Association of Helicobacter pylori with central serous chorioretinopathy in Iranian patients.

AIM: This study was conducted to investigate a possible association between H. pylori infection and CSR. BACKGROUND: Helicobacter pylori infection is one of the most common infections worldwide. Central Serous Chorioretinopathy (CSR) is a serious macular detachment that usually affects young people. The etiopathogenesis of the disease is still not completely understood. PATIENTS AND METHODS: A prospective study was performed and we evaluated a total of 35 CSR patients and control group of138 patients who referred to gastroenterology research center of Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Central serous chorioretinopathy was diagnosed on the basis of findings in ophthalmic examinations and confirmed by fluoresce in angiogram. All patients underwent a 13C-urea breath test (UBT) to detect H. pylori infection. Patients were defined as H. pylori infected, if breath test was positive. RESULTS: The mean duration of symptoms before diagnosis was8.3± 2.5 days. Overall, no statistically significant difference was found between left and right eyes, bilateral CSR was observed in 5 patients (14.2%).The incidence of H. pylori infection was 85.7% in CSR patients and 55.1% in control subjects (p=0.001). Odd's ratio was 4.895. CONCLUSION: These results indicate that the prevalence of H. pylori infection is significantly higher in patients with CSR than in controls. No effect of age or sex was seen on H.pylori test results. Further multiple centers, randomized, case control trials are necessary to confirm the potential contributory role of the H. pylori infection in the pathogenesis of CSR as a possible association between infectious agents and endothelial dysfunction.

Cholangiocarcinoma in magnetic resonance cholangiopancreatography and fascioliasis in endoscopic ultrasonography.

Fascioliasis is a worldwide zoonotic infection with Fasciola hepatica and Fasciola gigantica. The zoonoses are particularly endemic in sheep-raising countries and are also endemic in Iran. Typical symptoms that may be associated with fascioliasis can be divided by phases of the disease, including the acute or liver phase, the chronic or biliary phase, and ectopic or pharyngeal fascioliasis. Cholestatic symptoms may be absent, and in some cases diagnosis and treatment may be preceded by a long period of abdominal pain, eosinophilia and vague gastrointestinal symptoms. We report a case with epigastric and upper quadrant abdominal pain for the last 4 years, with imaging suggesting cholangiocarcinoma. Considering a new concept of endoscopic ultrasonography, at last F. hepatica was extracted with endoscopic retrograde cholangiography.