. Acta Gastro-enterologica Belgica, 2019, 82(2), 322-325 Het abstract is terug te vinden op pagina 4.
ABSTRACT 2 How dyspepsia led to the diagnosis of Morbus Crohn. Maertens A, Persyn D, Van Moerkercke W, et al. Acta Clinica Belgica, 2019, Online ahead of print, 1-3
OBJECTIVE It is well known that Crohn's disease can involve the stomach. However, most often this upper gastrointestinal tract involvement is asymptomatic. Typically, there is involvement of the small intestine with the typical associated symptoms of Crohn's disease: abdominal cramps, diarrhoea and weight loss.
Lenfant M, Alaerts H, Van Moerkercke W, et al. Acta Gastro-enterologica Belgica, 2019, 82(1), 83-86
OBJECTIVE A 62-year-old man of North African descent presented with weight loss in the past year and diarrhea for three weeks. His medical history included erosive rheumatoid arthritis, treated with methotrexate and adalimumab. Histological examination of a duodenal biopsy showed foamy macrophages in the lamina propria, with PAS-positive cytoplasmatic inclusions. These findings are compatible with Whipple's disease, a rare chronic infectious disease caused by Tropheryma whipplei, an opportunistic bacterium. It is typically seen in middle-aged Caucasian men and the immunocompromised host. The classical presentation of Whipple's disease consists of intermittent migratory arthralgia, followed by intestinal symptoms which typically occur six to seven years later.
MATERIALS/METHODS The clinical image can be very variable, and this complicates the diagnostic process. PAS-staining and PCR are the diagnostic cornerstones.
MATERIALS/METHODS We report a case of a young woman with complaints of dyspepsia since 2 months.
RESULTS Gastroscopy revealed severe aphthous pangastritis with biopsies showing a focal active and chronic gastritis with presence of granulomas. We therefore performed a coloscopy showing an aphthous terminal ileum. The pathologic report indicated granulomatous reaction concordant with a slightly active, mildly chronic terminal ileitis typical for Crohn's disease.
RESULTS In our case, treatment consisted of a prolonged cure of antibiotics: intravenous ceftriaxone for two weeks, followed by an oral maintenance therapy of doxycycline and hydroxychloroquine for at least one year.
CONCLUSION A therapeutic dilemma arose as continued anti-TNF blockade was necessary to maintain remission of the rheumatoid arthritis. Lifelong follow-up is necessary because relapse is possible.
CONCLUSION The incidence of upper gastrointestinal tract involvement of Crohn's disease is still underestimated, partially due to the asymptomatic nature in two thirds of patients. IBD gastritis should always be included in the differential diagnosis of gastritis, considering the increased risk of a more severe disease course and complications.
ABSTRACT 4 A toothpick a day, keeps the doctor away? Depoorter L, Billiet T, Van Moerkercke W, et al. Acta Gastro-enterologica Belgica, 2019, 82(1), 97-98
OBJECTIVE A toothpick is a dreaded offender when ingested, as it is risky to cause impaction, obstruction or perforation of the
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