Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

Metabolic bone disease is common in patients with inflammatory bowel disease [IBD]. Our aim was to determine the frequency of bone loss among Saudi patients with IBD and possible contributing risk factors. We retrospectively reviewed Saudi patients with IBD, between 18 and 70 years of age, who had bone mass density [BMD] determined by dual-energy X-ray absorptiometry scanning at one of three hospitals in the Kingdom of Saudi Arabia from 2001 to 2008. Case notes and BMDs results were carefully reviewed for demographic and clinical data. Low bone mass, osteopenia, and osteoporosis were defined according to the WHO guidelines. Predictive factors for BMD were analyzed using group comparisons and stepwise regression analyses. Ninety-five patients were included; 46% had Crohn's disease [CD] and 54% had ulcerative colitis [UC]. The average age was 30.9 +/- 11.6 years. Using T-scores, the frequency of osteopenia was 44.2, and the frequency of osteoporosis was 30.5% at both lumbar spine and proximal femur. Only 25.3% of patients exhibited a BMD within the normal range. Our both lumbar spine and proximal femur. Only 25.3% of patients exhibited a BMD within the normal range. Our results revealed a positive correlation between the Z-score in both the lumbar spine and the proximal femur and body mass index [BMI] [P=0.042 and P=0.018, respectively]. On regression analysis BMI, age, and calcium supplementation were found to be the most important dependent predictors of BMD. Saudi patients with IBD are at an increased risk of low BMD and the frequency of decreased BMD in Saudi patients with CD and UC were similar. BMI and age were the most important independent predictors of low BMD

Pseudomyxoma peritonei

Pseudomyxoma peritonei is very rare, and its exact pathogenesis is unknown. It is characterized by intra-abdominal extracellular gelatinous fluid collections. We report a case of pseudomyxoma peritonei in a 38-year-old Saudi male who presented with right iliac fossa mass and weight loss. He was treated initially as an appendicular mass and computed tomography was helpful in making the diagnosis. He was treated by laparotomy, right hemicolectomy and omentectomy but no perioperative intraperitoneal chemotherapy was instilled. He received postoperative chemotherapy and remained alive with no recurrence at 18-month follow-up

Idiopathic pulmonary alveolar microlithiasis in a child

Although pulmonary alveolar microlithiasis is seen mostly in adults, it commonly starts in childhood, but is usually asymptomatic and so not diagnosed. It is of unknown etiology, and it simulates a variety of clinical conditions with almost the same radiologic appearance. The diagnosis rests on the X-ray findings with paucity of clinical signs. There is no known treatment. This is a report of a Kuwaiti child with this condition

Huge pre-sacral teratoma

A huge pre-sacral teratoma in an eight year old Saudi boy is described. The presentation and management are briefly discussed