Impaired monocyte function in patients succesfully treated for Wipple's disease

Peripheral blood mononuclear cells (monocytes) from patients with Whipple's disease in long-term remission were tested for their ability to handle intracellular microorganisms. Phagocytosis and lysis of Candida tropicalis by monocytes of patients (n=12) andcontrols (n=8) were quantified after 30 min of incubation. Phagocytosis was similar in both groups but intracellular Killing of Candida tropicalis was significativily lower in patients (p<0.001). We concluded that our study showed an in vitro defect in the intracellular Killing function of monocytes in subjects in remission many years after diagnosis of Whipple's disease. The defective function did not seem to be related to relapse or to the susceptibility to other infections.

Abnormal colonic transit time in untreated celiac sprue

Motility disorders of the digestive tract have long been implicated in the pathophysiology of diarrhea in patients with celiac sprue. However, the contribution of the colon to the intestinal transit of celiac sprue has not been reported. Our aim was to determine whether sprue alters gut transit and whether differences in the clinical status of the disease influences colonic transit. We prospectively studied 25 patients with untreated celiac sprue, 15 treated patients and 15 healthy controls. Oro-cecal transit time, measured by the lactulose breath H2 test, was significantly delayed in untreated patients compared with treated patients and controls (p<0.001 and p<0.01 respectively). The delayed transit through the stomach and small bowel was not related to the presence of the steatorrhea. Transit of radiopaque makers, a measure of total colonic tansit, was significantly faster in untreated patients (p<0.05). The major finding was that this abnormal colonic behavior was principally due to a subpopulation of untreated patients with very fast transit times (<18 hours). A weakly significant inverse correlation between transit and fecal weight (r:-0.55, p<0.01), and between transit and steatorrhea (r:-0.38, p<0.05), was observed. We confirm previous descriptions of delayed oro-cecal transit time in untreated patients, and also provide the first evidence that disordered colonic transit contributes to the pathophysiology of the diarrhea in sprue.

Osteo-artropatias de las enfermedades inflamatorias del colon. / Osteoarthropathies of inflammatory diseases of the colon

Se presentan 15 pacientes portadores de enfermedades inflamatorias del colon (14 rectocolitis ulcerosas inespecificas y 1 enfermedad de Crohn) que se complicaron con afectacion de grandes articulaciones y columna vertebral (espondilitis anquilosante). Se comenta la incidencia de estas manifestaciones, la clinica, la radiologia, la patologia, la serologia y evolucion con relacion a la enfermedad inflamatoria

Manifestaciones cutaneo-mucosas de la enfermedad de Crohn. / Mucocutaneous manifestations of the Crohn's disease

Se presenta un caso de la infrecuente asociacion de pioderma gangrenoso y enfermedad granulomatosa del colon (enfermedad de Crohn del colon). Se realiza una revision de la literatura acerca de la asociacion del mismo con otras afecciones gastrointestinales. Se actualizan los probables mecanismos etiopatogenicos y resultados terapeuticos

Ulcera necrotica de cavidad bucal en colitis ulcerosa. / Necrotic ulcer of the bucal cavity in ulcerative colitis

Los autores presentan un caso de asociacion de ulcera necrotica de cavidad bucal durante un brote agudo de rectocolitis ulcerosa inespecifica que evoluciono hacia la curacion con el tratamiento de la enfermedad de base. Se realiza una revision de las enfermedades gastrointestinales que pueden asociarse a ulceras bucales, y se detalla su diagnostico diferencial con otras ulceras bucales especificas e inespecificas

Pioderma gangrenoso en enfermedades de Crohn del colon. / Pyoderma gangrenosum in Crohn's diseases of the colon

Se presenta un caso de la infrecuente asociacion de pioderma gangrenoso y enfermedad granulomatosa del colon (enfermedad de Crohn).Se realiza una revision de la literatura acerca de las asociaciones del mismo con otras afecciones gastrointestinales. Se actualizan los probables mecanismos etiopatogenicos y resultados terapeuticos