[Primary chronic ulcerative jejunoileitis complicated by hemophagocytic syndrome]

An observation of chronic ulcerative ileo-jejunitis associated with a hemophagocytic syndrome leading to death is described. It was not associated with coeliac disease. The hemophagocytic syndrome had no other etiology than chronic ulcerative ileo-jejunitis. The relations between these two disorders are discussed.

[Angina-like chest pain and exertional esophageal ph monitoring]

OBJECTIVES

Spontaneous chest pain attacks are uncommon during 24-hour esophageal pH monitoring in patients suffering from angina-like chest pain suspected to be acid-related. The aim of this study was to assess the diagnostic value of exertional esophageal pH monitoring and to prove that exercise testing induces chest pain and gastro-esophageal reflux and therefore improves symptomatic correlation study.

METHODS

Forty three patients suffering from angina-like chest pain underwent treadmill exercise testing during a 24-hour esophageal pH monitoring. Symptom analysis was made using the symptom-association probability described by Weusten.

RESULTS

During the 24-hour pH monitoring, 10 patients (23%) had a pathologic esophageal acid exposure, 20 (46%) experienced chest pain and 3 (7%) had a symptom association probability > 95%. During the exercise testing on a treadmill, 19 patients (44%) had gastro-esophageal reflux, and 14 (32%) experienced chest pain, coinciding with a gastro-esophageal reflux in 8 (19%). After exercise testing, the symptom-association probability analysis was significantly changed in 9 patients (21%), > 95% in 6 patients (14%).

CONCLUSION

Exercise testing on a treadmill induces chest pain episodes during a 24-hour esophageal pH monitoring and therefore improves symptomatic correlation study in patients suffering from angina-like chest pain.