Severe pembrolizumab-induced gastritis in a patient with lung adenocarcinoma.

Cancer immunotherapy is an increasingly common treatment option based on anti-tumor immune response. However, a challenge is arising regarding its potential, which is the poorly understood recognized immune-mediated adverse effects.

Long-Term Incidence of Advanced Colorectal Neoplasia in Patients with Serrated Polyposis Syndrome: Experience in a Single Academic Centre.

Serrated polyposis syndrome (SPS) implies a slightly elevated risk of colorectal cancer (CRC) during endoscopic follow-up, but its natural course is still not well known. The main objective of this study was to describe the long-term risk of developing advanced neoplasia (AN) in these patients. Until October 2020, individuals who fulfilled 2010 WHO criteria I and/or III for SPS were retrospectively recruited. We selected those under endoscopic surveillance after resection of all lesions >3 mm in a high-quality colonoscopy. We excluded patients with total colectomy at diagnosis and those with any interval between colonoscopies >3.5 years. We defined AN as advanced serrated polyp (≥10 mm and/or with dysplasia), advanced adenoma, or CRC. In 109 patients, 342 colonoscopies were performed (median = 3, median interval = 1.8 years) during a median follow-up after colonic clearance of 5.0 years. Five-year cumulative incidences of AN were 21.6% globally, and 5.6%, 10.8%, and 50.8% in patients who fulfilled criterion I, III, and both, respectively (p < 0.001). No CRC was diagnosed and only 1 (0.9%) patient underwent surgery. In conclusion, cumulative incidences of AN could be lower than previously described, at least in patients who fulfil the 2010 WHO criterion III alone. Therefore, low-risk individuals might benefit from less stringent surveillance.

Mielitis transversa asociada a enfermedad de Crohn: un caso excepcional ¿idiopático o secundario? / No disponible

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Transverse myelitis associated with Crohn's disease: an exceptional case, idiopathic or secondary?

Transverse myelitis (TM) is a serious inflammatory disorder of the spinal cord. The annual incidence is 1 to 5 cases per million people. It produces sensory, motor and autonomic symptoms. Once metabolic and vascular causes and demyelinating diseases have been ruled out, they can be classified as paraneoplastic, parainfectious (up to half debut after infection), toxic-pharmacological (TNFα receptor inhibitors can induce TM) or associated with systemic diseases (Lupus). After a complete study, up to 30 % are considered idiopathic.

Proctitis as the clinical presentation of lymphogranuloma venereum, a re-emerging disease in developed countries.

Lymphogranuloma venereum (LGV) is a sexually transmitted infectious disease caused by serovars L1, L2 and L3 of Chlamydia trachomatis. The initial presentation is usually a painless ulcerated papule on the genitalia or distal proctitis. The progression of the infection can lead to major complications: rectal strictures, intestinal obstruction or perforation. We present five cases of LGV proctitis as the initial presentation of the disease. All patients were male, mean age 44.6 years, with positive serology to human immunodeficiency virus (HIV) and promiscuous men who have sex with men (MSM).The initial diagnosis was made by rectosigmoidoscopy indicated for pain and anal discharge. All cases were confirmed by polymerase chain reaction technique in rectal tissue. Endoscopic images obtained showed a great variety of rectal lesions, from mild erythema of the mucosa and ulcers to deep ulcers with elevated borders and purulent exudate. All cases were resolved after treatment with doxycycline for 3 weeks. It emphasizes the importance of suspecting this re-emerging disease in patients with risk factors (HIV and MSM), with the aim of early treatment and to avoid major complications.

Proctitis como forma de presentación del linfogranuloma venéreo, una entidad emergente en los países desarrollados / Proctitis as the clinical presentation of lymphogranuloma venereum, a re-emerging disease in developed countries

El linfogranuloma venéreo (LGV) es una enfermedad infecciosa de transmisión sexual causada por los serotipos L1, L2 y L3 de Chlamydia trachomatis. Se manifiesta inicialmente como una pápula ulcerada e indolora en los genitales o como una proctitis distal. La progresión de la infección puede dar lugar a complicaciones mayores: estenosis rectal, obstrucción o perforación intestinal. Se presentan cinco casos de LGV con proctitis como signo inicial de la enfermedad. Todos los pacientes eran varones, de edad media 44,6 años, con serología positiva al virus de inmunodeficiencia humana (VIH) y homosexuales promiscuos. El diagnóstico se realizó mediante rectoscopia indicada por dolor y supuración anal. Todos los casos fueron confirmados mediante técnica de reacción en cadena de la polimerasa en tejido rectal. Las imágenes endoscópicas obtenidas muestran la gran diversidad de lesiones rectales posibles, desde leve eritema de la mucosa con aftas hasta úlceras profundas con bordes sobreelevados y abundante fibrina. Tras tratamiento con doxiciclina, durante 3 semanas, todos los casos se resolvieron de forma satisfactoria. Se enfatiza la importancia de sospechar esta patología emergente en pacientes con factores de riesgo (VIH y homosexuales), con el fin de instaurar un tratamiento precoz y evitar las complicaciones mayores (AU)

Lymphogranuloma venereum (LGV) is a sexually transmitted infectious disease caused by serovars L1, L2 and L3 of Chlamydia trachomatis. The initial presentation is usually a painless ulcerated papule on the genitalia or distal proctitis. The progression of the infection can lead to major complications: rectal strictures, intestinal obstruction or perforation. We present five cases of LGV proctitis as the initial presentation of the disease. All patients were male, mean age 44.6 years, with positive serology to human immunodeficiency virus (HIV) and promiscuous men who have sex with men (MSM). The initial diagnosis was made by rectosigmoidoscopy indicated for pain and anal discharge. All cases were confirmed by polymerase chain reaction technique in rectal tissue. Endoscopic images obtained showed a great variety of rectal lesions, from mild erythema of the mucosa and ulcers to deep ulcers with elevated borders and purulent exudate. All cases were resolved after treatment with doxycycline for 3 weeks. It emphasizes the importance of suspecting this re-emerging disease in patients with risk factors (HIV and MSM), with the aim of early treatment and to avoid major complications (AU)