RESUMO
BACKGROUNE/AIMS: Esophageal variceal ligation (EVL) is the most preferable method for controling variceal bleeding. However, EVL is associated with complications such as hemorrhage, chest pain, dysphagia, and odynophagia due to post-EVL ulcers in the esophageal mucosa. The aim of this study was to assess the effect of proton pump inhibitor (PPI), pantoprazole on the healing of post-EVL ulcers. METHODS: Forty seven patients were randomly allocated into PPI group and control group. Patients in PPI group received 40 mg of pantoprazole intravenously for 3 days after EVL, then 40 mg of oral pantoprazole for 11 days consecutively. Control patients received intravenous and oral placebo. Endoscopic examinations were performed twice at 7+/-2 days and 14+/-2 days after EVL respectively. Clinical outcomes include the size of ulcers, symptoms reported by patients; chest pain, dysphagia, and odynophagia. RESULTS: Forty seven patients completed the 7 days protocol (PPI/control; 25/22), and twenty six patients completed the 14 days protocol (PPI/control; 16/10). Post-EVL ulcers in PPI group were significantly smaller than those in control group (7 days; 98.7 mm2/119.4 mm2, 14 days; 32.3 mm2/43.8 mm2, p0.05). Nineteen patients (PPI/control; 9/10) did not complete the 14 days protocol due to patients' refusal and adverse outcomes, such as hepatic failure and sepsis with bleeding from post-EVL ulcer occurred in two patients of control group. CONCLUSIONS: PPI treatment following EVL may be effective in healing post-EVL ulcer.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , 2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Antiulcerosos/administração & dosagem , Varizes Esofágicas e Gástricas/complicações , Esofagoscopia , Hemorragia Gastrointestinal/prevenção & controle , Ligadura , Inibidores da Bomba de Prótons/administração & dosagem , Análise de Regressão , Perfil de Impacto da Doença , Úlcera/tratamento farmacológicoRESUMO
Multiple sclerosis is an autoimmune disorder, which may be associated with other rheumatologic or endocrine diseases induced by autoantibodies. Hashimoto's thyroiditis is also an organ-specific autoimmune disorder, and its association with multiple sclerosis during interferon therapy has been reported. Cases of Hashimoto's thyroiditis with multiple sclerosis are very rare. Herein is reported our experience of a 27 year-old woman who presented with general weakness, cold intolerance and progressive muscle weakness. She had been treated with levothyroxine due to subclinical hypothyroidism, which rather aggravated the symptom. In a CSF analysis, the myelin basic protein level was above 10 ng/dL and that of the IgG and the IgG index were 135 mg/dL and 7.8, respectively. In a brain MRI, demyelinating lesions in the left middle pontocerebellar junction and right subcortex were shown. She was diagnosed with multiple sclerosis, and the symptom improved after glucocorticoid and levothyroxine therapy. Herein is reported the first Korean case of Hashimoto's thyroiditis associated with multiple sclerosis
Assuntos
Adulto , Feminino , Humanos , Autoanticorpos , Encéfalo , Doenças do Sistema Endócrino , Hipotireoidismo , Imunoglobulina G , Interferons , Imageamento por Ressonância Magnética , Esclerose Múltipla , Debilidade Muscular , Proteína Básica da Mielina , Glândula Tireoide , Tireoidite , TiroxinaRESUMO
Multiple sclerosis is an autoimmune disorder, which may be associated with other rheumatologic or endocrine diseases induced by autoantibodies. Hashimoto's thyroiditis is also an organ-specific autoimmune disorder, and its association with multiple sclerosis during interferon therapy has been reported. Cases of Hashimoto's thyroiditis with multiple sclerosis are very rare. Herein is reported our experience of a 27 year-old woman who presented with general weakness, cold intolerance and progressive muscle weakness. She had been treated with levothyroxine due to subclinical hypothyroidism, which rather aggravated the symptom. In a CSF analysis, the myelin basic protein level was above 10 ng/dL and that of the IgG and the IgG index were 135 mg/dL and 7.8, respectively. In a brain MRI, demyelinating lesions in the left middle pontocerebellar junction and right subcortex were shown. She was diagnosed with multiple sclerosis, and the symptom improved after glucocorticoid and levothyroxine therapy. Herein is reported the first Korean case of Hashimoto's thyroiditis associated with multiple sclerosis
Assuntos
Adulto , Feminino , Humanos , Autoanticorpos , Encéfalo , Doenças do Sistema Endócrino , Hipotireoidismo , Imunoglobulina G , Interferons , Imageamento por Ressonância Magnética , Esclerose Múltipla , Debilidade Muscular , Proteína Básica da Mielina , Glândula Tireoide , Tireoidite , TiroxinaRESUMO
Diffuse alveolar hemorrhage (DAH) is a relatively uncommon disorder that most often occurs in patients with systemic autoimmune or idiopathic disease. DAH may result from coagulation disorders, inhaled toxins, or infection. The principal histopathologic features of pulmonary capillaritis include capillary wall necrosis with infiltration by neutrophils, interstitial erythrocytes, and/or hemosiderin, and interalveolar septal capillary occlusion by fibrin thrombi. New inert materials such as polymerized silicones, artecoll is used as injectable aesthetic microimplants. They are still able to stimulate a clinically evident granulomatous reaction. The rate of allergic reaction is very low. We report the case of diffuse alveolar hemorrhage following administration of artecoll.