Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Colo/efeitos dos fármacos , Doenças do Colo/induzido quimicamente , Diclofenaco/efeitos adversos , Mucosa Intestinal/efeitos dos fármacos , Úlcera/induzido quimicamente , Idoso de 80 Anos ou mais , Colo/diagnóstico por imagem , Colo/patologia , Doenças do Colo/diagnóstico , Doenças do Colo/tratamento farmacológico , Colonoscopia , Feminino , Compostos Férricos/uso terapêutico , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/patologia , Maltose/análogos & derivados , Maltose/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Úlcera/diagnóstico , Úlcera/tratamento farmacológicoAssuntos
Colestase Extra-Hepática/etiologia , Ducto Colédoco , Divertículo/complicações , Duodenopatias/complicações , Idoso de 80 Anos ou mais , Colangiopancreatografia por Ressonância Magnética , Colestase Extra-Hepática/diagnóstico por imagem , Colestase Extra-Hepática/terapia , Ducto Colédoco/diagnóstico por imagem , Tratamento Conservador , Divertículo/diagnóstico por imagem , Divertículo/terapia , Duodenopatias/diagnóstico por imagem , Duodenopatias/terapia , Feminino , Humanos , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND AND OBJECTIVES: Faecal calprotectin is a valuable noninvasive marker for inflammatory bowel disease (IBD). The aim of our study was to determine the correlation between six different calprotectin assays and compare their performance for diagnosis and follow up of IBD. METHODS: Thirty-one patients with suspected IBD and 31 patients in follow up were included. We determined calprotectin by means of three rapid immmunochromatographic tests, two enzyme-linked immunosorbent assays, and one automated fluoroimmunoassay. Results were correlated with endoscopic and histological findings. RESULTS: Although all methods correlated significantly, slopes and intercepts differed extensively, with up to 5-fold quantitative differences between assays. Sensitivity and specificity for diagnosis of IBD were 82-83 and 84-89%, respectively. For follow up, sensitivity in detecting mild ulcerative colitis was 71-100%. In moderate-to-severe ulcerative colitis, sensitivity was 100% for all assays. Specificity was 67-86% in both subgroups. In Crohn's disease, only moderate-to-severe disease could be differentiated from remission, with sensitivity 83-86% and specificity 75% for all tests. CONCLUSIONS: All calprotectin assays showed comparable clinical performance for diagnosis of IBD. For follow up, performance was acceptable, except for mild Crohn's disease. Because of the large quantitative differences, further efforts are needed to standardize calprotectin assays.
RESUMO
CMV colitis in an immunocompetent host is a rare occurrence. We report a case of CMV colitis after biliopancreatic diversion surgery. The diagnosis of primary CMV infection with CMV colitis was based on histological examination of tissues biopsies obtained at colonoscopy, serology positive for CMV-IgM and CMV-IgG antibodies and a good response to systemic gancyclovir treatment. Malnutrition and colonic mucosal damage, both consequences of biliopancreatic diversion surgery, were thought to be predisposing factors. To our knowledge this is the first report in the English language literature of an association between CMV colitis and status following biliopancreatic diversion surgery.
