Dasatinib induces severe hemorrhagic colitis in a patient with accelerated phase of chronic myelogenous leukemia

No abstract available.

Acute Hemorrhagic Colitis Induced by Oral Administration of Oseltamivir / 이화의대지

Oseltamivir has been used as a worldwide preparation for treatment of influenza A and B including H1N1. Gastrointestinal discomforts as like nausea, vomiting are commonly reported but acute hemorrhagic colitis is a very rare adverse effect. We report a case of a 17-year-old male who showed abdominal pain, diarrhea and hematochezia after the second administration of oseltamivir. Computed tomography revealed continuous, circumferential and edematous wall thickening involving ascending to descending colon with pericolic infiltration. Colonoscopic examination revealed diffuse mucosal edema, congestion and friability, suggesting hemorrhagic colitis. Histopathological examination showed ischemia and focal loss of the crypts. It also showed hyalinization and minimal inflammatory cell infiltration in the lamina propria, consistent with acute to subacute ischemic colitis. This report is the first case of oseltamivir-related ischemic colitis proved by both endoscopic examination and pathologic findings in the patient who had no risk factor of ischemic colitis in Korea.

Escherichia coli enterohemorrágica O157: H7 em bovinos leiteiros saudáveis no Centro-Oeste do Brasil: ocorrência e caracterização molecular / Enterohemorrhagic Escherichia coli O157: H7 from healthy dairy cattle in Mid-West Brazil: occurrence and molecular characterization

Enterohemorrhagic Escherichia coli (EHEC) serotype O157:H7 represents the major Shiga toxin-producing E. coli (STEC) strain related to large outbreaks and severe diseases such as hemorrhagic colitis (HC) and the potentially lethal hemolytic uremic syndrome (HUS). The aim of this study was to report the occurrence and molecular characterization of O157:H7 isolates obtained by rectal swab from 52 healthy dairy cattle belonging to 21 farms in Mid-West of Brazil. Detection of 16SrRNA, stx1, stx2, rfbO157, fliCh7, eae, ehxA, saa, cnf1, chuA, yjaA and TSPE4.C2 genes was performed by PCR. The isolates were further characterized by serotyping. Two hundred and sixty E. coli isolates were obtained, of which 126 were characterized as STEC. Two isolates from the same cow were identified as serotype O157:H7. Both isolates presented the stx2, eae, ehxA, saa and cnf1 virulence factor genes and the chuA gene in the phylogenetic classification (virulent group D), suggesting that they were clones. The prevalence of O157:H7 was found to be 1.92% (1/52 animals), demonstrating that healthy dairy cattle from farms in the Mid-West of Brazil are an important reservoir for highly pathogenic E. coli O157:H7.

Escherichia coli enterohemorrágica (EHEC) sorotipo O157:H7 representa as principais cepas de E. coli produtoras de toxina Shiga (STEC) relatadas em grandes surtos e doenças graves, tais como colite hemorrágica (CH) e síndrome hemolítica urêmica (SHU), potencialmente letais. O objetivo deste estudo foi reportar a ocorrência e caracterização molecular de STEC 0157:H7 isoladas por swab retal de 52 bovinos saudáveis pertencentes a 21 rebanhos leiteiros do Centro-Oeste do Brasil. A detecção dos genes 16SrRNA, stx1, stx2, rfbO157, fliCh7, eae, ehxA, saa, cnf1, chuA, yjaA e TSPE4.C2 foi realizada por PCR. Os isolados foram ainda caracterizados por sorotipagem. Dos 260 isolados de E. coli obtidos, 126 foram caracterizados como STEC. Dois deles, oriundos do mesmo animal, foram caracterizados como pertencentes ao sorotipo O157:H7. Ambos apresentaram os genes de virulência stx2, eae, ehxA, saa e cnf1 e na caracterização filogenética, o gene chuA (grupo patogênico D), sugerindo que eles foram clones. A prevalência de O157:H7 foi de 1,92% (1/52 animais), demonstrando que os bovinos leiteiros saudáveis de fazendas do Centro-Oeste do Brasil são importantes reservatórios de E. coli O157:H7 altamente patogênicas.

Acute Hemorrhagic Colitis Associated with the Use of Oseltamivir / 대한내과학회지

Oseltamivir is a potent selective neuraminidase enzyme inhibitor and effective against nearly all strains of influenza A and B. The importance of treating influenza has been recognized, and oseltamivir has been prescribed frequently at the onset of the H1N1 influenza A pandemic this year. However, oseltamivir can cause hemorrhagic colitis as a rare adverse effect. Until now, only two cases of hemorrhagic colitis following the use of oseltamivir have been reported in Japan, and none have been reported in Korea. We report a case of acute hemorrhagic colitis in a 15-year-old boy after the oral administration of oseltamivir for swine originating influenza A.

Ulcerative Colitis Mimicking Acute Hemorrhagic Colitis / 영남의대학술지

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

A case of henoch-Sch?nlein purpura complicated by hemorrhagic gastroenteritis and IgA nephropathy in a patient suffering with juvenile rheumatoid arthritis / 대한내과학회지

Henoch-Sch?nlein purpura (HSP) is a systemic vasculitis with IgA dominant immune complex deposits that affect the small vessels in the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal symptoms are common and the manifestations include abdominal pain, bleeding, bowel infarction, intussusceptions or even perforation. Polyarticular onset juvenile rheumatoid arthritis (JRA) is a rare form of arthritis that affects children and young adults. The relationship between HSP and JRA is uncertain. We report on a 24-year-old man with a history of polyarticular onset JRA and HSP that was complicated by hemorrhagic gastroenteritis. The gastroscopy and colonoscopic findings showed extensive hemorrhagic inflammatory changes of the gastric and intestinal mucosa. The patient had severe bloody diarrheal symptoms, abdominal pain and gross hematuria. The 24 hours urine chemistry profile showed the proteinuria was greater than 4.5 g/day, and immunofluorescent staining of the renal biopsy specimen showed diffuse granular mesangial deposits of IgA and C3. The abdominal manifestations and proteinuria were improved after methylprednisolone therapy.

A Case of Hemorrhagic Colitis Complicated by Thrombotic Thrombocytopenic Purpura / 대한소화기내시경학회지

Hemorrhagic colitis may be seen as a complication of inflammatory bowel disease, as well as infectious colitis related to several pathogens, including enterohemorrhagic E. coli, Shigella, Yersinia and Campylobacter. Also, it is seen in the form of antibiotic-associated hemorrhagic colitis. However, Escherichia coli serotype O157:H7 is now recognized as an important identifiable cause of hemorrhagic colitis. Occasionally, patients with E. coli serotype O157:H7 infection are diagnosed as having thrombotic thrombocytopenic purpura (TTP), a condition similar to hemolytic uremic syndrome (HUS) but with more prominent neurological findings and less renal involvement. We report a case in a 47-year-old woman who developed hemorrhagic colitis complicated by TTP, responded to steroid and antibiotic treatment.

A Case of Amoxicillin-induced Segmental Hemorrhagic Colitis / 대한소화기내시경학회지

Clinically, we often encounter patients who have symptoms of loose stool or diarrhea due to the use of antibiotics. Psuedomembranous colitis is the most frequent, but hemorrhagic colitis is rare. Penicillin-like-antibiotics-induced hemorrhagic colitis was infrequently reported in abroad, but in Korea, quinolone-induced colitis was reported. We found a case that the patient had the hematochezia after use of amoxicillin for eradication of H. pylori. Colonoscopic abnormalities showed superficial ulceration and mucosal edematous change without pseudomembrane on the ascending and transverse colon. We diagnosed the amoxicillin-induced hemorrhagic colitis by clinical course, colonoscopic findings, histologic findings and other laboratory results for differential diagnosis. This disease is rare but rapidly recovered after the withdrawal of the antibiotics and has a good prognosis. Therefore, we should differentiate this disease from hemorrhagic colitis of other causes by history taking.

A Case of Amoxicillin-induced Segmental Hemorrhagic Colitis / 대한소화기내시경학회지

Clinically, we often encounter patients who have symptoms of loose stool or diarrhea due to the use of antibiotics. Psuedomembranous colitis is the most frequent, but hemorrhagic colitis is rare. Penicillin-like-antibiotics-induced hemorrhagic colitis was infrequently reported in abroad, but in Korea, quinolone-induced colitis was reported. We found a case that the patient had the hematochezia after use of amoxicillin for eradication of H. pylori. Colonoscopic abnormalities showed superficial ulceration and mucosal edematous change without pseudomembrane on the ascending and transverse colon. We diagnosed the amoxicillin-induced hemorrhagic colitis by clinical course, colonoscopic findings, histologic findings and other laboratory results for differential diagnosis. This disease is rare but rapidly recovered after the withdrawal of the antibiotics and has a good prognosis. Therefore, we should differentiate this disease from hemorrhagic colitis of other causes by history taking.

A Case of Hemolytic Uremic Syndrome Caused by Escherichia coli O8: Case Report / 대한소화기내시경학회지

Since 1982, many countries have reported outbreaks or sporadic cases by enterohemorrhagic Escherichia coli (E. coli) serogroup strains, mainly E. coli O157 : H7. Hemorrhagic E. coli induces hemolytic uremic syndrome (HUS) in 10 to 15% of cases in infants and young chilidren. HUS is a clinical syndrome of hemolytic anemia, acute renal failure, and thrombocytopenia. We experienced a case of E. coli O8 as the causative organism of hemorrhagic colitis and hemolytic uremic syndrome in 16 year-old man. Hemorrhagic colitis was diagnosed by the sigmoidoscopy and E. coli O8 was identified in the stool culture. Hemolytic uremic syndrome was clinically diagnosed. A conservative management including total parenteral nutrition, plasma exchange transfusion, hemodialysis and continuous arteriovenous hemofiltration with dialysis resulted in a complete recovery of the patient. We herein report this manifestations of E. coli O8 and discuss the therapeutic issues related to hemorrhagic colitis and hemolytic uremic syndrome.

Antibiotics Associated Hemorrhagic Colitis: A report of two cases / 대한소화기내시경학회지

Antibiotics related colitis is a well recognized disease entity which in its severest form may result in pseudomembranous colitis, whereas in another form, acute hemorrhagic colitis without pseudomembrane, related to the use of penicillin-type antibiotics is rarely reported. The clinical features of hemorrhagic colitis associated with antibiotics was characterized that the bloody diarrhea, often with abdominal cramping pain begins 2~7 days after starting the antibiotics and rapidly recovered after its withdrawal. Pathogenesis of this disease is not entirely clear. It has been believed that right-sided hemorrhagic colitis is one of the main forms of colitis associated with antibiotics, especially ampicillin derivatives or cephalosporin, but recent reports presented left-sided colitis. We experienced 2 cases of hemorrhagic colitis developed on the left colon after the introduction of quinolone.

A Case of Hemorrhagic Colitis Complicated by Hemolytic Uremic Syndrome / 감염

We report a case of hemolytic uremic syndrome (HUS) associated with hemorrhagic colitis. A 35-year-old man was admitted to a local hospital because of abdominal pain and watery diarrhea that had developed about 6 hours after taking roast beef. He was treated with intravenous fluids and antibiotics, but watery diarrhea changed to bloody in nature from the next day. He was transferred to our hospital due to progressive ascites and jaundice on his 8th day of illness. Examinations revealed ascites, jaundice, microangiopathic hemolytic anemia, thrombocytopenia and uremia. Sorbitol-negative Escherichia coli was isolated from his stool, which proved as Shiga-like toxin-negative E. coli, serotype O25. His conditions improved markedly after three times of plasmapheresis and intravenous fluid therapy, and the organism was not isolated from the follow-up stool culture.