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Nadour Z, Rosenbaum B, Blons H, Loriot MA, Paul JL, Pallet N. [Clinical, biochemical and epidemiological features of macro-AST preceding inflammatory bowel disease diagnosis by several years]. Rev Med Interne 2023; 44:259-262. [PMID: 36958982 DOI: 10.1016/j.revmed.2023.03.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/05/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION An isolated elevation of aspartate aminotransferase (AST) is a diagnostic issue. Macro-aspartate aminotransferase (macro-AST) corresponds to the formation of complexes between AST and immunoglobulins. CASE REPORT We report the case of a patient with macro-AST identified several years before the onset of inflammatory bowel disease (IBD). A 6-year retrospective analysis in our laboratory identified only one case out of 42 540 adult patients. CONCLUSION The objective of this work is to increase awareness of this benign disorder among clinicians and biologists, as well as to aid in prescribing only the required tests.
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Affiliation(s)
- Z Nadour
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France.
| | - B Rosenbaum
- Service de gastroentérologie et endoscopie digestive, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - H Blons
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - M A Loriot
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - J-L Paul
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
| | - N Pallet
- Service de biochimie, hôpital européen Georges-Pompidou, assistance publique-hôpitaux de Paris (AP-HP), 75013 Paris, France
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Enea D, Lauwers G, Svrcek M. [Conventional and non-conventional dysplasia in patients with inflammatory bowel disease]. Ann Pathol 2023:S0242-6498(23)00049-4. [PMID: 36906454 DOI: 10.1016/j.annpat.2023.02.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 03/11/2023]
Abstract
Compared to the general population, patients with inflammatory bowel disease (IBD), both ulcerative colitis (UC) or Crohn's disease (CD), are at increased risk of developing some cancers, particularly colorectal cancers (CRC). CRCs, the vast majority of which are adenocarcinomas, develop from a precancerous lesion called dysplasia (or intraepithelial neoplasia) via an inflammation-dysplasia-adenocarcinoma sequence. The advancements of new endoscopic techniques, including visualisation and resection techniques, has led to a reclassification of dysplasia lesions into visible and invisible lesions and their therapeutic management, with a more conservative approach to the colorectal setting. In addition, besides conventional dysplasia, of intestinal phenotype, classically described in IBD, non-conventional dysplasias (as opposed to conventional dysplasia of intestinal phenotype) are now described, including at least seven subtypes. Recognition of these unconventional subtypes, which are still poorly known from pathologists, is becoming crucial, as some of these subtypes appear to be at high risk of developing advanced neoplasia (i.e. high-grade dysplasia or CRC). This review briefly describes the macroscopic features of dysplastic lesions in IBD, as well as their therapeutic management, followed by the clinicopathological features of these dysplastic lesions, with particular emphasis on the new subtypes of unconventional dysplasia, both from a morphological and molecular point of view.
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Affiliation(s)
- Diana Enea
- Sorbonne université, Assistance publique-Hôpitaux de Paris, hôpital Saint-Antoine, service d'anatomie et cytologie pathologiques, SIRIC CURAMUS, Paris, France
| | - Grégory Lauwers
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute and Departments of Pathology and Oncologic Sciences, University of South Florida, Tampa, FL, États-Unis
| | - Magali Svrcek
- Sorbonne université, Assistance publique-Hôpitaux de Paris, hôpital Saint-Antoine, service d'anatomie et cytologie pathologiques, SIRIC CURAMUS, Paris, France.
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Abstract
Since World War II, several factors such as an impressive industrial growth, an enhanced environmental bioavailability and intensified food consumption have contributed to a significant amplification of human exposure to aluminum. Aluminum is particularly present in food, beverages, some drugs and airbone dust. In our food, aluminum is superimposed via additives and cooking utensils. Therefore, the tolerable intake of aluminum is exceeded for a significant part of the world population, especially in children who are more vulnerable to toxic effects of pollutants than adults. Faced with this oral aluminum influx, intestinal tract is an essential barrier, especially as 38% of ingested aluminum accumulates at the intestinal mucosa. Although still poorly documented to date, the impact of oral exposure to aluminum in conditions relevant to real human exposure appears to be deleterious for gut homeostasis. Aluminum ingestion affects the regulation of the permeability, the microflora and the immune function of intestine. Nowadays, several arguments are consistent with an involvement of aluminum as an environmental risk factor for inflammatory bowel diseases.
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Affiliation(s)
- C Vignal
- Université de Lille, LIRIC UMR 995, 59000 Lille, France; Inserm, LIRIC UMR 995, 59000 Lille, France.
| | - P Desreumaux
- Université de Lille, LIRIC UMR 995, 59000 Lille, France; Inserm, LIRIC UMR 995, 59000 Lille, France; CHRU de Lille, LIRIC UMR 995, 59000 Lille, France
| | - M Body-Malapel
- Université de Lille, LIRIC UMR 995, 59000 Lille, France; Inserm, LIRIC UMR 995, 59000 Lille, France
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Aounallah A, Zerriaa S, Ksiaa M, Jaziri H, Boussofara L, Ghariani N, Mokni S, Saidi W, Sriha B, Belajouza C, Denguezli M, Nouira R. [Bowel-associated dermatosis-arthritis syndrome during ulcerative colitis: A rare extra-intestinal sign of inflammatory bowel disease]. Ann Dermatol Venereol 2016; 143:377-81. [PMID: 26988382 DOI: 10.1016/j.annder.2016.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/20/2015] [Accepted: 02/03/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Bowel-associated dermatosis-arthritis syndrome (BADAS) is characterized by combined pustular skin eruption and arthralgia. It may be associated with inflammatory bowel disease or bowel bypass surgery. We report a case of BADAS in a patient with ulcerative colitis. CASE REPORT A 39-year-old woman was being treated for a severe flare-up of ulcerative colitis present over the preceding 2 months and treated with prednisone, azathioprine and cyclosporine. She was also presenting a cutaneous eruption and arthralgia that had begun three days earlier. Dermatological examination revealed profuse vesicular and pustular lesions. Biopsy specimens showed mature neutrophilic infiltrate within the dermis. A diagnosis of BADAS was made and the same treatment was maintained. Systemic symptoms were resolved but the vesicular lesions were superseded by hypertrophic scars. DISCUSSION Bowel-associated dermatosis-arthritis syndrome consists of a vesiculopustular eruption associated with arthralgia and/or arthritis and fever, as was the case in our patient. The histological picture is characterized by abundant neutrophilic infiltrate in the superficial dermis. The clinical and histological features and the course of BADAS allow this entity to be classified within the spectrum of neutrophilic dermatoses. Treatment chiefly involves systemic corticosteroids.
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Affiliation(s)
- A Aounallah
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
| | - S Zerriaa
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - M Ksiaa
- Service de gastro-entérologie, hôpital universitaire Sahloul, route Ceinture Cité Sahloul, 4054 Sousse, Tunisie
| | - H Jaziri
- Service de gastro-entérologie, hôpital universitaire Sahloul, route Ceinture Cité Sahloul, 4054 Sousse, Tunisie
| | - L Boussofara
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - N Ghariani
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - S Mokni
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - W Saidi
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - B Sriha
- Laboratoire d'anatomie et de cytologie pathologiques, hôpital Fahat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - C Belajouza
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - M Denguezli
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - R Nouira
- Université de Sousse, avenue Khlifa Karoui, 4054 Sousse, Tunisie; Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
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