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Extremely severe hypochloremic metabolic alkalosis after ileorectal anastomosis in a patient with chronic intestinal pseudo-obstruction

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Gastroenterology Report 2023年第1期11卷 563-565页

作者： Peter heinz-Erian Andreas RJanecke Thomas Muller Peter Rehder Elisabeth Bruder Thomas Menter heinz zoller Markus Pirklbauer Michael Rieger Department of Pediatric and Adolescent Medicine Medical University of InnsbruckInnsbruckTyrolAustria Department of Urology Medical University of InnsbruckInnsbruckTyrolAustria Institute of Pathology University Hospital BaselBaselBaselSwitzerland Department of Internal Medicine I Medical University of InnsbruckInnsbruckTyrolAustria Department of Internal Medicine IV Medical University of InnsbruckInnsbruckTyrolAustria Department of Radiology District Hospital HallHallTyrolAustria

Introduction Chronic intestinal pseudo-obstruction(CIPO),defined as chronic constipation without mechanical obstruction of the gastrointestinal tract[1,2],often presents with a truly chameleon-like symptomatology including irregular defecation,abdominal pain and distension,nausea,vomiting,and sometimes fluid/electrolyte *** diarrhea was found in17%of CIPO cases,its nature,however,has not been precisely *** deviations of electrolyte and acid–base status,to the best of our knowledge,have not been reported.

关键词： obstruction diarrhea chronic

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patients with inflammatory bowel disease:Mechanisms and possible clinical impact

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World Journal of Gastroenterology 2021年第17期27卷 2039-2053页

作者： Trond Espen Detlie Jonas Christoffer Lindstrøm Marte Eide Jahnsen Elisabeth Finnes heinz zoller Bjørn Moum Jørgen Jahnsen Department of Gastroenterology Akershus University HospitalLørenskog 1478Norway Institute of Clinical Medicine University of OsloOslo 0316Norway Health Services Research Unit Akershus University HospitalLørenskog 1478Norway Division of Medicine Department of GastroenterologyOslo University Hospital UllevålOslo 0424Norway Department of Medicine II Gastroenterology and HepatologyMedical University of InnsbruckInnsbruck A-6020Austria

BACKGROUND High-dose intravenous iron is an effective treatment option for iron deficiency(ID)or ID anaemia(IDA)in inflammatory bowel disease(IBD).However,treatment with ferric carboxymaltose(FCM)has been associated with the development of *** To investigate mechanisms behind the development of hypophosphatemia after intravenous iron treatment,and disclose symptoms and clinical manifestations related to hypophosphatemia *** A prospective observational study of adult IBD patients with ID or IDA was conducted between February 1,2017 and July 1,2018 at two separate university hospitals in the southeast region of *** received one dose of 1000 mg of either FCM or ferric derisomaltose(FDI)and were followed for an observation period of at least 7 *** and urine samples were collected for relevant analyses at baseline,week 2 and at week *** symptoms were assessed at the same timepoints using a respiratory function test,a visual analogue scale,and a health-related quality of life *** A total of 106 patients was available for analysis in this *** FCM treatment group consisted of 52 patients and hypophosphatemia was present in 72.5%of the patients at week 2,and in 21.6%at week *** comparison,the FDI treatment group consisted of 54 patients and 11.3%of the patients had hypophosphatemia at week 2,and 3.7%at week *** difference in incidence was highly significant at both week 2 and 6(P<0.001 and P<0.013,respectively).We observed a significantly higher mean concentration of intact fibroblast growth factor 23(P<0.001),a significant rise in mean urine fractional excretion of phosphate(P=0.004),a significant decrease of 1,25-dihydroxyvitamin D(P<0.001)and of ionised calcium levels(P<0.012)in the FCM-treated patients compared with patients who received *** clinical symptoms could with certainty be related to hypophosphatemia,since neither the respiratory function test,SF-36(36-item short form health s

关键词： Iron deficiency Hypophosphatemia Inflammatory bowel disease Ferric carboxymaltose Ferric derisomaltose

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Occult celiac disease prevents penetrance of hemochromatosis

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World Journal of Gastroenterology 2005年第21期11卷 3323-3326页

作者： Andreas Geier Carsten Gartung Igor Theurl Guenter Weiss Frank Lammert Christoph G.Dietrich Ralf Weiskirchen heinz zoller Benita Hermanns Siegfried Matern Department of Internal Medicine Ⅲ Aachen University (RWTH) AachenGermany Department of Internal Medicine University of Innsbruck InnsbruckAustria Department of Clinical Chemistry and Pathobiochemistry Aachen University(RWTH) AachenGermany Department of Pathology Aachen University (RWTH) AachenGermany Department of Internal Medicine Ⅲ Aachen University(RWTH) Aachen Germany

AIM:To report a patient with C282Y homozygocity,depleted body iron and intestinal atrophy caused by celiac disease (CD) who experienced resolution of the enteropathy with subsequent normalization of iron metabolism upon gluten free diet. METHODS:To obtain information on the tissue distribution and quantitative expression of proteins involved in duodenal iron trafficking,we determined the expression of divalent-metal transporter 1 (DMT1),ferroportin 1 (FP1) and transferrin receptor (TfR1) by means of immunohist-ochemistry and real-time PCR in duodenal biopsies of this patient. RESULTS:Whereas in hereditary hemochromatosis patients without CD, DMT1 expression was up-regulated leading to excessive uptake of iron, we identified a significant reduction in protein ana mRNA expression of DMT1 as a compensatory mechanism in this patient with HH and CD. CONCLUSION:Occult CD may compensate for increased DMT1 expression in a specific subset of individuals with homozygous C282Y mutations in the hemochromatosis (HFE) gene,thus contributing to the low penetrance of HH.

关键词： Hemochromatosis Celiac disease Divalentmetal transporter 1 Transferrin receptor Iron metabolism

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