ABSTRACT
Alterations of normal function of interstitial cells of Cajal (ICC) are reported in many intestinal disorders. Diagnosis of their involvement is rare (infrequent), but necessary to propose a specific treatment. This article reviews the place of ICC in the pathogenesis of achalasia, gastroesophageal reflux disease, infantile hypertrophic pyloric stenosis, chronic intestinal pseudo-obstruction and slow transit constipation. Moreover we discuss the role of the Cajal cells in the development of stromal tumors of the gastrointestinal tract.
Subject(s)
Biological Clocks , Gastroenterology , Gastrointestinal Diseases/pathology , Gastrointestinal Motility , Gastrointestinal Tract/pathology , Constipation/pathology , Constipation/physiopathology , Esophageal Achalasia/pathology , Esophageal Achalasia/physiopathology , Esophagus/pathology , Esophagus/physiopathology , Gastroesophageal Reflux/pathology , Gastroesophageal Reflux/physiopathology , Gastrointestinal Diseases/physiopathology , Gastrointestinal Stromal Tumors/pathology , Gastrointestinal Stromal Tumors/physiopathology , Gastrointestinal Tract/physiopathology , Gastroparesis/pathology , Gastroparesis/physiopathology , Humans , Intestinal Pseudo-Obstruction/pathology , Intestinal Pseudo-Obstruction/physiopathology , Intestines/pathology , Intestines/physiopathology , Pyloric Stenosis, Hypertrophic/pathology , Pyloric Stenosis, Hypertrophic/physiopathology , Stomach/pathology , Stomach/physiopathologyABSTRACT
A case of an 84 year old woman addressed for dysphagia is discussed. The endoscopic and histologic examination revealed a gastric linitis with cardial invasion. Classically, there is no characteristic macroscopic description associated with gastric linitis. An endoscopic aspect considered highly suggestive for gastric linitis is presented.
Subject(s)
Endoscopy , Linitis Plastica/diagnosis , Stomach Neoplasms/diagnosis , Aged , Aged, 80 and over , Biopsy , Esophageal Achalasia/etiology , Female , Humans , Linitis Plastica/diagnostic imaging , Linitis Plastica/pathology , Radiography, Abdominal , Stomach/pathology , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Acute fatty liver of pregnancy (AFLP) is a rare liver disease unique to pregnancy potentially fatal for both mother and child. Only a few cases of recurrence have been published. We report a new case. A 27-year-old primiparous patient presented a first episode of AFLP in 1991 at 37 week's gestation. Diagnosis was suspected because of vomiting, thrombocytopenia, and liver function tests abnormalities. It was confirmed by liver ultrasonography and abdominal computed tomography. Clinical and biological improvement was observed after caesarean delivery. Six years later, the woman began a second pregnancy. Liver function tests and complete blood count were regularly checked. At 30 weeks' gestation, recurrent AFLP occurred and caesarean section was performed. Again, diagnosis was confirmed by both ultrasonography and abdominal computed tomography. In 2006, the mother and the two girls, 15 and 8-year-old respectively, were in good health. The study of the HADHA gene, coding alpha subunit long chain 3-hydroxyacyl coenzyme A dehydrogenase (LCHAD) in the patient failed to find mutations, particularly the common mutation c.1528G>C (Glu474-Gln, p.E474Q). In conclusion, after an episode of AFLP, women should be clearly warned of the risk of recurrence and regularly monitored during the next pregnancy, even if the search of HADHA gene mutation is negative.
Subject(s)
Fatty Liver/complications , Pregnancy Complications/diagnosis , Adult , Cesarean Section , Fatty Liver/diagnosis , Fatty Liver/diagnostic imaging , Female , Follow-Up Studies , Humans , Pregnancy , Pregnancy Complications/diagnostic imaging , Pregnancy Outcome , Radiography, Abdominal , Recurrence , Tomography, X-Ray Computed , UltrasonographyABSTRACT
We report the case of a 45-year-old man admitted for severe autoimmune thrombopenia and neutropenia associated with chronic viral C hepatitis. After failed, intravenous gammaglobulin and corticosteroid therapy antiviral treatment with interferon and ribavirin was given for one year. Thrombopenia improved progressively during antiviral therapy and worsened after the end of treatment. Neutropenia improved during antiviral therapy. Two years after the end of treatment, serum RNA-HCV was positive, white cell count was normal and platelet count was 77 G/L. In conclusion, these results suggest that antiviral therapy may be useful in patients with auto-immune cytopenia associated with viral hepatitis C infection.
