1/10. Chronic intestinal lymphocytic microphlebitis.The authors report two cases of a peculiar microphlebitis of the intestines, similar to that described by Saraga and Costa quite recently [5]. The patients had undergone hemicolectomy because of evolving ileus caused by cecal polyps or lipohyperplasia, respectively. Pseudomembranous-ulcerative inflammation of the cecum and variously intense lymphocytic infiltrates of numerous small submucosal veins and venules of the intestines were found in both cases. thrombosis occurred very rarely in the affected vessels, although sometimes it was found in deeper and larger veins. arteries, lymphatics, mesenterial veins and lymph nodes were normal. Parts of the distal ileum and ascending colon displayed the phlebitic changes without mucosal alterations. The authors hypothesize that it was not the abnormal local circulation, but some hitherto not fully clarified immunological disorder that resulted in the disease. In contrast to the claim of Saraga and Costa [5], it is suggested that thrombosis of the small veins does not have a significant role in the development of the lesions, but a complex process that includes the entry of antigens via the altered mucosa followed by an immunogenic inflammatory response of the small veins is responsible for the pathogenesis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/10. clostridium difficile-associated reactive arthritis in two children.In adults, reactive arthritis (ReA) following clostridium difficile-enterocolitis has been documented. In children, only one case of C. difficile-associated ReA has been reported. We now describe two other cases of ReA associated with C. difficile in children. The characteristics of ReA due to C. difficile appear to be similar in adults and children. Both children show polyarthritis after an episode of diarrhoea with positive stool cultures for C. difficile. arthritis is asymmetrical with a self-limiting course. Nonsteroidal antiinflammatory drug (NSAID) therapy is sufficient. One case is remarkable because of its prolonged course of ReA despite NSAID therapy, and its association with the presence of hla-b27 antigen.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/10. coinfection with giardia lamblia and clostridium difficile after use of ranitidine.A 49-year-old man presented with a 3-week history of vomiting and diarrhea. He reported foamy stools but no blood or melena and had crampy epigastric pain. He denied usage of antibiotics. He had been taking ranitidine for intermittent epigastric pain for the last few months and noted an 11-pound weight loss during the 3 weeks before admission. Stool was positive for clostridium difficile toxin and giardia lamblia antigen. Cultures and occult blood tests were negative. Oral metronidazole, 500 mg 3 times a day, was administered, and the patient was hydrated. The diarrhea resolved, and patient was discharged on the fourth hospital day. Prior antibiotic therapy is the most common risk factor for C difficile colitis. This patient developed concomitant infection with C difficile and G lamblia while he used ranitidine. He had no other risk factors for these infections. Hence, we propose that ranitidine-induced hypochlorhydria predisposed this patient to the enteric infections.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/10. Intravascular haemolysis in association with necrotising enterocolitis.Severe haemolysis is an unusual occurrence in association with necrotising enterocolitis (NEC). Activation of the Thomsen-Friedenreich (T) antigen on the neonatal erythrocytes is proposed as the mechanism. This haemolytic process is precipitated by transfusion with serum-containing blood products, which should therefore be avoided. Once haemolysis has become established the outcome is usually fatal. This report describes the management of four neonates who had established haemolysis complicating severe NEC. T activation was confirmed in two infants, but could not be tested for in the other two. Exchange transfusion abolished the haemolysis in two patients, who survived. Despite reduced use of blood products the other two infants died. We believe that exchange transfusion was essential in the successful management of the infants who survived, and recommend early exchange transfusion when haemolysis complicates NEC.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/10. Naturally occurring anti-Kell stimulated by E. coli enterocolitis in a 20-day-old child.Anti-A and anti-K have been found in the serum of a 20-day-old child who had not been transfused but who was acutely ill with E. coli enterocolitis. Both antibodies are IgM proteins. The mother's serum does not contain either antibody and the anti-A and anti-K in the infant's serum are not of maternal origin. Both parents and the child are of the Kell phenotype K-k . Stool cultures made from the child yielded E. coli O 125:B15, an uncommon B-variant pathogenic coliform. Cell-free preparations made from broth cultures of this organism have strong specific inhibitory activity against IgM anti-A and anti-K, and both antigens have been identified on the bacterial cells. At age 3 months the child had made a clinical recovery, stool cultures showed no pathogenic coliforms, and anti-A and anti-K were no longer detectable in her serum. These data indicate that absorption of metabolites with A-like and K-like activity produced by a pathogenic coliform in the intestinal tract were responsible for the appearance of apparent naturally occurring anti-A and anti-K in the child's serum.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/10. Acute oligoarthritis associated with clostridium difficile pseudomembranous colitis.The abrupt onset of a sterile inflammatory oligoarthritis developed in a patient with active clostridium difficile pseudomembranous colitis. The arthritis affected a hip and a knee. Leukocyte counts of synovial fluid obtained from the patient's left hip and knee were elevated. He was haplotyped as hla-b27 antigen-positive. The colitis and arthritis promptly abated after treatment with oral vancomycin hydrochloride. Three other cases of arthritis associated with antibiotic-induced colitis were reviewed. It seems as if treatment of the colitis leads to resolution of the arthritis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/10. enterocolitis complicating chrysotherapy. Case report and review of the literature.We report a case of a 71-yr old man with seronegative rheumatoid arthritis, who developed severe enterocolitis during gold therapy. Radiological studies, endoscopy and biopsies showed diffuse involvement of the stomach, duodenum and small and large intestines. The clinical course was prolonged and complicated by multiple infections. Of the 10 cases with chrysotherapy-induced enterocolitis reported in the literature, 3 were from israel. There may be a relationship between the development of enterocolitis following gold therapy, ethnic group and HLA-B8 and DRw3 antigens.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/10. Reactive arthritis associated with clostridium difficile pseudomembranous colitis.Reactive arthritis is associated with several gastrointestinal pathogens, particularly shigella, salmonella, campylobacter, and yersinia. Another, less well recognized bowel infection leading to reactive arthritis is pseudomembranous colitis, caused by clostridium difficile. An illustrative case is presented, and the clinical features and characteristics of all reported patients with this association are reviewed. The pathogenesis of the reactive arthritis seems to be related to an immunological response in joints and other tissues against bacterial antigens, which gain access to the systemic circulation through increased intestinal permeability. Therapy with nonspecific antiinflammatory drugs, anticlostridial agents, or a combination of the above is effective. Despite the possibility of persistent articular involvement after gastrointestinal symptoms have subsided, the long-term prognosis seems to be excellent.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/10. A fatal case of necrotizing enterocolitis in a neonate with polyagglutination of red blood cells.An infant of 30 weeks gestation developed necrotizing enterocolitis (NEC) 8 days after birth and died 2 days later after a fulminating course. During her illness she received two blood transfusions, both of which produced sub-optimal rises in her haemoglobin and were associated with evidence of haemolysis. Retrospective analysis demonstrated T antigen (Tk) polyagglutination of the infant's red blood cells and donor plasma. Although bacterial cultures were negative throughout the course of the illness in this case, T antigen exposure is associated with certain anaerobic infections and with severity of NEC. Infants with NEC should be regularly screened for T antigen exposure and if this test is positive, plasma (immunoglobulin) containing infusions should be avoided.- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
10/10. Bacterial-induced activation of erythrocyte T-antigen complicating necrotising enterocolitis: a case report.Erythrocyte Thomsen-Friedenreich crypt antigen (T-antigen) activation is not an uncommon event in infants with severe necrotising enterocolitis (NEC). Transfusion of these infants with blood products containing plasma carries the risk of causing intravascular haemolysis. T-antigen activation is easily detected using a rapid simple lectin agglutination test. Early recognition of T-antigen activation ensures the correct choice of plasma free transfusion therapy. We describe an infant with severe NEC complicated by T-antigen activation and haemolysis.- - - - - - - - - - ranking = 9keywords = antigen (Clic here for more details about this article) |
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