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Severe hemorrhagic colitis in a patient with chronic myeloid leukemia in the blastic phase after dasatinib use

World Journal of Gastrointestinal Pathophysiology 2013年第3期4卷 59-62页

作者： Zahra Kmira Ben Sayed Nesrine Zaghouani Houneida Ben Fredj Wafa slama aida Ben Youssef Yosra Zaier Monia Badreddine Sriha Khelif Abderrahim Department of Clinical Hematology University Hospital Farhat Hached Sousse 4000 Tunisia Department of Radiology University Hospital Farhat Hached Sousse 4000 Tunisia Department of Gastroenterology University Hospital Sahloul Sousse 4000 Tunisia Department of Anatomopathology University Hospital Farhat Hached Sousse 4000 Tunisia

Dasatinib is a second-line tyrosine kinase inhibitor used in patients with imatinib resistant or intolerant chronic myeloid leukemia (CML) and Philadelphia chromosomepositive acute leukemia. Gastrointestinal bleeding may occur in up to 7% of patients using dasatinib, although, severe dasatinib-related acute colitis had rarely been reported. Here, we present the case of a 36-year-old female who progressed to acute myeloid leukemia after fourteen months of receiving imatinib for CML in the chronic phase and was treated with a dasatinib-containing chemotherapy regimen. On day 34 of treatment, the patient developed moderate abdominal pain and bloody diarrhea with mucous. Analyses of stool specimens were negative for parasites, Clostridium difficile , and other pathogenic bacteria. The cytomegalovirus pp65 antigen was negative in her blood leukocytes. A colonoscopy revealed acute colitis, and a mucosal biopsy showed nonspecific colitis. The patient was treated with broad-spectrum antibiotics, bowel rest and hydration, and dasatinib treatment was stopped. Her bloody diarrhea improved within 72 h. After confirming cytological remission, the patient received initial course of consolidation, and dasatinib treatment was reinstated. However, hemorrhagic colitis recurred. After discontinuing dasatinib, herhemorrhagic colitis drastically improved and did not recur following the administration of nilotinib. The characteristics of our patient suggest that dasatinib treatment can lead to hemorrhagic colitis, which typically resolves after discontinuation of the drug.

关键词： Philadelphia chromosome Chronic myeloid leukemia Dasatinib Colitis

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Vogt-Koyanagi-Harada syndrome and Crohn’s disease:an exceptional association

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Gastroenterology Report 2018年第1期6卷 65-67,I0003页

作者： Ahlem Souguir Aya Hammami Wafa Dahmeni Hanene Jaziri Imed Ben Mansour Ahlem Zayene aida Ben slama Mehdi Ksiaa Ahlem Brahem Salem Ajmi Ali Jmaa Department of Gastroenterology University Hospital SahloulSousseTunisia

Vogt-Koyanagi-Harada disease(VKH)is a rare,multisystem disease of melanocyte-containing *** is characterized by diffuse,granulomatous inflammation involving various *** has been reported to occur in association with other autoimmune *** report the case of a female patient who was diagnosed with VKH at the age of 4 years and who was treated with corticosteroids until the age of *** years later,Crohn’s disease was diagnosed,with a severe *** cases of VKH associated with ulcerative colitis have previously been reported anecdotally but,to our knowledge,this is the first case occurring in association to Crohn’s disease.

关键词： Vogt-Koyanagi-Harada disease granulomatous inflammation Crohn’s disease

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Predictive Factors of Surgery in Peptic Stenosis of the Bulb

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Open Journal of Gastroenterology 2015年第9期5卷 129-133页

作者： Mohamed Ben Mabrouk aida Ben slama Trabelsi Mehdi Ksiaa Waad Farhat Ali Jmaa Ali Ben Ali Department of Digestive Surgery Sahloul Hospital Sousse Tunisia Department of Gastroenterology Sahloul Hospital Sousse Tunisia

The bulb ulcer stenosis, becoming exceptional in developed countries, remains frequent in our country despite the use of the antisecretory. The purpose of our study was to study epidemiological, diagnostic, and evolutionary complication particularities, and to find potential predictive factors of resistance of ulcer stenosis of the bulb to the pump inhibitors Proton through a recent series. This is a retrospective and descriptive study involving 105 patients, treated for ulcer stenosis of the bulb between January 2007 and December 2012. All our patients had received inhibitors of Proton pump, parenterally for 7 days. They were divided into 2 groups according to their response to treatment: the first group (G1) was sensitive and the second (G2) was resistant. All patients of the G2 were operated. We had compared the two groups. There was no statistically significant difference concerning age, sex, blood group and smoking between the two groups. In univariate study, the age of the epigastralgies was greater than or equal to 9 years;the clapotage fasting, dilation and gastric atony, objectified by the oesogastroduodenal transit were significantly associated with the failure of medical treatment. Only gastric atony and seniority of the disease over 9 years were independent risk factors of resistance to the Proton pump inhibitors in multivariate study.

关键词： Bulbar Ulcer Stenosis Surgery Proton Pump Inhibitors

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Azathioprine induced liver cirrhosis: An unusual side effect

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Open Journal of Gastroenterology 2013年第6期3卷 295-297页

作者： aida Ben slama Trabelsi Eya Hamami Mehdi Ksiaa Ahlem Souguir Mohamed Ben Mabrouk Ahlem Brahem Ali Jmaa Salem Ajmi Department of Gastroenterology Sahloul Hospital Sousse Tunisia Department of Surgery Sahloul Hospital Sousse Tunisia

In recent years, the hepatotoxic potential of thiopurines, in particular 6-thioguanine (6-TG), has been discussed in literature. However, cirrhosis was exceptionally reported. We report the case of a 56-year-old woman with ileocaecal Crohn’s disease treated with azathioprine. After taking azathioprine (2 mg/kg daily) for four years, she underwent surgical treatment for acute intestinal obstruction. In peroperative, we noticed a cirrhotic liver. A surgical biopsy was performed and the diagnosis of cirrhosis was confirmed. Autoimmune and viral liver diseases were ruled out by laboratory parameters. Therefore, Azathioprine is believed to be the causative factor for inducing liver cirrhosis. Thus, treating inflammatory bowel disease effectively while trying to limit iatrogenic disease is a continuous struggle.

关键词： Azathioprine Crohn’s Disease Hepatotoxicity Liver Cirrhosis

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Role of Coelioscopy in the Etiologic Diagnosis of Exudative Ascites of Unknown Origin of the Women

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Journal of Cancer Therapy 2015年第5期6卷 466-471页

作者： Mohamed Ben Mabrouk aida Ben slama Trabelsi Mohamed Ben Rejeb Hanène Jaziri Mehdi Ksiaa Sassi Bouguizane Badreddine Sriha Ali Jmaa Ali Ben Ali Department of Digestive Surgery Sahloul Hospital Sousse Tunisia Department of Gastroenterology Sahloul Hospital Sousse Tunisia Department of Preventive Medicine Sahloul Hospital Sousse Tunisia Department of Gynecology Farhat Hached Hospital Sousse Tunisia Department of Pathology Farhat Hached Hospital Sousse Tunisia

Introduction: The aim of this study was to clarify the role of laparoscopy in the etiological diagnosis of exudative ascites of unknown origin in women. Materials and Methods: This?was?a prospective study from 2007 to 2012, including 83 women with exudative ascites of unknown origin and had a laparoscopy diagnostic purpose. Results: Carcinomatosis and peritoneal tuberculosis were the two most common causes found in 31% (26 cases) and 66% (55 cases) of cases respectively. The average age of the patients was 56 years. Weight loss and abdominal pain were the most frequent, observed symptoms in 71 cases (85.5%) and 53 cases (63.8%) respectively. The CT scan abnormalities noted?were a peritoneal thickening in 32 cases (38.5%), peritoneal nodules in 15 cases (18%), and agglutination of the digestive handles in 12 cases (14.4%). Laparoscopic Visual diagnosis was in favor of a peritoneal carcinomatosis in 32 cases (38.5%), peritoneal tuberculosis in 45 cases (54.2%), and non specific infection in 6 cases (7.3%). The histological diagnosis was a peritoneal carcinomatosis in 26 cases (31%), and peritoneal tuberculosis in 55 cases (66%). The positive predictive value of laparoscopic vision Diagnostics in Peritoneal tuberculosis was 100% and the negative predictive value was 73.7%. In peritoneal carcinomatosis, the positive predictive value was 81.3% and the negative predictive value was 100%. Conclusion: The etiologic diagnosis of exudative ascites in women is difficult despite the availability of several tests. Currently, laparoscopy with peritoneal biopsy remains the gold standard for etiologic diagnosis.

关键词： Ascites Exudative Laparoscopy Peritoneal Tuberculosis Peritoneal Carcinomatosis

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