[Wegner's granulomatosis with gastrointestinal manifestation: a case report]

A 55 year-old man was referred with periumbilical and colicky abdominal pain cutaneous lesions' palpable purpura in extremities and 10 kg weight loss. A 55 cm cavitary mass lesion was seen in the lower lobe of right lung in CXR. Pansinusitis in paranasal CT scan was reported. Intramural hemorrhage in ileum and jejunum in abdominal CT scan was noted. ESR was >100 and C-ANCA was positive. Microscopic hematuria was reported in lab studies.Wegner's granulomatosis was diagnosed and prednisolone plus cyclophosphamide was administered. He was improved dramatically in a few days. After 3 months' he had no symptoms or signs' lab data were normal and lung mass lesion became smaller. After six months' he had deep vein thrombosis in left lower extremity

[Celiac disease in Gonbad-Kavoos]

Northeast Iran has one of the highest rates of esophageal cancer in the world which is mainly squamous cell carcinoma [E SCC]. Celiac disease [CD] has been identified as a risk factor for ESCC. The aim of this study is to determine the prevalence of CD in Gonbad at northeast Iran and probable relation between celiac and ESCC. fourteen hundred inhabitants of north eastern Iran were randomly selected. The subjects underwent blood sampling for determination of IgA antibodies against tissue transglutaminase [anti- TTG]. Subjects with positive anti-TTG underwent an interview, upper endoscopy and duodenal biopsy. The duodenal biopsies were classified according to Marsh criteria. A total of 1209 subjects [female: 699] with mean age of 50 +/- 11.7 years were studied. Twelve subjects [female: 9] had a positive anti-TTG [1%]. Four patients did not accept endoscopy. Eight cases underwent endoscopy and duodenal biopsy. Four, two and two subjects had Marsh III, II and I respectively. Flatulence and diarrhea [the most symptoms] were in five and four subjects and characteristic skin manifestation was reported in three subjects. One subject was already diagnosed as CD. although prevalence of ESCC in northeast Iran is significantly higher than central Iran, the prevalence of gluten sensitive enteropathy is the same [1%]. It dose not appear that CD has any impact on the prevalence of ESCC in Iran