1
|
Bioinformatics Analysis of Immune Cell Infiltration and Diagnostic Biomarkers between Ankylosing Spondylitis and Inflammatory Bowel Disease. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2023; 2023:9065561. [PMID: 36643579 PMCID: PMC9836798 DOI: 10.1155/2023/9065561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/09/2022] [Accepted: 11/26/2022] [Indexed: 01/07/2023]
Abstract
Background Ankylosing spondylitis (AS) and inflammatory bowel disease (IBD) are both autoimmune diseases, and they often occur together in clinical practice, but the pathogenesis is unclear. This study is aimed at identifying the hub genes and explore the related immune molecular mechanisms between AS and IBD by bioinformatics analysis. Methods From the public Gene Expression Omnibus (GEO) database, the AS and IBD datasets (GSE73754, GSE59071, GSE25101, and GSE36807) were obtained. The immune cell infiltration in the peripheral blood tissues of GSE73754 and GSE59071 was assessed using the CIBERSORT algorithm. Then, we used the Weighted Gene Coexpression Network Analysis (WGCNA) to identify the Differentially Expressed Genes (DEGs) related to AS and IBD. Then, the immune genes from the ImmPort database intersected with the DEGs to obtain hub genes. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyzed the functional correlation of hub genes. Then, hub genes were verified in GSE25101 and GSE36807. The clusterProfiler software and Gene Set Enrichment Analysis (GSEA) were used to conduct functional enrichment and pathway enrichment studies. Finally, the diagnostic efficacy was assessed using Receiver Operating Characteristic (ROC) curve analysis. Results The analysis of immune characteristics showed that both AS and IBD were related to immunity, and neutrophils were positively correlated in both diseases. Nine coexpressed genes, including FCGRT, S100A11, IFNGR1, NFKBIZ, JAK2, LYN, PLAUR, ADM, and IL1RN, were linked to immune cells. The GO and KEGG analyses results showed that enrichment analysis was mainly related to cell transport and migration. Finally, the ROC curve was verified with the validation set, and it was found that PLAUR has clinical diagnostic significance and the most excellent specificity and sensitivity, respectively. Conclusions PLAUR (uPAR) is a promising biomarker and will be an underlying genetic biomarker for diagnosing AS comorbid IBD. Inflammation and immunological modulation mediated by neutrophil infiltration were important in the development of AS and IBD and may be diagnostic and therapeutic targets.
Collapse
|
2
|
Otieno SB, Altahan A, Karri S, Kaweeta F, Lands L, Weir A. CIN or not: An approach to the evaluation and management of chronic idiopathic neutrophilia. Blood Rev 2020; 46:100739. [PMID: 32811689 DOI: 10.1016/j.blre.2020.100739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
Abstract
Neutrophilia refers to an increase in the number of circulating neutrophils in the peripheral blood. Some common etiologies include infection, inflammatory conditions, myeloproliferative disorders, malignancies, endocrinopathies, drugs, and anemia. Rare disorders such as leukocyte adhesion deficiency can also cause neutrophilia. In many cases, there is an elevation of neutrophil count that persists for months or even years with no clear underlying cause in an otherwise asymptomatic patient. This is referred to as chronic idiopathic neutrophilia (CIN). Despite being a condition encountered by many physicians, there is a paucity of literature addressing CIN. Certain conditions such as stress, exercise, smoking, obesity, and obstructive sleep apnea have been associated with CIN and may provide explanations for neutrophilia previously thought to be idiopathic. Herein, we present a review of the literature on CIN and propose a systematic approach to this commonly encountered clinical condition.
Collapse
Affiliation(s)
- Steve Biko Otieno
- The University of Tennessee Health Science Center, Department of Hematology/Oncology, 19 S. Manassas, Memphis, TN 38103, USA; The Veterans Affairs Medical Center, 1030 Jefferson Ave, Memphis, TN 38104, USA; The West Cancer and Research Institute, 7945 Wolf River Blvd, Germantown, TN 38138, USA.
| | - Alaa Altahan
- The University of Tennessee Health Science Center, Department of Hematology/Oncology, 19 S. Manassas, Memphis, TN 38103, USA; The Veterans Affairs Medical Center, 1030 Jefferson Ave, Memphis, TN 38104, USA; The West Cancer and Research Institute, 7945 Wolf River Blvd, Germantown, TN 38138, USA.
| | - Saradasri Karri
- The University of Tennessee Health Science Center, Department of Hematology/Oncology, 19 S. Manassas, Memphis, TN 38103, USA; The Veterans Affairs Medical Center, 1030 Jefferson Ave, Memphis, TN 38104, USA; The West Cancer and Research Institute, 7945 Wolf River Blvd, Germantown, TN 38138, USA.
| | - Fnu Kaweeta
- The University of Tennessee Health Science Center, Department of Hematology/Oncology, 19 S. Manassas, Memphis, TN 38103, USA; The Veterans Affairs Medical Center, 1030 Jefferson Ave, Memphis, TN 38104, USA; The West Cancer and Research Institute, 7945 Wolf River Blvd, Germantown, TN 38138, USA.
| | - Lindsey Lands
- The University of Tennessee Health Science Center, Department of Hematology/Oncology, 19 S. Manassas, Memphis, TN 38103, USA; The Veterans Affairs Medical Center, 1030 Jefferson Ave, Memphis, TN 38104, USA.
| | - Alva Weir
- The University of Tennessee Health Science Center, Department of Hematology/Oncology, 19 S. Manassas, Memphis, TN 38103, USA; The Veterans Affairs Medical Center, 1030 Jefferson Ave, Memphis, TN 38104, USA; The West Cancer and Research Institute, 7945 Wolf River Blvd, Germantown, TN 38138, USA.
| |
Collapse
|
3
|
Adeniyi OF, Odeghe E, Olatona FA, Lawal M, Onywekwelu VI, Akinbolagbe YO, Ikobah JM. Inflammatory Bowel Disease in Children: Experience and Constraints in a Resource-limited Setting. Cureus 2020; 12:e7848. [PMID: 32483499 PMCID: PMC7253077 DOI: 10.7759/cureus.7848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: Inflammatory bowel disease (IBD), though well described in the Caucasian population, is rarely encountered in the black African children. The aim of this study was to increase the awareness of this emerging condition in African children and highlight the constraints of management in a resource-limited setting like Nigeria. Methods: This study included an audit of children with IBD who were seen between January 2015 and February 2020 at the Lagos University Teaching Hospital (LUTH). The clinical records of children aged one to 16 years who presented with recurrent abdominal pain, weight loss, and gastrointestinal (GI) bleeding with clinical suspicion of IBD were reviewed. Clinical features, endoscopic findings, histopathologic findings, and treatment were documented. Results: Eight children with IBD were seen during the study period. The median age was 12.0 years (range: five to 15 years). The most common reported concerns in the children were chronic abdominal pain [seen in four patients (50%)] and bloody diarrhea [seen in three patients (42.30%)]. Weight loss and arthritis were seen in three (37.5%) and one (12.5%) children, respectively. Endoscopy confirmed two cases of Crohn’s disease (CD), three cases of ulcerative colitis (UC), and three cases of indeterminate colitis (IC). The children with CD were treated with steroids and exclusive enteral nutrition, with one patient receiving methotrexate, while the UC and IC patients received 5-aminosalicylate therapy. Conclusion: Although IBD is uncommon in Nigeria, a high index of suspicion is vital to enable early diagnosis and appropriate treatment. Management in the African setting is severely constrained by limited access to endoscopy facilities and nonavailability of other effective treatment options such as biologic agents.
Collapse
Affiliation(s)
- Oluwafunmilayo F Adeniyi
- Pediatrics/Gastroenterology, College of Medicine, University of Lagos, Lagos, NGA.,Pediatrics/Gastroenterology, Lagos University Teaching Hospital, Lagos, NGA
| | - Emuobor Odeghe
- Gastroenterology, University of Lagos and Lagos University Teaching Hospital, Lagos, NGA
| | - Foluke A Olatona
- Community Medicine and Primary Care, College of Medicine, University of Lagos, Lagos, NGA
| | - Mary Lawal
- Pediatrics, Lagos University Teaching Hospital, Lagos, NGA
| | | | - Yeside O Akinbolagbe
- Pediatrics, College of Medicine, University of Lagos, Lagos, NGA.,Pediatrics, Lagos University Teaching Hospital, Lagos, NGA
| | - Joanah M Ikobah
- Pediatrics/Pediatric Gastroenterology, Hepatology and Nutrition Division, University of Calabar/University of Calabar Teaching Hospital, Calabar, NGA
| |
Collapse
|
4
|
Mărginean CO, Meliţ LE, Grigorescu G, Puiac C, Simu I. Hypercalcemia, an Important Puzzle Piece in Uncommon Onset Pediatric Sarcoidosis-A Case Report and a Review of the Literature. Front Pediatr 2020; 8:497. [PMID: 32984210 PMCID: PMC7479091 DOI: 10.3389/fped.2020.00497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022] Open
Abstract
Sarcoidosis (SD) is a systemic granulomatous condition that is especially encountered in young adults and rarely in children, affecting predominantly the lungs and lymph nodes. We report the case of a 14-year-old teenage boy admitted to our clinic for nausea, vomiting, and weight loss. Clinical examination at the time of admission revealed malaise, pallor, and abdominal tenderness in the epigastric area at palpation. Laboratory tests revealed an elevated level of hemoglobin, mild thrombocytosis, increased erythrocyte sedimentation rate, and a mild increase in creatinine and urea levels along with hypercalcemia. An abdominal ultrasound revealed a right ectopic kidney, whereas the upper digestive endoscopy showed intense hyperemia and edema of the gastric mucosa. Thoracic computed tomography scan revealed giant hilar and mediastinal lymphadenopathy, along with multiple micronodules within the lung parenchyma and ground-glass aspect. The level of angiotensin-converting enzyme was high, parathormone was normal, and vitamin D level was low. Pathological examination of the bronchial, mediastinal, and lung biopsies established the diagnosis of SD. We administered oral corticosteroids for 2 months with outstandingly favorable outcome and no signs of recurrence 6 months after the cessation of the therapy.
Collapse
Affiliation(s)
- Cristina Oana Mărginean
- Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
| | - Lorena Elena Meliţ
- Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
| | - Gabriel Grigorescu
- Pneumology Clinic, County Emergency Hospital Târgu Mureș, Târgu Mureș, Romania
| | - Claudiu Puiac
- Department of Emergency Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
| | - Iunius Simu
- Department of Radiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Târgu Mureș, Romania
| |
Collapse
|
5
|
Abstract
RATIONALE Extremes of age is an important risk factor for the development of coronary arteries aneurysms (CAAs) associated to Kawasaki disease (KD) along with male gender, prolonged fever and a delay in diagnosis or treatment. PATIENT CONCERNS We report two cases of KD in the extremes of age, a 5-month-old male infant and a 9-year-old child in order to underline the features of this disorder outside the typical age range of 1 to 4 years. The 5-month-old male was admitted in our clinic for generalized polymorphous exanthema and fever for approximately 7 days. The laboratory test pointed out leukocytosis and increased inflammatory biomarkers. The 9-year-old male child was admitted in our clinic for fever and submandibular adenopathy. The onset was approximately 5 days before the admission with a sudden development of unilateral, painless, submandibular lymphadenopathy for which the ENT specialist recommended antibiotics and nonsteroid anti-inflammatory drugs. In the 2nd day of admission, he presented severe desquamation of hands and soles. DIAGNOSIS Both cases were diagnosed with KD. The echocardiography showed no cardiac impairment in the infant, while in the older patient it revealed mild dilation of the left coronary artery. INTERVENTIONS Both patients received intravenously immunoglobulin and pulsed methylprednisolone. OUTCOMES The evolution was favorable in both cases, but in the infant, the C-reactive protein levels persisted mildly elevated for approximately 2 months after the diagnosis. LESSONS The peculiarities of KD in the extremes of age are related to a higher frequency of incomplete features and an increased incidence of coronary artery lesions resulting in a delay of the diagnosis, and subsequent poorer outcomes.
Collapse
Affiliation(s)
| | | | - Maria Oana Mărginean
- Department of Paediatric, University of Medicine, Pharmacy, Sciences and Technology of Târgu Mures, Gheorghe Marinescu Street No. 38, Târgu Mures 540136, Romania
| |
Collapse
|
6
|
Mărginean CO, Meliţ LE, Patraulea F, Iunius S, Mărginean MO. Early onset Peutz-Jeghers syndrome, the importance of appropriate diagnosis and follow-up: A case report. Medicine (Baltimore) 2019; 98:e16381. [PMID: 31277194 PMCID: PMC6635162 DOI: 10.1097/md.0000000000016381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Peutz-Jeghers syndrome (PJS) is currently defined as an inherited condition, also called a familial hamartomatous polyposis syndrome, characterized by the association between pigmented mucocutaneous lesions and hamartomatous polyps in the gastrointestinal tract, especially in the small bowel. PATIENT CONCERNS We present the case of a 7-year-old male patients, diagnosed at the age of 3 years with PJS due to a surgical intervention for acute abdominal pain that revealed a rectal polyp associated with hyperpigmented maculae on the lips and oral mucosa. His family history revealed the same condition in his mother, who was diagnosed much later, at the age of 25 years. DIAGNOSES The upper and lower digestive endoscopy revealed multiple polyps of different sizes within the stomach, and 2 polyps at 5 cm from the anal orifice. The barium enterography revealed 3 polyps within the ileum. INTERVENTIONS We administered blood transfusions and both recto-anal polyps were surgically removed. OUTCOMES The outcome was favorable and the patient was discharged with the recommendations for clinical assessment at least every 6 months, annual laboratory tests, but also follow-up of the detected polyps and screening by upper digestive endoscopy, barium enterography and colonoscopy every 2 years. LESSONS Early onset of PJS presenting with polys is quite rare since they require time for their development manifesting usually after the first decade of life. Close monitoring is essential for PJS in order to prevent potential complications and early detect the development of related malignancies.
Collapse
Affiliation(s)
| | - Lorena Elena Meliţ
- Department of Pediatrics I, University of Medicine, Pharmacy, Sciences and Technology
| | | | | | - Maria Oana Mărginean
- Department of Pediatrics III, University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureş, Romania
| |
Collapse
|
7
|
Mărginean CO, Mărginean C, Chinceşan M, Mărginean MO, Meliţ LE, Săsăran V, Mărginean CD. Pediatric ovarian tumors, a challenge for pediatrician and gynecologist: Three case reports (CARE compliant). Medicine (Baltimore) 2019; 98:e15242. [PMID: 31008957 PMCID: PMC6494269 DOI: 10.1097/md.0000000000015242] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Ovarian or adnexal tumors are very rare in patients below the age of 18 years, most of them being functional cysts, only 10% being malignant. We report 3 cases of ovarian tumors with the aim of revealing the particularities regarding the diagnosis and management of benign and malignant ovarian tumors in pediatric patients. PATIENT CONCERNS The 1st case, a 9-year-old girl presented for diffuse abdominal pain, distended abdomen and rapid increase in abdominal volume. The 2nd case describes a 13-year-old female patient admitted for acute abdominal pain and nausea, and the 3rd one was an 18-year-old female teenager who presented for distended abdomen, intermittent diffuse abdominal pain and rapid increase in abdomen volume. DIAGNOSES The abdominal ultrasound revealed in all 3 patients suggestive signs for ovarian tumors. INTERVENTIONS The 1st patient underwent laparotomy with adnexectomy, and the histopathological exam showed the diagnosis of dysgerminoma. The 2nd patient underwent laparoscopy with adnexectomy, and the histopathological exam revealed a borderline tumor. The 3rd patient benefited by a laparotomy with left ovariectomy, and the histopathological exam pointed out a mature teratoma. OUTCOMES The outcome was favorable in all 3 cases, but the patients with dysgerminoma and mature teratoma were further referred to the oncologist for proper assessment. LESSONS Laparoscopy may represent the first choice for uncomplicated ovarian masses. The diagnosis and the therapeutic plan must be based on symptoms, pelvic ultrasound, the time of menarche and the potential serum markers.
Collapse
|
8
|
Mărginean CO, Meliţ LE, Gozar H, Horvath E, Mărginean CD. Atypical onset of total colonic Hirschsprung disease in a small female infant: A case report. Medicine (Baltimore) 2018; 97:e12315. [PMID: 30235683 PMCID: PMC6160117 DOI: 10.1097/md.0000000000012315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Hirschsprung disease (HD) or colonic aganglionosis is a congenital disorder, which results from the abnormal migration of neuronal cells of the neural crest leading to a disorder of the enteric nervous system consisting in the absence of ganglion cells within the submucosal and myenteric plexus. PATIENT CONCERNS We report the case of a 7-month-old female infant admitted in our clinic for constipation and failure to thrive. At the age of 6 months, she was examined in our clinic for the same reasons, and we recommended symptomatic treatment without improvements. The clinical examination revealed pallor of the skin and mucosa, distended abdomen, and abdominal tenderness at palpation. DIAGNOSES The abdominal ultrasound showed abdominal bloating, and the barium enema was normal. The patient's evolution worsened progressively within the following 3 days after admission associating sings of toxic megacolon. INTERVENTIONS She underwent a surgical intervention with total colectomy and ileostomy, and the final diagnosis confirmed by the histological examination was of total colonic aganglionosis (TCA). OUTCOMES The evolution immediately after the surgery and the follow-up examination after approximately 3 months pointed out normal weight gain and the laboratory tests were within normal limits. LESSONS TCA can also manifest in older infants. Barium enemas can guide the diagnosis in most cases of HD. Nevertheless, in patients with TCA, it can be normal. Moreover, it could represent a trigger for toxic megacolon.
Collapse
|
9
|
Yu T, Yu Q, Chen X, Zhou L, Wang Y, Yu C. Exclusive enteral nutrition protects against inflammatory bowel disease by inhibiting NF‑κB activation through regulation of the p38/MSK1 pathway. Int J Mol Med 2018; 42:1305-1316. [PMID: 29901086 PMCID: PMC6089761 DOI: 10.3892/ijmm.2018.3713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 05/30/2018] [Indexed: 12/28/2022] Open
Abstract
Although enteral nutrition therapy for inflammatory bowel disease has been confirmed to be an effective treatment method, the exact mechanism responsible for the effects of enteral nutrition remains unclear. The aim of the present study was to investigate the protective effect of exclusive enteral nutrition (EEN) against colitis, and to elucidate the potential mechanisms by inhibiting p65 activation via regulating the p38/mitogen‑ and stress‑activated protein kinase‑1 (MSK1) pathway. Experiments were performed by establishing dextran sulfate sodium (DSS)‑mice colitis and picrylsulfonic acid solution (TNBS)‑induced rat colitis, and the results demonstrated that EEN treatment attenuated body weight loss, colon length shortening and colonic pathological damage caused by colitis. EEN also inhibited inflammatory cells infiltration and decreased myeloperoxidase and inducible nitric oxide synthase activities. Furthermore, EEN significantly reduced the production of pro‑inflammatory mediators in serum and the colon. Mechanically, EEN suppressed activation of p65 by inhibiting the p38/MSK1 pathway. In conclusion, the present study demonstrated that EEN attenuated DSS‑ and TNBS‑induced colitis by inhibiting p65 activation via regulating the p38/MSK1 pathway, thus suggesting that EEN is effective in the treatment of colitis.
Collapse
Affiliation(s)
- Ting Yu
- Department of Gastroenterology, Gulou School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Qian Yu
- Department of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, P.R. China
| | - Xiaotian Chen
- Department of Gastroenterology, Gulou School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Lixing Zhou
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, P.R. China
| | - Yuming Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, P.R. China
| | - Chenggong Yu
- Department of Gastroenterology, Gulou School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| |
Collapse
|
10
|
Boeing T, de Souza P, Bonomini TJ, Mariano LNB, Somensi LB, Lucinda RM, Malheiros A, da Silva LM, Andrade SFD. Antioxidant and anti-inflammatory effect of plumieride in dextran sulfate sodium-induced colitis in mice. Biomed Pharmacother 2018; 99:697-703. [DOI: 10.1016/j.biopha.2018.01.142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/21/2017] [Accepted: 01/28/2018] [Indexed: 11/26/2022] Open
|
11
|
Mǎrginean CO, Meliţ LE, Mǎrginean MO. Segmental Colitis Associated Diverticulosis-A Possible Diagnosis in Teenagers. Front Pediatr 2018; 6:168. [PMID: 29922640 PMCID: PMC5996823 DOI: 10.3389/fped.2018.00168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 05/21/2018] [Indexed: 01/19/2023] Open
Abstract
Segmental colitis associated with diverticulosis (SCAD) is manifested by active chronic inflammation of the colonic segments affected by diverticulosis, luminal-mucosal inflammation, independent of the presence of inflammation within and/or around the diverticula, and it usually spares the rectum. We present the case of a 15-year-old female admitted to our clinic due to lower digestive hemorrhage and abdominal pain in the previous week, associated with fever 1 day prior to admission. The patient had pallor, painful abdomen upon palpation, accelerated bowel movements, and macroscopic evidence of blood in the stools. Initial laboratory tests showed leukocytosis with neutrophilia, thrombocytosis, anemia, and elevated inflammatory biomarkers. Moreover, colonoscopy revealed multiple ulcerations, hemorrhage, and edema of the sigmoid colon; however, multiple orifices raised the suspicion of a colonic diverticulosis and this was later on confirmed through a barium enema. The histopathological examination pointed out signs of an active chronic inflammation and mucosal architectural changes associated with crypt abscesses, therefore suggesting the diagnosis of SCAD. The patient's prognosis was favorable; her condition improved following steroid and 5-aminosalicylate therapy, without any symptoms or recurrences at the 4 months follow-up. In conclusion, SCAD is a very rare disease entity that is usually confused with other inflammatory bowel conditions. Moreover, it has not been reported in the pediatric age group until now.
Collapse
Affiliation(s)
- Cristina O Mǎrginean
- Department of Pediatrics I, University of Medicine and Pharmacy of Tîrgu Mureş, Târgu Mureş, Romania
| | - Lorena E Meliţ
- Department of Pediatrics I, University of Medicine and Pharmacy of Tîrgu Mureş, Târgu Mureş, Romania
| | - Maria O Mǎrginean
- Department of Pediatrics I, University of Medicine and Pharmacy of Tîrgu Mureş, Târgu Mureş, Romania
| |
Collapse
|