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1.
Medicina (Kaunas) ; 59(1)2023 Jan 12.
Article in English | MEDLINE | ID: mdl-36676780

ABSTRACT

Colonic malakoplakia is an uncommon granulomatous development of cells resulting from the impaired capacity of the mononuclear cells to eliminate the phagocytosed bacteria, and in rare cases it can also affect the gastrointestinal tract. We report the case of a 78-year-old female patient that was admitted to hospital by The Emergency Department with the diagnosis of bowel obstruction, confirmed by the clinical and paraclinical investigations. We decided to surgically manage the case for suspicious symptomatic colonic neoplasm. The histological examination of the surgical specimens revealed colonic malakoplakia, characterized by the presence of the aggregated granular histiocytes and Michaelis-Gutmann bodies. Through this paper, we want to raise awareness for Malakoplakia, which remains an extremely rare disease that may affect multiple organs, and because it does not present specific symptoms or clinical manifestations, the final diagnosis remains the histopathological study. The clinical conduct should be decided after taking into consideration all the aspects of this pathology along with the benefits and risks for the patient.


Subject(s)
Colonic Neoplasms , Malacoplakia , Female , Humans , Aged , Malacoplakia/diagnosis , Malacoplakia/pathology , Colonic Neoplasms/surgery
2.
J Cell Mol Med ; 19(9): 2253-61, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26081945

ABSTRACT

We studied whether the serum levels of glial fibrillary acidic protein (GFAP) and of antibodies against the N-methyl-d-aspartate receptor subunit NR2 (NR2 RNMDA ) can discriminate between intracerebral haemorrhage (ICH) and ischaemic stroke (IS) in stroke patients. We prospectively recruited patients with suspected stroke (72 confirmed) and 52 healthy controls. The type of brain lesion (ICH or IS) was established using brain imaging. The levels of GFAP and of antibodies against NR2 RNMDA were measured in blood samples obtained within 12 hrs after stroke onset and 24, 48 and 72 hrs and 1 and 2 weeks later using ELISA immunoassay. Improvement in diagnostic performance was assessed in logistic regression models designed to predict the diagnosis and the type of stroke. GFAP peaks early during haemorrhagic brain lesions (at significantly higher levels), and late in ischaemic events, whereas antibodies against NR2 RNMDA have significantly higher levels during IS at all time-points. Neither of the two biomarkers used on its own could sufficiently discriminate patients, but when they are used in combination they can differentiate at 12 hrs after stroke, between ischaemic and haemorrhagic stroke with a sensitivity and specificity of 94% and 91%, respectively.


Subject(s)
Antibodies/metabolism , Cerebrovascular Disorders/metabolism , Glial Fibrillary Acidic Protein/metabolism , Protein Subunits/metabolism , Receptors, N-Methyl-D-Aspartate/immunology , Acute Disease , Aged , Biomarkers/metabolism , Female , Humans , Logistic Models , Male , Middle Aged , ROC Curve , Stroke/metabolism
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