Résumé
Objective To sum up the experience in diagnosis of fungal esophagitis. Methods An analysis was per-formed on clinical data of 38 cases of fungal esophagitis diagnosed through gastroscopy in Peking Union Medical College Hospital from Jan. 2013 to Dec. 2015. Results Of 38 cases, 26 were males and 12 were females. The mean age was(54.0±1.5) years old.76.3% had at least one risk factor.7 patients had oral candidiasis and 10 pa-tients had typical symptom of fungal esophagitis. Endoscopic severity was classified according to Kodsi's grade:gradeⅠ6 cases,grade Ⅱ29 cases, grade Ⅲ 1 case,grade Ⅳ 2 cases. Most patients were treated with systemic antifungal therapy. However,one patient's fungal esophagitis resolved without any treatment. Conclusions Endos-copy with biopsy is a valuable definitive diagnostic method for fungal esophagitis, especially for asymptomatic pa-tients or those without oral candidiasis. Systemic antifungal treatment is recommended with fluconazole as the first choice. More evaluation is needed to determine if systemic antifungal therapy is necessary for asymptomatic and im-munocompetent patients with mild fungal esophagitis.
Résumé
Objective To improve the diagnosis and treatment of type Ⅰ autoimmune pancreatitis, a study was carried out to summarize the epidemiological characteristics, clinical manifestations and diagnosis of autoimmune pancreatitis (AIP).Methods This study retrospectively analyzed the clinical data of all the patients diagnosed with AIP from January 1998 to December 2016 in the ward of Peking union medical college hospital.Results 194 type 1 AIP patients were enrolled in this study.The M/F ratio of the disease was 3.51/1,with an average age of 57±15 years.The most common symptom is jaundice, abdominal pain and weight loss.The most common diseases of the pancreas are sclerosing cholangitis, salivary glands, IgG4 nephropathy.There are 36.68 percent of AIP patients with diabetes mellitus.IgG4, ANA, ESR, c-reactive protein and CA199 are all contribute to disease diagnosis and follow-up.Pathology, pet-CT and hormone therapy response all contribute to the diagnosis of AIP.Conclusions As a systemic disease, the type 1 AIP has special clinical features and laboratory profiles.The diagnosis of AIP can be applied in many ways.
Résumé
Objective To sum up the experience in diagnosis of fungal esophagitis. Methods An analysis was per-formed on clinical data of 38 cases of fungal esophagitis diagnosed through gastroscopy in Peking Union Medical College Hospital from Jan. 2013 to Dec. 2015. Results Of 38 cases, 26 were males and 12 were females. The mean age was(54.0±1.5) years old.76.3% had at least one risk factor.7 patients had oral candidiasis and 10 pa-tients had typical symptom of fungal esophagitis. Endoscopic severity was classified according to Kodsi's grade:gradeⅠ6 cases,grade Ⅱ29 cases, grade Ⅲ 1 case,grade Ⅳ 2 cases. Most patients were treated with systemic antifungal therapy. However,one patient's fungal esophagitis resolved without any treatment. Conclusions Endos-copy with biopsy is a valuable definitive diagnostic method for fungal esophagitis, especially for asymptomatic pa-tients or those without oral candidiasis. Systemic antifungal treatment is recommended with fluconazole as the first choice. More evaluation is needed to determine if systemic antifungal therapy is necessary for asymptomatic and im-munocompetent patients with mild fungal esophagitis.