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Strnisa L, Plut S, Golob S, Gavric A. Endoscopic resection of a large symptomatic duodenal lipoma. Gastroenterol Hepatol 2024; 47:384-386. [PMID: 36965578 DOI: 10.1016/j.gastrohep.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/27/2023]
Affiliation(s)
- Luka Strnisa
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Samo Plut
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Sasa Golob
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Aleksandar Gavric
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia.
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Gavric A, Krajc M, Strnisa L, Gavric AU, Plut S. MSH3-related adenomatous polyposis in a patient with the negative family history of colorectal polyps. Gastroenterol Hepatol 2024; 47:397-400. [PMID: 37597744 DOI: 10.1016/j.gastrohep.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/02/2023] [Accepted: 08/14/2023] [Indexed: 08/21/2023]
Abstract
Recently, biallelic MSH3 germline pathogenic/likely pathogenic variants have been recognized as a rare cause of adenomatous polyposis. We present a 49-year-old woman who was admitted to our high-risk colorectal cancer clinic after incidental detection of a biallelic MSH3 (likely) pathogenic variant when tested for the germline (likely) pathogenic variants in hereditary breast and ovarian cancer related genes. The focus of this case report is to describe the genotype and phenotype of our patient with MSH3-related adenomatous polyposis. More than half of the polyps (13/19) were located in the right colon. In addition, benign and malignant extraintestinal lesions may be common as our patient had simple liver and kidney cysts and two basal cell skin carcinomas.
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Affiliation(s)
- Aleksandar Gavric
- Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
| | - Mateja Krajc
- Department of Clinical Cancer Genetics, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Luka Strnisa
- Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ana Ursula Gavric
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Samo Plut
- Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Affiliation(s)
- Martin Zaplotnik
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Samo Plut
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Strnisa
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Aleksandar Gavric
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
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Drobne D, Kurent T, Golob S, Svegl P, Rajar P, Terzic S, Kozelj M, Novak G, Smrekar N, Plut S, Sever N, Strnisa L, Hanzel J, Brecelj J, Urlep D, Osredkar J, Homan M, Orel R, Stabuc B, Ferkolj I, Smid A. Success and safety of high infliximab trough levels in inflammatory bowel disease. Scand J Gastroenterol 2018; 53:940-946. [PMID: 29987967 DOI: 10.1080/00365521.2018.1486882] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE A prospective trial suggests target infliximab trough levels of 3-7 μg/mL, yet data on additional therapeutic benefits and safety of higher trough levels are scarce. AIM To explore whether high infliximab trough levels (≥7 μg/mL) are more effective and still safe. MATERIAL AND METHODS In this cohort study of 183 patients (109 Crohn's disease and 74 ulcerative colitis) on infliximab maintenance treatment at a tertiary referral center we correlated fecal calprotectin and C-reactive protein to trough levels (426 samples) at different time points during treatment. Rates of infections were compared in quadrimesters (four-month periods) with high trough levels to quadrimesters with trough levels <7 μg/mL during 420 patient-years. RESULTS Fecal calprotectin and C-reactive protein (median [interquartile range]) were lower in patients with high trough levels (fecal calprotectin 66 mg/kg [30-257]; C-reactive protein 3 mg/L [3-3]) compared to trough levels below 7 μg/mL (fecal calprotectin 155 mg/kg [72-474]; C-reactive protein 3 mg/L [3-14.5]) (p < .001). High trough levels were superior also after excluding samples with trough levels <3 μg/mL from analysis. No differences in rates of infections were observed in quadrimesters with high trough levels (16/129 [12.4%]) compared to quadrimesters with trough levels <7 μg/mL (32/344 [9.3%]) (p = .32). Maintaining high trough levels resulted in 32% (interquartile range: 2-54%) increase of infliximab consumption. CONCLUSION High infliximab trough levels provide better control of inflammation in inflammatory bowel disease without increasing the risk of infection.
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Affiliation(s)
- David Drobne
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.,b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Tina Kurent
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Sasa Golob
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Polona Svegl
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Polona Rajar
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Sara Terzic
- c Department of Infectious Diseases , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Matic Kozelj
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Gregor Novak
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Natasa Smrekar
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Samo Plut
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.,b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Nejc Sever
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Luka Strnisa
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.,b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Jurij Hanzel
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Jernej Brecelj
- b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia.,d Department of Gastroenterology Hepatology and Nutrition , Children's Hospital University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Darja Urlep
- d Department of Gastroenterology Hepatology and Nutrition , Children's Hospital University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Josko Osredkar
- e Clinical Institute of Clinical Chemistry , Biochemistry University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Matjaz Homan
- b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia.,d Department of Gastroenterology Hepatology and Nutrition , Children's Hospital University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Rok Orel
- b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia.,d Department of Gastroenterology Hepatology and Nutrition , Children's Hospital University Medical Centre Ljubljana , Ljubljana , Slovenia
| | - Borut Stabuc
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.,b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Ivan Ferkolj
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.,b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia
| | - Alojz Smid
- a Department of Gastroenterology , University Medical Centre Ljubljana , Ljubljana , Slovenia.,b Medical Faculty , University of Ljubljana , Ljubljana , Slovenia
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