Mesenteric panniculitis presenting as liver dysfunction

Mesenteric Panniculitis Can Be Diagnosed by Examination and Cured by Comprehensive Therapy

Mesenteric panniculitis is a rare, slowly progressive, benign, and chronic fibrous inflammatory disease that affects the adipose tissue of the mesentery. In the present study, we aim to investigate its clinical presentations, computed tomography/sonography scan features, effectiveness of the treatment, and overall prognosis. We investigated various presentations, etiologies, diagnostic approaches, potential treatment modalities, and overall prognosis of mesenteric panniculitis. We present one case of mesenteric panniculitis with abdominal pain, which underwent steroid treatment regimens subsequently and gained weight moderately. An abdomen and pelvis cavity computed tomography scan showed misty mesentery, an ill-defined increase in the density of the peritoneal fat at the base of the mesentery with few small associated lymph nodes. The appearance is that of a panniculitis. His symptoms gradually decreased in intensity and disappeared totally within 1 month after oral prednisone 40 mg per day and moderate gain weight. Computed tomography scan features of the disease have recently been delineated clearly. Standard treatment strategy does not exist, and the current ways mainly consist of immunosuppressor or anti-inflammation agents. Overall prognosis is usually good and recurrence seems to be rare.

Lactose malabsorption testing in daily clinical practice: a critical retrospective analysis and comparison of the hydrogen/methane breath test and genetic test (c/t-13910 polymorphism) results

The aim of this study was to establish a retrospective evaluation and comparison of the hydrogen/methane (H2/CH4) breath test and genetic test (C/T-13910 polymorphism) results in lactose malabsorption testing. In total 263 consecutive patients with suspected lactose malabsorption were included in this study. They underwent the H2/CH4 breath test following the ingestion of 50 g lactose and were tested for the C/T-13910 polymorphism. In total 51 patients (19.4%) had a C/C-13910 genotype, indicating primary lactose malabsorption. Only 19 patients (7.2%) also had a positive H2/CH4 breath test. All in all 136 patients (51.69%) had a C/T-13910 and 76 patients (28.91%) a T/T-13910 genotype, indicating lactase persistence. Four patients (1.5%) with the C/T-13910 genotype and one patient (0.4%) with the T/T-13910 genotype had a positive H2/CH4 breath test result, indicating secondary lactose malabsorption. Cohen's Kappa measuring agreement between the two methods was 0.44. Twenty patients (7.6%) with a positive H2/CH4 peak within 60 minutes after lactose ingestion were classified as patients with lactose-dependent small intestinal bacterial overgrowth (SIBO). In conclusion, only moderate agreement between the breath test and the genetic test was shown. Secondary lactose malabsorption as well as preanalytical limitations of the combined H2/CH4 breath test procedure can cause discrepant results. This trial is registered with K-42-13.

Is the observed association between dairy intake and fibroids in African Americans explained by genetic ancestry?

Uterine leiomyomata are a major source of gynecological morbidity and are 2-3 times more prevalent in African Americans than European Americans. In an earlier report, we found that dairy intake was inversely associated with uterine leiomyomata among African Americans. Because African Americans are more likely to have lactose intolerance and avoid dairy products, the observed association might have been confounded by genetic ancestry. This report reevaluates the dairy-uterine leiomyomata association after accounting for genetic ancestry among 1,968 cases and 2,183 noncases from the Black Women's Health Study (1997-2007). Dairy intake was estimated by using food frequency questionnaires in 1995 and 2001. Percent European ancestry was estimated by using a panel of ancestry informative markers. Incidence rate ratios and 95% confidence intervals were estimated by using Cox regression, with adjustment for potential confounders and percent European ancestry. Incidence rate ratios comparing 1, 2, 3, and ≥4 servings/day with <1 serving/day of dairy products were 0.95 (95% confidence interval (CI): 0.85, 1.06), 0.75 (95% CI: 0.61, 0.92), 0.77 (95% CI: 0.57, 1.04), and 0.59 (95% CI: 0.41, 0.86), respectively (Ptrend = 0.0003). These effect estimates were similar to those obtained without control for ancestry. The findings suggest that the observed inverse association between dairy consumption and uterine leiomyomata in African Americans is not explained by percent European ancestry.