PATHOMORPHOLOGICAL FEATURES OF GASTROESOPHAGEAL REFLUX DISEASE REALIZATION IN YOUNG PEOPLE WITH AUTOIMMUNE THYROIDITIS

OBJECTIVE

The aim: To evaluate the pathomorphological features of the esophageal mucous membrane in young people with GERD and autoimmune thyroiditis.

PATIENTS AND METHODS

Materials and methods: 120 patients with GERD and AIT and 45 people with isolated GERD matched for age, gender and social status were examined. Esophagogastroduodenoscopy, histological study and comparative morphometry of the esophageal mucosa were performed.

RESULTS

Results: The frequency of erosive GERD in the examined groups of patients did not statistically differ. At the same time, integral analysis of the structure of erosive forms of GERD revealed statistically significant redistribution of grades of esophagitis towards its enhancement in patients with comorbid pathology. The histological study showed that in patients with GERD and AIT all the morphometric parameters studied had a significantly more severe course and exceeded similar indicators of the group with isolated GERD: epithelium total thickness, epithelium basal layer thickness, connective tissue papillae height, intercellular space. The analysis of morphological changes frequency showed that epithelium basal layer hyperplasia, dystrophic changes and epithelial edema, elongation of papillae and dilation of intercellular space were significantly more frequent in the group with comorbid pathology.

CONCLUSION

Conclusions: GERD and euthyroid AIT comorbidity in the student population is accompanied by a statistically significant redistribution of esophagitis grades towards its aggravation. The presence of concomitant euthyroid AIT in patients with non-erosive GERD leads to statistically more pronounced disorganization of esophageal mucosal epithelium.

TOTAL ANTIOXIDANT ACTIVITY AND MANGANESE SUPEROXIDE DISMUTASE IN COMORBIDITY OF GASTROESOPHAGEAL REFLUX DISEASE AND AUTOIMMUNE THYROIDITIS IN STUDENT POPULATION

OBJECTIVE

The aim: To determine the state of total antioxidant activity and the content of the mitochondrial enzyme - manganese superoxide dismutase in students with gastroesophageal reflux disease (GERD) and autoimmune thyroiditis (AIT) comorbidity.

PATIENTS AND METHODS

Materials and methods: 120 patients with GERD and AIT, 45 patients with GERD and 42 patients with AIT were examined. The patients involved in the study were students. The international standardized GerdQ questionnaire was used. Total antioxidant activity and manganese superoxide dismutase levels were determined.

RESULTS

Results: The study showed that comorbidity of GERD and AIT was accompanied with a significant increase in the frequency and intensity of heartburn, sleep disorders and the use of additional medications to relieve symptoms. Patients with GERD and AIT had significantly lower total antioxidant activity than patients with isolated GERD and isolated AIT. At the same time, the manganese superoxide dismutase level was significantly higher in group with comorbidity than in patients with isolated diseases.

CONCLUSION

Conclusions: The presence of concomitant AIT in patients with GERD among the student population contributes to some deviations in the clinical characteristics, inhibition of total antioxidant activity and activation of manganese superoxide dismutase.

CHRONIC PANCREATITIS AS A PREDICTOR OF OSTEOPOROSIS FORMATION

The issues of formation of secondary osteoporosis in patients with chronic pancreatitis (CP) were discussed in this paper. It was shown that the chronic relapsing nature of the disease process in the pancreas leads to hypokalemia due to malabsorption of calcium and vitamin D as the result of maldigestion. As well as the redistribution of ionized and total calcium blood between the body fluids, which can be a consequence of long-term nature of pain. At the same time, the study of the content of enzymes bone found their decline to a greater extent characteristic index tartrate resistant acid fosfatazy-marker of bone resorption. Changes in bone metabolism were confirmed by ultrasound bone (densitometry) at which proved the development of osteoporosis in 47,7% of cases, and osteopenia in 35,7% of patients. The conclusions about the need for pre-clinical diagnosis of osteoporotic states in patients with CP, correction of diet and administration of appropriate therapy were made.