ABSTRACT
Ranitidine is a safe, widely prescribed drug for the treatment of peptic ulcer disease and is rarely associated with serious adverse reactions. This report describes a patient who suffered three episodes of acute pancreatitis associated with ranitidine prescribed for duodenal ulcer disease. On each occasion the pancreatitis resolved after withdrawal of ranitidine and recurred upon re-exposure. Underlying biliary and pancreatic disease was excluded. There has been no recurrence of pancreatitis in the five years of follow-up since ranitidine was discontinued.
Subject(s)
Pancreatitis/chemically induced , Ranitidine/adverse effects , Acute Disease , Aged , Aged, 80 and over , Female , Humans , RecurrenceABSTRACT
Factors influencing small bowel morphology in dermatitis herpetiformis (DH) were investigated by comparing patients with DH and normal small bowel biopsies to patients with DH and abnormal small bowel biopsies. The mean age of 18 patients with morphological changes in small bowel (38 years) was significantly lower (P less than 0-001) than the mean age of nine patients with normal bowel mucosa (60 years). HLA typing confirmed the high frequency of HLA-B8 in DH (64%) but HLA-B8 was unrelated to the presence or severity of small bowel lesions. Four patients had diarrhoea with progressive weight loss or abdominal cramps subsequently responsive to gluten withdrawal. In this subgroup serum levels of IgG and IgM were significantly lower than in patients with normal small bowel mucosa. Small bowel involvement appeared to be independent of the duration and severity of skin disease, and the deposition of immunoglobulin and complement (C3) in the dermal papillae of skin adjacent to skin lesions.
Subject(s)
Dermatitis Herpetiformis/pathology , Intestine, Small/pathology , Adult , Age Factors , Aged , Dermatitis Herpetiformis/immunology , Dermatitis Herpetiformis/physiopathology , Dietary Fats , Female , HLA Antigens , Humans , Immunoglobulins/analysis , Intestinal Absorption , Intestine, Small/physiopathology , Male , Middle Aged , Plasma Cells , Skin/immunologyABSTRACT
Two patients with multiple myeloma died in acute liver failure. Both had been treated with the anabolic steroid oxymetholone and both subsequently developed severe cholestatic hepatitis. In one the histological lesion progressed despite cessation of oxymetholone therapy. Myeloma infiltration of the liver and peliosis hepatis were not seen. As a fatal outcome from cholestatic hepatitis due to oxymetholone is rare it is possible that an unknown potentiating factor is present in multiple myeloma that can lead to a fatal outcome. If oxymetholone therapy is to be used in such patients then close clinical and laboratory assessment of liver function should be carried out in an attempt to prevent this unusual and fatal complication.
Subject(s)
Hepatic Encephalopathy/chemically induced , Multiple Myeloma/drug therapy , Oxymetholone/adverse effects , Cholestasis/chemically induced , Female , Humans , Male , Middle Aged , Oxymetholone/therapeutic useABSTRACT
Two patients are described with chronic liver disease and portal hypertension in association with ulcerative colitis for which colectomy and ileostomy had been performed. Both patients developed bleeding from the varices situated around the ileostomy stoma and one also bled from the oesophageal varices. Each had a successful portacaval shunt performed because of this bleeding. The occurrence of such ileal varices is uncommon, but is important as a manifestation of portal hypertension. Although it can usually be easily controlled by local measures, portal-systemic shunt should always be considered, particularly as such patients are also very likely to bleed from oesophageal varices.
