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Obeticholic acid for severe bile acid diarrhea with intestinal failure:A case report and review of the literature

World Journal of Gastroenterology 2018年第21期24卷 2320-2326页

作者： Christian Lodberg Hvas Peter Ott Peter Paine Simon Lal Soren Peter Jorgensen jens frederik dahlerup Department of Hepatology and Gastroenterology Aarhus University HospitalAarhus C 8000Denmark Department of Gastroenterology Salford Royal NHS Foundation TrustSalfordManchester M6 8HDUnited Kingdom

Bile acid diarrhea results from excessive amounts of bile acids entering the colon due to hepatic overexcretion of bile acids or bile acid malabsorption in the terminal ileum. The main therapies include bile acid sequestrants, such as colestyramine and colesevelam, which may be given in combination with the opioid receptor agonist loperamide. Some patients are refractory to conventional treatments. We report the use of the farnesoid X receptor agonist obeticholic acid in a patient with refractory bile acid diarrhea and subsequent intestinal failure. A 32-year-old woman with quiescent colonic Crohn's disease and a normal terminal ileum had been diagnosed with severe bile acid malabsorption and complained of watery diarrhea and fatigue. The diarrhea resulted in hypokalemia and sodium depletion that made her dependent on twice weekly intravenous fluid and electrolyte infusions. Conventional therapies with colestyramine, colesevelam, and loperamide had no effect. Second-line antisecretory therapies with pantoprazole, liraglutide, and octreotide also failed. Third-line treatment with obeticholic acid reduced the number of stools from an average of 13 to an average of 7 per 24h and improved the patient's quality of life. The fluid and electrolyte balances normalized. The effect was sustained during follow-up for 6 mo with treatment at a daily dosage of 25 mg. The diarrhea worsened shortly after cessation of obeticholic acid. This case report supports the initial report that obeticholic acid may reduce bile acid production and improve symptoms in patients with bile acid diarrhea.

关键词： Bile acid malabsorption Diarrhea Farnesoid X-activated receptor Crohn’s disease

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Deep hyperammonemic hepatic encephalopathy precipitated by fecal microbiota transplantation for fulminant Clostridioides difficile infection

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Gastroenterology Report 2022年第1期10卷 612-614页

作者： Lotte Lindgreen Eriksen Simon Mark Dahl Baunwall Peter Lykke Eriksen Kirstine Petrea Bak-Fredslund jens Erik Nielsen jens frederik dahlerup Karen Louise Thomsen Hendrik Vilstrup Christian Lodberg Hvas Department of Hepatology and Gastroenterology Aarhus University HospitalAarhus NDenmark Department of Hepatology and Gastroenterology Randers Regional HospitalRandersDenmark Department of Radiology Aarhus University HospitalAarhus NDenmark

Introduction Fecal microbiota transplantation(FMT)is highly effective and potentially life-saving for recurrent Clostridioides difficile infection(CDI)[1].Recent pilot trials also reported the use of FMT to revert hepatic encephalopathy(HE)in patients with decompensated liver cirrhosis without infectious colitis[2,3].Intestinal microbiota-driven hyperammonemia is central to HE development and most treatments aim to reduce ammonia levels by modulating the intestinal ***,FMT might lead to increased intestinal ammonia production,as we describe here.

关键词： hepatic infection encephalopathy

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Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology

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World Journal of Gastroenterology 2011年第7期17卷 922-925页

作者： Mikkel Malham SΦren Peter JΦrgensen Peter Ott JΦrgen Agnholt Hendrik Vilstrup Mette Borre jens F dahlerup Department of Medicine V (Hepatology and Gastroenterology) Aarhus University Hospital

AIM: To examine the vitamin D status in patients with alcoholic cirrhosis compared to those with primary biliary cirrhosis. METHODS: Our retrospective case series comprised 89 patients with alcoholic cirrhosis and 34 patients with primary biliary cirrhosis who visited our outpatient clinic in 2005 and underwent a serum vitamin D status assessment. RESULTS: Among the patients with alcoholic cirrhosis, 85% had serum vitamin D levels below 50 nmol/L and 55% had levels below 25 nmol/L, as compared to 60% and 16% of the patients with primary biliary cirrhosis, respectively (P < 0.001). In both groups, serum vitamin D levels decreased with increasing liver disease severity, as determined by the Child-Pugh score. CONCLUSION: Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology, with lower levels of vitamin D in alcoholic cirrhosis than in primary biliary cirrhosis.

关键词： Alcoholic liver cirrhosis Child-Pugh score Primary biliary cirrhosis Vitamin D deficiency

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3D cardiac strain estimation using spatio-temporal elastic registration:in-vivo application

3D cardiac strain estimation using spatio-temporal elastic r...

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2008 IEEE International Ultrasonics Symposium

作者： An Elen Andras Horvath Javier Ganame Brage Amundsen jens-Uwe Voigt Piet Claus frederik Maes Jan D'hooge Catholic University of Leuven ESAT Catholic University of Leuven Cardiovascular DiseasesLeuven Norwegian University of Science and Technology Circulation and Medical Imaging

＜正＞Background,Motivation and Objective Doppler-and speckle-tracking based deformation imaging of the heart has already proven its clinical value. Despite promising findings,both methodologies remain limited as they...

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越南河内国家会议中心(NCC)

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建筑技艺 2010年第7期16卷 40-47页

作者：曼哈德.冯.格康 Susi Winter Tuyen Tran Viet Robert Wildegger Hito Ueda Marcus Tanzen Udo Meyer Birgit Fllmer jens Reichert Uli Rsler frederik Heisel Annika Schrder Elena Melnikova Markus Carlsen Nicole Flores Schlotfeldt Licht Müller BBM Breimann Bruun Christian Gahl 德国gmp建筑师事务所越南国家建设咨询公司

会议中心、酒店和博物馆镶嵌在一片以越南文化和传统作为特色主题和象征的开阔的景观园林内。会议中心作为主导建筑坐落于南北轴线上,几乎占据了以大湖、小池和假山为特色的整个景观公园的中心地带。与园林景观的有机形状形成鲜明对比... 详细信息

会议中心、酒店和博物馆镶嵌在一片以越南文化和传统作为特色主题和象征的开阔的景观园林内。会议中心作为主导建筑坐落于南北轴线上,几乎占据了以大湖、小池和假山为特色的整个景观公园的中心地带。与园林景观的有机形状形成鲜明对比的是：道路和步道系统规划为一个严密的线性网格。

关键词：南河景观园林中心地带园林景观博物馆酒店建筑公园

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