SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.

KASID Guidance for Clinical Practice Management of Adult Inflammatory Bowel Disease during the COVID-19 Pandemic: Expert Consensus Statement / 대한소화기학회지

The coronavirus disease 2019 (COVID-19) pandemic has reduced the ability to prevent or control chronic disease due to the concerns about safety in accessing health care. Inflammatory bowel disease (IBD) is a chronic condition requiring long- term sustained treatment, which is difficult in the current panedemic situation. The Korean Association for the Study of Intestinal Diseases (KASID) has developed an expert consensus statement on the clinical practice management of adult inflammatory bowel disease during the COVID-19 pandemic. This expert consensus statement is based on guidelines and clinical reports from several countries around the world. It provides recommendations to deal with the risk of COVID-19 and medication use in IBD patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and emphasizes the importance of right treatment approach to avoid worsening of the disease condition in IBD patients.

SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID / 대한소화기학회지

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases (KASID) developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.

Cytomegalovirus Infection Associated with Simultaneous Gastric and Colonic Ulcers / 대한소화기학회지

no abstract available

KASID Guidance for Clinical Practice Management of Adult Inflammatory Bowel Disease during the COVID-19 Pandemic: Expert Consensus Statement / 대한소화기학회지

The coronavirus disease 2019 (COVID-19) pandemic has reduced the ability to prevent or control chronic disease due to the concerns about safety in accessing health care. Inflammatory bowel disease (IBD) is a chronic condition requiring long- term sustained treatment, which is difficult in the current panedemic situation. The Korean Association for the Study of Intestinal Diseases (KASID) has developed an expert consensus statement on the clinical practice management of adult inflammatory bowel disease during the COVID-19 pandemic. This expert consensus statement is based on guidelines and clinical reports from several countries around the world. It provides recommendations to deal with the risk of COVID-19 and medication use in IBD patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and emphasizes the importance of right treatment approach to avoid worsening of the disease condition in IBD patients.

SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID / 대한소화기학회지

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases (KASID) developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.

Multidisciplinary and Multisociety Practice Guideline on Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories

The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly.

Is Early Colonoscopy Required in Acute Lower Gastrointestinal Bleeding? / 대한소화기학회지

No abstract available.

Feasibility of Adopting the “Step-up Approach” in Managing Necrotizing Pancreatitis-induced Pancreatic-colonic Fistula / 대한소화기병학회잡지

Managing acute pancreatitis is clinically challenging because of the generally poor patient condition, the variety of treatment options depending on the severity and complications, and the uncertainty of outcomes. Recently, the step-up approach, which involves less invasive initial treatment and more invasive subsequent treatment, where necessary, has been proposed as the mainstay of managing pancreatitis. This paper presents a case of a 57-year-old man with severe acute pancreatitis, who developed an unexpected fistula in the rectum, which was treated successfully using the step-up approach. In managing this case, the authors faced clinical challenges in determining the infection of necrotic tissue in the early phase of the disease, the optimal timing and method of drainage, and the fistula closure or repair technique. Successful management of this case using the step-up approach validated current recommendations and suggests that it is a reasonable treatment strategy for pancreatic-colonic fistulas. This case also highlights the importance of an awareness that pancreatitis-associated complications can develop in an unexpected manner.

Feasibility of Adopting the “Step-up Approach” in Managing Necrotizing Pancreatitis-induced Pancreatic-colonic Fistula / 대한소화기학회지

Managing acute pancreatitis is clinically challenging because of the generally poor patient condition, the variety of treatment options depending on the severity and complications, and the uncertainty of outcomes. Recently, the step-up approach, which involves less invasive initial treatment and more invasive subsequent treatment, where necessary, has been proposed as the mainstay of managing pancreatitis. This paper presents a case of a 57-year-old man with severe acute pancreatitis, who developed an unexpected fistula in the rectum, which was treated successfully using the step-up approach. In managing this case, the authors faced clinical challenges in determining the infection of necrotic tissue in the early phase of the disease, the optimal timing and method of drainage, and the fistula closure or repair technique. Successful management of this case using the step-up approach validated current recommendations and suggests that it is a reasonable treatment strategy for pancreatic-colonic fistulas. This case also highlights the importance of an awareness that pancreatitis-associated complications can develop in an unexpected manner.

Endoscopic Ultrasound-Guided Liver Biopsy Using a Core Needle for Hepatic Solid Mass

BACKGROUND/AIMS: This study aimed to evaluate the feasibility and efficacy of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a core needle for hepatic solid masses (HSMs). Additionally, the study aimed to assess factors that influence the diagnostic accuracy of EUS-FNB for HSMs. METHODS: A retrospective analysis of patients who underwent EUS-FNB for the pathological diagnosis of HSMs was conducted between January 2013 and July 2017. The procedure had been performed using core needles of different calibers. The assessed variables were mass size, puncture route, needle type, and the number of needle passes. RESULTS: Fifty-eight patients underwent EUS-FNB for the pathologic evaluation of HSMs with a mean mass size of 21.4±9.2 mm. EUS-FNB was performed with either a 20-G (n=14), 22-G (n=29) or a 25-G core needle (n=15). The diagnostic accuracy for this procedure was 89.7%, but both specimen adequacy for histology and available immunohistochemistry stain were 91.4%. The sensitivity and specificity of EUS-FNB were 89.7% and 100%, respectively. There was one case involving bleeding as a complication, which was controlled with endoscopic hemostasis. According to the multivariate analysis, no variable was independently associated with a correct final diagnosis. CONCLUSIONS: EUS-FNB with core biopsy needle is a safe and highly accurate diagnostic option for assessing HSMs. There were no variable factors associated with diagnostic accuracy.

Is Preoperative Work-Up Colonoscopy Necessary for Patient with Gastric Cancer?

BACKGROUND/AIMS: Recently, many studies have reported the incidence of colorectal neoplasm (CRN) to be increased in patients with gastric cancer. Thus preoperative colonoscopy is recommended for the screening of CRN. The purpose of this study is to investigate the prevalence of colorectal adenoma and cancer in patients with gastric cancer and evaluate the necessity of preoperative colonoscopy in patients with gastric cancer. MATERIALS AND METHODS: We collected data from 293 patients who underwent gastrectomy due to gastric cancer at one tertiary institution between January to December 2015. Preoperative colonoscopy was performed in 127 patients of 293 patients. To compare the prevalence of colorectal neoplasm, we selected 900 persons who underwent upper esophagogastroduodenoscopy and colonoscopy for health screening during 2015. RESULTS: The prevalence of overall CRN was similar in the gastric cancer group and the control group. The prevalence of colorectal advanced adenoma and cancer was higher in the gastric cancer group compared with control group, but it did not show statistical significance. The prevalence of colorectal advanced adenoma was significantly higher in the group of age ≥ years and smoking. CONCLUSIONS: The risk of advanced colorectal adenoma increases significantly in patients with old age but not in patients with gastric cancer. We suggest that all patients with gastric cancer might not carry a high risk for advanced colorectal adenoma compared with the normal population. Patients with old age might require surveillance colonoscopy.

A Case of ANA-negative, Anti-dsDNA Negative, and Anti-Ro/SSA Positive Membranous Lupus Nephropathy

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of diverse autoantibodies with various systemic organ involvements. In patients with SLE, autoantibodies, such as antinuclear antibody (ANA) and anti-dsDNA antibody, play an important role not only in diagnosing the disease, but also representing the pathogenesis of the disease. ANA is the main screening tool in diagnosis and serum complement levels and anti-dsDNA antibody level are closely related to the disease activities. Nevertheless, exceptionally, some patients represent with negative ANA and/or anti-dsDNA antibody leading to difficulties in diagnosing the disease. Here, we report a case of 37-year old female SLE patient with negative ANA, negative anti-dsDNA antibody, and positive anti-Ro/SSA antibody, which manifested with nephrotic syndrome.

Hemorrhagic fever with renal syndrome and coexisting hantavirus pulmonary syndrome

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease with fever, hemorrhage and renal failure caused by hantavirus infection. Hantavirus induces HFRS or hantavirus pulmonary syndrome (HPS). HPS progression to a life-threatening pulmonary disease is found primarily in the USA and very rarely in South Korea. Here, we report a case of HFRS and coexisting HPS.

The Prevalence and Associated Factors of Kidney Disease in Korean Rheumatoid Arthritis Patients

OBJECTIVE: To determine the prevalence and associated factors of kidney disease in Korean rheumatoid arthritis (RA) patient, and describe the profile of RA drugs prescribed in RA patients. METHODS: A total of 284 patients at the division of rheumatology with confirmed RA were prospectively included in this study from May 1 to August 31, 2008. Renal function was assessed using Cockcroft-Gault (CG) and abbreviated Modification of Diet in Renal Disease (aMDRD) study formulae, and classified by the National Kidney Foundation (NKF) classification. Comparisons was were performed by the two sample t-test, chi-square-test and binary logistic regression analysis. RESULTS: Of 281 patients with RA, only 7 (2.5%) patients had abnormal serum creatinine (sCr) levels. According to the NFK classification, the prevalence of kidney disease using aMDRD and CG formula was 23.8% and 31.7%, respectively. Among the patients with eGRF <60 mL/min/m2 according to aMDRD or CG formulae, 91.8~100% received at least one drug that was potentially nephrotoxic. RA patients with renal dysfunction was associated with advanced age, body mass index (BMI), antinuclear antibody (ANA). CONCLUSION: Estimation of renal function with CG or aMDRD formulae is important in RA patients, particularly in those with low BMI or old age. Also, appropriate dosage adjustment is needed in patients with renal dysfunction.