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Clinical characteristics of Caroli's syndrome

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World Journal of Gastroenterology 2007年第13期13卷 1934-1937页

Caroli's syndrome is characterized by multiple segmental cystic or saccular dilatations of intrahepatic bile ducts associated with congenital hepatic fibrosis. The clinical features of this syndrome reflect both the characteristics of congenital hepatic fibrosis such as portal hypertension and that of Caroli's disease named as recurrent cholangitis and cholelithiasis. The diagnosis depends on both histology and imaging methods which can show the communication between the sacculi and the bile ducts. Treatment consists of symptomatic treatment of cholangitis attacks by antibiotics, some endoscopic, radiological and surgical drainage procedures and surgery. Liver transplantation seems the ultimate treatment for this disease. Prognosis is fairly good unless recurrent cholangitis and renal failure develops.

关键词： Caroli's syndrome Liver transplantation Endoscopic retrograde cholangiopancreatography

Clinical characteristics of Caroli’s disease

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World Journal of Gastroenterology 2007年第13期13卷 1930-1933页

Caroli's disease is a rare congenital condition chara- cterized by non-obstructive saccular or fusiform dilatation of larger intrahepatic bile ducts. Cholangitis, liver cirrhosis, and cholangiocarcinoma are its potential complications. The diagnosis of Caroli's disease depends on demonstrating that the cystic lesions are in continuity with the biliary tree which can be showed by ultrasonography, computerized tomography, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography or magnetic resonance cholangiopancreatography. Treatment of Caroli's disease relies on the location of the biliary abnormalities. While localized forms confined to one lobe can be treated with surgery, liver transplantation is the only effective modality for diffuse forms. Although a rare disorder; Caroli's disease should always be considered in the differential diagnosis of chronic cholestasis of unknown cause.

关键词： Caroli's disease Liver transplantation Endoscopic retrograde cholangiopancreatography

Increased levels of homocysteine in patients with ulcerative colitis

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World Journal of Gastroenterology 2010年第19期16卷 2411-2416页

作者： Sabiye Akbulut Emin Altiparmak Firdevs Topal Ersan Ozaslan Metin Kucukazman ozlem yonem Department of Gastroenterology Kartal Kosuyolu High Specialty Education and Research Hospital 34846 Istanbul Turkey Department of Gastroenterology Ankara Numune Training and Education Hospital 06443 Ankara Turkey Department of Gastroenterology ankiri State Hospital 18200 Cankiri Turkey Department of Gastroenterology Kecioren Teaching and Research Hospital 06380 Ankara Turkey Department of Gastroenterology Cumhuriyet University Cumhuriyet Universitesi Hastanesi 58140 Sivas Turkey

AIM: To investigate serum levels of homocysteine (Hcys) and the risk that altered levels carry for thrombosis development in ulcerative colitis (UC) patients. METHODS: 55 UC patients and 45 healthy adults were included. Hcys, vitamin B12 and folic acid levels were measured in both groups. Clinical history and thrombo- embolic events were investigated. RESULTS: The average Hcys level in the UC patients was 13.3 ± 1.93 μmmol/L (range 4.60-87) and was higher than the average Hcys level of the control group which was 11.2 ± 3.58 μmmol/L (range 4.00-20.8) (P < 0.001). Vitamin B12 and folic acid average values were also lower in the UC group (P < 0.001). Whenmultivariate regression analysis was performed, it was seen that folic acid deficiency was the only risk factor for hyperhomocysteinemia. Frequencies of thromboembolic complications were not statistically significantly different in UC and control groups. When those with and without a thrombosis history in the UC group were compared according to Hcys levels, it was seen that there were no statistically significant differences. A negative linear relationship was found between folic acid levels and Hcys. CONCLUSION: We could not find any correlations between Hcys levels and history of prior thromboembolic events.

关键词： Ulcerative colitis Homocysteine Folate Vitamin B12

Cytomegalovirus gastritis after rituximab treatment in a nonHodgkln's lymphoma patient

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World Journal of Gastroenterology 2006年第12期12卷 1978-1979页

作者： Ugur Unluturk Sercan Aksoy ozlem yonem Yusuf Bayraktar Gulten Tekuzman Hacettepe University Faculty of Medicine Department of Internal Medicine Ankara Turkey Hacettepe University Institute of Ontology Ankara Turkey Hacettepe University Faculty of Medicine Department of Internal Medicine Unit of Gastroenterology Ankara Turkey

Rituximab is a chimeric monoclonal antibody against CD20 antigen expressed on most B cells and is used for the treatment of malignant lymphomas expressing the CD20 antigen. It temporarily eliminates normal B-lymphocytes without a substantial decrease in serum immunoglobulin levels. Recently, several serious viral infections have been reported in association with rituximab use. Cytomegalovirus （CMV） is one of the agents that may be a cause of morbidity and mortality in immunocompromised individuals. In the face of exogenous or endogenous causes of immunosuppression, cytomegalovirus can result in retinitis, colitis, pneumonitis, or encephalitis. Presented here is a case of a patient with non-Hodgkin＇s lymphoma （NHL） who developed gastritis and enterocolitis due to CMV infection after treatment with rituximab.

关键词：巨细胞病毒胃炎非霍奇金淋巴瘤病理机制临床表现

Novel variant syndrome associated with congenital hepatic fibrosis

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World Journal of Clinical Cases 2015年第10期3卷 904-910页

作者： Yusuf Bayraktar ozlem yonem Kubilay Varl? Hande Taylan Ali Shorbagi Cenk Sokmensuer Department of Gastroenterology Faculty of MedicineHacettepe University Department of Gastroenterology Cumhuriyet University Department of Neurology Hacettepe University Department of Ophthalmology Hacettepe University Department of Pathology Hacettepe University

Congenital hepatic fibrosis is part of many different malformation syndromes, of which oculo-encephalohepato-renal syndrome is the most common. These syndromes largely overlap, and so accurate classification of individual patients may be difficult. We present herein three syndromic siblings who were products of a consanguineous marriage. We investigated in detail at least six organ systems in these patients, namely the liver, brain, eye, kidneys, skeleton, and gonads. The common features observed in these three cases were congenital hepatic fibrosis, retinitis pigmentosa, truncal obesity, rotatory nystagmus, mental retardation, advanced myopia, and high-arched palate. The clinical dysmorphology in these patients was distinct and lacked the major features of the known syndromes associated with congenital hepatic fibrosis. Although some features of these presented cases are similar to those found in Bardet-Biedl syndrome(BBS), the absence of some major criteria of BBS(polydactyly, renal abnormality, and hypogonadism) suggests that this may be a new syndrome. All three patients remain under follow-up in the departments of Gastroenterology, Ophthalmology, and Neurology at Hacettepe University.

关键词： Congenital hepatic fibrosis Nystagmus Mental retardation Retinitis pigmentosa High-arched palate

An adult case of celiac sprue triggered after an ileal resection for perforated Meckel's diverticulum

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World Journal of Gastroenterology 2009年第32期15卷 4075-4076页

作者： Firdevs Topal Sabiye Akbulut Ismail Cagatay Topcu Yasemin Dolek ozlem yonem Department of Gastroenterology Cumhuriyet University Cumhuriyet Universitesi Hastanesi 58140 Sivas Turkey Department of Gastroenterology ankiri State HospitalCankiri Devlet Hastanesi18200 CankiriTurkey Department of Gastroenterology Kartal Kosuyolu High Speciality Education and Research HospitalKartal Kosuyolu Devlet Hastanesi34846 IstanbulTurkey Department of Surgery Cankiri State HospitalCankiri Devlet Hastanesi18200 CankiriTurkey Department of Pathology Cankiri State HospitalCankiri Devlet Hastanesi18200 CankiriTurkey

Celiac disease can be triggered by upper abdominal surgery, such as vagotomy, oesophagectomy, pancreatico-duodenectomy, and gastrojejunal anastomosis. Here we report a case of a 24 year-old woman who developed celiac disease after an ileal resection for perforated Meckel's diverticula. This is the first reported celiac case that has been triggered, not by upper abdominal surgery, but after ileal resection for Meckel's diverticula.

关键词： Celiac disease Meckel's diverticula Ilealresection