ABSTRACT
Peritonsillar abscess is a common deep throat infection. Early diagnosis and prompt, appropriate management of a peritonsillar abscess prevents mortality. A 45-year-old woman on steroids for an ulcerative colitis (UC) exacerbation presented with sore throat and multiple skin ulcers on her left forearm and right foot. Computed tomography of the neck revealed a peritonsillar abscess. Gram staining and culture of the abscess were negative, and a skin biopsy suggested pyoderma gangrenosum (PG). The final diagnosis was peritonsillar involvement of steroid-refractory PG-associated UC. The patient showed a complete response to infliximab. Here, we report a case of successful infliximab treatment for peritonsillar involvement of steroid-refractory PG-associated UC.
Subject(s)
Female , Humans , Middle Aged , Abscess , Biopsy , Colitis, Ulcerative , Diagnosis , Early Diagnosis , Foot , Forearm , Infliximab , Mortality , Neck , Peritonsillar Abscess , Pharyngitis , Pharynx , Pyoderma Gangrenosum , Skin , Skin Ulcer , SteroidsABSTRACT
Bezoars are collection of indigestible materials in the gastrointestinal tract. Many endoscopic techniques for removal of bezoars have been reported recently, but these methods need much equipment. We treated a gastric bezoar with a distal attachment device easily available for an endoscope. A 74-year-old man with a history of diabetes mellitus was admitted to hospital with hematemesis. On the second endoscopic examination, a gastric bezoar (6x4x4 cm) was detected in the stomach. Then, using a distal attachment device, we injected Coca-Cola directly into the bezoar by an injector. With tension force, the bezoar was easily broken due to the impulse of the distal attachment device. The endoscopic technique used in our case can be easily performed and has fewer complications compared to those of other techniques. Therefore, we report here on this new treatment modality that uses a distal attachment device.
Subject(s)
Aged , Humans , Bezoars , Diabetes Mellitus , Endoscopes , Gastrointestinal Tract , Hematemesis , StomachABSTRACT
OBJECTIVE: Anti-glucose-6-phosphate isomerase (GPI) antibody (Ab) is known to be arthritogenic in K/BxN mice. Anti-GPI Ab is present in some patients with rheumatoid arthritis (RA), but their clinical manifestations are not clearly elucidated. The purpose of this study was to evaluate whether GPI serves as a specific autoantigen in patients with RA and to investigate the relationship of anti-GPI Ab with clinical parameters of RA. METHODS: Sera were collected from 54 patients with RA, 15 patients with osteoarthritis (OA) and 28 healthy controls. The samples were tested by enzyme-linked immunosorbent assay (ELISA) using human recombinant GPI as antigen. Patients with RA were classified according to rheumatoid factor (RF) positivity, the presence of RA shared epitope (SE), the presence of extraarticular manifestations, and evidence of bony erosive changes. RESULTS: Serum levels of anti-GPI Ab were higher in patients with RA than controls (1599.46+/-1022.48 versus 344.82+/-223.16 AU, p<0.001), and the levels of patients with OA were also higher than controls (1161.47+/-917.44 versus 344.82+/-223.16 AU, p<0.01). In RA, there were no significant difference in anti-GPI Ab levels according to RF positivity, the presence of RA SE, the presence of extraarticular manifestations, and evidence of bony erosive changes. CONCLUSION: Our results suggest that anti-GPI Ab may not be RA specific Ab and not related to the severity of RA.