ABSTRACT
Introduction: The autoimmune process in Crohn's disease exacerbates destructive changes in the intestinal wall and leads to complications such as bleeding (21. 9%), strictures (21.6%), and abscesses (19.7%). Case Presentation: The case of a 32-year-old male patient with an 8-year history of Crohn's disease is presented. He was admitted for emergency indications with severe pain in the right lower quadrant, chills, and a fever reaching 39.0°C. The patient had anemia, hypocoagulation and immunodeficiency. Ultrasound and CT scans of the abdominal organs revealed an abscess in the right iliac region. It was immediately drained under ultrasound control and X-ray. A fistulogram showed the fistula between the abscess and the ileum. Routine antibiotic therapy selected in accordance with the sensitivity of the microflora and sanitization of the abscess cavity were not effective. The immunomodulatory therapy, intravenous administration of cryoprecipitate, and the introduction of fibrin glue into the abscess cavity were added to the treatment. After the treatment, the patient's immune status corresponded to normal, the abscess healed, and the fistula was closed. Conclusion: In patients suffering from Crohn's disease with the formation of an abscess and a long-term non-healing intestinal fistula, it is essential that the diagnostic algorithm includes the examination of the immune status. Treatment should include immunomodulators, intravenous administration of cryoprecipitate. To close the fistula in these patients, it is advisable to use fibrin glue that has a local immunomodulatory effect.
ABSTRACT
BACKGROUND: Portal hypertensive colonopathy is a consequence of portal hypertension that develops in hepatic cirrhosis. Pathological processes occurring in intestinal epithelium cells can be revealed by changes in the autoantibody titers to intestinal antigens. It is important both in diagnosis and in the evaluation of the treatment effectiveness. PURPOSE: To investigate the effect of portal hypertension in patients with liver cirrhosis on degenerative processes in the walls of the small and large intestines after stimulation of liver regeneration with cryoprecipitate. METHODS: Thirty-six patients with liver cirrhosis underwent a procedure for percutaneous introduction of cryoprecipitate into the liver tissue. Before and 1 year after it, all the patients were measured for portal blood flow parameters, performed colonoscopy with biopsy, and determined autoantibodies to intestinal antigens (ItM, SCM) in the blood. Comparative analyses of changes in the large intestine mucosa before and after reducing portal hypertension by stimulating liver regeneration with cryoprecipitate were conducted. RESULTS: Here, we show that the degenerative process in the mucosa of the intestines increases, despite the positive dynamics of portal blood flow parameters after the liver regeneration. Autoantibodies values for the intestine antigens were higher than normal in 22 of the 36 patients after 1 year of introduction of cryoprecipitate into the liver. Morphological analysis of the intestinal wall showed the presence of edema/mucosal atrophy and neutrophilic/lymphocytic-histiocytic infiltration in 28 of the 36 patients. CONCLUSION: Changes in autoantibodies to intestinal antigens are an informative method for diagnosing colonopathy and enteropathy at early stages, providing the possibility to administer proper timely treatment. Patients with hepatic cirrhosis are recommended to have their intestinal microflora tested and be administered drugs that improve their composition.
ABSTRACT
BACKGROUND: In this manuscript, we show that the detection of telomerase activity in pancreatic mass tissue provides early evidence of a cancerous process that requires a well-timed surgical treatment. METHODS: Eighty-eight patients with pancreatic mass (both benign and malignant) were involved in the research. Comparative analyses of the data and instrumental methods to define the histological structure of tumor mass and measure telomerase activity have been carried out. RESULTS: Intense telomerase activity (+++) in the tissue of pancreatic mass determines cancer with high accuracy. One hundred percent of patients with pancreatic cancer had high telomerase activity. In 32.4% of patients with average telomerase activity (++) pancreatic cancer was diagnosed. The average telomerase activity (++) in pancreatic tumors gives an early indication of pancreatic cancer and requires dynamic observation for 6 to 12 months (P<0.05). Low telomerase activity (+) in patients with benign tumors is an accurate sign for confirming a diagnosis. CONCLUSIONS: The detection of telomerase activity in pancreatic mass tissue provides early evidence of a cancerous process that requires a well-timed surgical treatment.
