ABSTRACT
We report the association of primary sclerosing cholangitis and systemic lupus erythematosus in a 39 year-old man. Six months after a diagnosis of primary sclerosing cholangitis was established, the patient was hospitalized for a pleural effusion and acute pericarditis. Emergency pericardiocentesis, was required due to sudden cardiac tamponnade. Plasmatic anti-DNA and anti-nuclear antibodies were present. Treatment by steroids greatly improved symptoms. This clinical association suggests that some immune disorders may be common to the two diseases.
Subject(s)
Cholangitis, Sclerosing/complications , Lupus Erythematosus, Systemic/complications , Adrenal Cortex Hormones/therapeutic use , Adult , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis, Sclerosing/diagnostic imaging , Cholangitis, Sclerosing/drug therapy , Cholangitis, Sclerosing/pathology , Drug Therapy, Combination , Humans , Lupus Erythematosus, Systemic/drug therapy , Male , Ursodeoxycholic Acid/therapeutic useABSTRACT
Most of the 150 leiomyomas of the rectum reported since 1872 were no larger than 5 cm. The authors report 3 new observations of leiomyomas of the rectum measuring more than 5 cm. The diagnosis of leiomyoma is difficult. The physical examination and rectoscopy suggest a submucal tumour of the rectum and endoendoscopy helps, describe the relations with the urogenital tract and the sphincters. Due to the lack of distinctive pathology features of malignancy, a leiomyosarcoma cannot be totally eliminated. The prognosis is uncertain due to the rate of relapse and the short follow-up (less than one year) in the previously reported cases. A slow spontaneous clinical course is however possible. The treatment goal is complete surgical removal. While local exeresis is indicated in tumours less than 5 cm in size, echo-guided endorectal protectomy with or without amputation of the sphincter should be discussed for larger tumours.
