Background: Many rheumatic diseases may cause gastrointestinal manifestations. The goal of this study was to analyze the prevalence and predictors of gastrointestinal involvement in patients with rheumatic disorders.
Methods: A retrospective chart review was performed for patients with systemic lupus erythematosus, rheumatoid arthritis, and sys- temic sclerosis who have consulted due to gastrointestinal symptoms. The relationship between clinical symptoms, gastroscopic/colo- noscopic findings, and histopathological results with current drugs and disease duration was evaluated.
Results: A total of 364 patients with rheumatic disorders and 740 people as control group were included in the study. Abdominal bloating followed by abdominal pain, regurgitation, and heartburn were reported as the main complaints by more than half of the patients. Most of the patients had gastric mucosal changes expressed as Lanza score, and the presence of major polypharmacy was the most important factor affecting Lanza score (odds ratio: 10, 95% CI: 1.882-54.111, P < .007) followed by disease duration (odds ratio: 1.559, 95% CI: 1.369-1.775, P < .001) and age (odds ratio: 1.069, 95% CI: 1.030-1.109, P < .001). In general, approximately 30% of the patients were posi- tive for Helicobacter pylori infection and 35% showed intestinal metaplasia in histopathological examination. Most of the colonoscopic findings were associated with colonic polyps (n = 81). In multivariate analysis, disease duration was the only factor that affected the pres- ence of colonic lesions (Area Under the Receiver Operating Characteristic (ROC) Curve (AUROC): 0.871, 95% CI: 0.824-0.918, P < .001).
Conclusion: Patients with rheumatologic diseases frequently have gastrointestinal manifestations. The most encountered gastrointes- tinal symptom was abdominal bloating, followed by abdominal pain. Being aware of gastrointestinal manifestations and their determi- nants may help physicians manage and follow patients with rheumatologic disorders.
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http://dx.doi.org/10.5152/tjg.2022.21780 | DOI Listing |
Haematologica
January 2025
Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati OH; University of Cincinnati College of Medicine, Cincinnati OH; Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati OH.
Over the past 40 years, the introduction and refinement of hydroxyurea therapy has led to remarkable progress for the care of individuals with sickle cell anemia (SCA). From initial small proof-of-principle studies to multi-center Phase 3 controlled clinical trials and then numerous open-label studies, the consistent benefits of once-daily oral hydroxyurea have been demonstrated across the lifespan. Elevated fetal hemoglobin (HbF) serves as the most important treatment response, as HbF delays sickle hemoglobin polymerization and reduces erythrocyte sickling.
View Article and Find Full Text PDFCureus
January 2025
Minimal Access Surgery, King's College Hospital NHS Foundation Trust, London, GBR.
Actinomycosis is a chronic, granulomatous infection caused by species, a group of anaerobic, gram-positive bacteria commonly found in the human oral cavity, gastrointestinal, and female genital tracts. Although it predominantly affects the cervicofacial region, rare manifestations such as gallbladder actinomycosis can occur. This report presents a case of gallbladder actinomycosis in a 61-year-old man who presented with a two-week history of right upper quadrant pain, jaundice, nausea, and vomiting.
View Article and Find Full Text PDFACG Case Rep J
January 2025
Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA.
While hematochezia is common in Crohn's disease (CD), severe gastrointestinal hemorrhage causing hemodynamic instability is rare. Strictures, another frequent complication, usually cause obstructive symptoms. We report the first case of hemorrhagic shock from ulcerated ileal strictures as the initial presentation of CD.
View Article and Find Full Text PDFCureus
December 2024
Private Practice and Research, American Dental Association, Penfield, USA.
Introduction The use of antibiotics such as oral clindamycin has been effective in treating bacterial infections. However, this medication often comes with significant side effects, particularly those affecting the gastrointestinal (GI) system. This study aims to evaluate the impact of different doses of clindamycin on GI health, specifically examining side effects like stomach upset, diarrhea duration, stomach pain, and recovery time.
View Article and Find Full Text PDFTher Adv Rare Dis
January 2025
Department of Pediatrics, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening systemic hyperinflammatory syndrome, rarely associated with bone marrow failure (BMF). Telomere biology disorders (TBD) are caused by inherited defects in telomerase processes and can have heterogeneous presentations including idiopathic pulmonary fibrosis, cirrhosis, and BMF. We report a case of a 10-year-old male from Lima, Peru, who presented with HLH as the initial manifestation of a TBD.
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