Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022104 (irritable bowel syndrome)
 8,033 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper reviews our five years' clinical experience (1987 to 1991) of 22 patients with inflammatory bowel disease (IBD). There were 12 patients with Crohn's disease and 10 patients with ulcerative colitis. The mean age at diagnosis was 8.7 years (2 to 14 years). Clinical impressions before referral were chronic diarrhea in 11, irritable bowel syndrome in 5, colon polyp in 4, lymphoma in 3, intestinal tuberculosis in 2, amoebic colitis in 2, ulcerative colitis in 2 children and other diseases. The mean interval from the onset of symptoms to the diagnosis of IBD was 18 months. Diagnosis of Crohn's disease was delayed for more than 13 months in 8 (67%), whereas that of ulcerative colitis was delayed for more than 13 months in 4 (40%). Diarrhea (50%), abdominal pain (36%) and rectal bleeding (36%) were the three most frequent presenting complaints of IBD. Moderately severe abdominal pain was a more common chief complaint in Crohn's disease (58%) than in ulcerative colitis (10%). Hematochezia (90% vs 17%) and moderately severe diarrhea (90% vs 75%) were more common gastrointestinal manifestations in ulcerative colitis than in Crohn's disease. The associated extraintestinal manifestations were oral ulcer in 7, arthralgia in 11 and arthritis in 4, skin lesions in 2, eye lesions in 2 and growth failure in 9 patients. Of 12 children with Crohn's disease, granuloma was found in 5, aphthous ulcerations in 8, cobble stone appearance in 8, skip area or asymmetric lesions in 6, transmural involvement in 7, and perianal fistula in 3. Among 10 children with ulcerative Colitis, there were crypt abscess in 8, granularity or friability in 10 and rectosigmoid ulcerations with purulent exudate in 8 children. The main sites of involvement in children with Crohn's disease were both the small and large bowels in 7 (58%), small bowel only in 2 (16%), and colon only in 3 (25%). Terminal ileum involvement was seen in 75% of Crohn's disease cases. The main sites of involvement in children with ulcerative colitis were total colon in 4 (40%), up to the splenic flexure in 2 (20%), rectosigmoid in 3 (30%) and rectum only in one (10%). Medical treatment including sulfasalazine, and systemic or topical steroid was administered initially in most patients. Seven of 12 patients with Crohn's disease and 2 of 10 patients with ulcerative colitis were operated on.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Inflammatory bowel disease in children--clinical, endoscopic, radiologic and histopathologic investigation. 128 21

We reviewed the clinical and pathologic features in 186 patients with large-cell lymphomas seen at Vanderbilt University Hospital between 1970 and 1986. Ninety-two cases (49%) were large noncleaved-cell lymphoma (LNCCL), 61 cases (33%) were large-cleaved-cell lymphoma (LCCL), 17 cases (9%) were peripheral T-cell lymphoma (PTCL), and 16 cases (9%) were immunoblastic sarcoma of B cells (IBS-B). These subsets of large-cell lymphoma did not differ with respect to median age, distribution by stage, or incidence of bone marrow involvement. Significant differences between groups were noted with regard to male:female ratio, incidence of symptoms, incidence of extranodal disease, and pattern of adenopathy. However, when LCCL was excluded from the analysis, none of these differences were significant. By univariate analysis, age, stage, marrow involvement, extranodal disease, B symptoms, elevated serum lactic dehydrogenase (LDH), and diffuse pattern were unfavorable prognostic features in large-cell lymphoma. However, when cases were stratified by cell of origin, nodular versus diffuse pattern was of no prognostic significance. Nodularity was favorable only because 71% of nodular and nodular-diffuse cases were LCCL, while the majority of diffuse cases were LNCCL. Although IBS-B is considered a "high-grade" lymphoma, we found no evidence for inferior survival in these patients compared with LNCCL or LCCL. In fact, survival was better in IBS-B than in LNCCL or LCCL, although this difference was not significant. However, survival was significantly inferior in PTCL (median, 11 months) compared with the other subsets of large-cell lymphoma (median, 46 months; P = .038, log-rank test). Since the association of PTCL and an inferior survival has most often been noted in the context of "second-generation" chemotherapy, we believe that this association may be therapy-dependent and may be minimized by the use of more aggressive chemotherapy regimens.
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PMID:Large-cell lymphomas: clinical and prognostic features. 219 23

Diffuse 'histiocytic' lymphoma (DHL) is heterogeneous pathologically, consisting of four subtypes within Lukes-Collins; large-cleaved (LC), large non-cleaved (LNC), immunoblastic sarcoma of B cells (B-IBS), and immunoblastic sarcoma of T-cells (T-IBS). This heterogeneity is also recognized in the Cooperative Working Formulation on non-Hodgkin's lymphoma. Prior studies have suggested clinical heterogeneity of DHL as well, although conclusions were hampered by small numbers, and lack of therapeutic uniformity. We treated 57 patients with advanced DHL, using BACOP: 22 LNC, 16 T-IBS, 13 B-IBS, six LC. Complete remission rate for LNC was 64 per cent (14/22); B-IBS was 54 per cent (7/13); LC was 33 per cent (2/6); T-IBS was 25 per cent (4/16). (p = 0.10). Median survival for LNC was 27.8 months, B-IBS was 25.9, LC was 14, T-IBS was 12.0. The survival was significantly shorter for T-IBS patients when compared to the others (p = 0.01). By multi-variate analysis, histologic subtype (p = 0.02), age (p = 0.03), and stage (p = 0.06) were significant and independent prognostic variables in predicting survival. We conclude that LNC may respond the most favourably to BACOP, whereas alternative regimens appear necessary for patients with T-IBS.
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PMID:Heterogeneity of response and survival in diffuse histiocytic lymphoma after BACOP therapy (bleomycin, doxorubicin, cyclophosphamide, vincristine, prednisone). 241 Mar 48

Thirty-four cases of oral lymphoma were classified by the Lukes-Collins system on the basis of morphology and immunoperoxidase staining. Ninety-seven percent of these were morphologically identified as B-cell neoplasms: 6% SCFCC, 9% LCFCC, 26% SNCFCC, 24% LNCFCC, 12% IBS, and 18% malignant plasma cell proliferations. Monoclonal immunoperoxidase staining for cytoplasmic immunoglobulin was positive in 41% of the cases overall, but 100% of the cases of immunoblastic sarcoma and malignant plasma cell lesions stained positively.
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PMID:Extranodal oral lymphoma. Part I. A morphologic and immunoperoxidase study of 34 cases. 242 20

IBD CT is the single best modality for diagnosis and staging of patients with suspected pancreatic carcinoma. While carefully performed real-time US is an excellent technique for determining the level and etiology of bile duct obstruction, it is of more limited value for diagnosis of tumors in the body and tail of the gland, and is less accurate than IBD CT for assessment of tumor resectability. Thus, most patients require IBD CT for accurate, nonoperative staging. ERCP and angiography continue to be useful adjunctive procedures for evaluation of patients with suspected pancreatic carcinoma, particularly for evaluation of equivocal CT or US findings. An isolated pancreatic mass, that is, a mass with no ancillary CT or US findings of carcinoma (local extension, distant metastases), is a non-specific finding and requires further evaluation with either ERCP or angiography, and perhaps most importantly, with FNAB. Other neoplasms may mimic pancreatic ductal carcinoma, particularly islet cell carcinoma and lymphoma. Pancreatitis also can result in a focal pancreatic mass, simulating a neoplasm. These diseases usually respond to therapy and thus it is essential to confirm the radiologic diagnosis of pancreatic carcinoma with biopsy, particularly if surgery is not planned or if chemoradiation therapy is anticipated.
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PMID:Radiologic diagnosis and staging of pancreatic ductal adenocarcinoma. 253 84

A retrospective morphologic survey (1973-1983) of 146 cases of malignant lymphoma among the Hawaii-Japanese (migrant Japanese and their offspring) was conducted to determine whether differences in the incidence and cytologic types of malignant lymphoma exist when compared to those of native Japanese (lifetime residents of Japan). The age-adjusted incidence rates for malignant lymphoma among the Hawaii-Japanese were similar to rates for U.S. whites. However, higher rates for follicular centre cell (FCC) lymphoma with a follicular pattern were observed in the Hawaii-Japanese population when compared with rates for native Japanese. On the basis of the cytologic types of the Lukes-Collins classification, non-Hodgkin's lymphomas among the Hawaii-Japanese resembled those of Western countries, rather than those of Japan. B-cell lymphomas predominated (72 per cent), while T-cell types comprised 23 per cent of cases. Follicular centre cell types were encountered most often (59 per cent), and the small cleaved FCC subtype was the most common (30 per cent). The high degree of follicularity (29 per cent) was at variance with the consistently low rates reported in Japan. This may be explained, in part, by higher rates of nodal lymphomas among the Hawaii-Japanese. Of the T-cell lymphomas, diffuse large cell types (T-cell immunoblastic sarcoma, T-IBS), often with cytologic pleomorphism, were relatively frequently encountered (16 per cent), and comprised 15 per cent of non-Hodgkin's lymphomas; this observation necessitates special clinical and epidemiologic consideration in view of the large Japanese migration to Hawaii from HTLV-I endemic regions of southern Japan. No registered cases of non-Hodgkin's lymphoma or of Hodgkin's disease were documented in Hawaii-Japanese subjects under the age of 15 years. The age-adjusted incidence rates for Hodgkin's disease among the Hawaii-Japanese were similar with those of native Japanese. Nodular sclerosis was the most frequent histologic subtype. The difficulty in distinguishing between Hodgkin's disease and non-Hodgkin's lymphoma, particularly when immunologic cell surface markers are not available, is addressed. Low rates for chronic lymphocytic leukemia among the Hawaii-Japanese were confirmed. Not one well-documented case was identified in the 11-year period surveyed.
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PMID:Malignant lymphoma in Hawaii-Japanese: a retrospective morphologic survey. 270 45

Malignant lymphomas originating primarily in the mediastinum consist predominantly of Hodgkin's disease of the nodular sclerosis type, lymphoblastic lymphomas, and large cell non-Hodgkin's lymphomas of diffuse growth pattern (DHL). This analysis of 20 cases of primary mediastinal DHL presents the clinical and pathologic findings in nine patients with T-immunoblastic sarcoma (T-IBS), six with sclerosing variants of follicular center cell lymphoma (FCCL), and five with B-immunoblastic sarcoma (B-IBS). T-IBS patients were predominantly young adult women (mean age 31 years) presenting with relatively well confined mediastinal tumors; four of nine manifested the SVC syndrome. The immunomorphologic findings in T-IBS were similar to those of node-based peripheral T-cell lymphomas. Patients with FCCL and B-IBS were predominantly men, exhibited a broad age range, and presented with larger tumors with a high incidence of contiguous involvement of intrathoracic structures (83% in FCCL, 60% in B-IBS). Chemotherapeutic intervention attained CR in 19 of 20 patients, with 14 of 20 remaining alive in relapse-free CR a median of 26 months after completion of therapy. Durable CR was attained in eight of nine T-IBS patients, in four of six patients with FCCL, and in three of five patients with B-IBS. The morphologic features of these lymphoma subtypes are presented in detail and discussed in relation to the complex differential diagnosis of mediastinal neoplasms.
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PMID:Primary large cell lymphomas of the mediastinum: an analysis of 20 cases. 387 48

In a patient with systemic and nervous system IBS, the CSF cells were investigated by light and electron microscopy. An IBS of the B-cell type was identified in the CSF which proved, at both morphological levels, to be identical to that recorded in IBS in lymphoid tissue with regard to the malignant cell types and the absence of surface specialization. In contrast, unusual macrophages were observed in the CSF instead of the reticular elements associated with IBS in lymph nodes which present desmosomes. They demonstrated both phagocytosis and emperipolesis and also displayed autodesmosomes. The CSF phagocytes are discussed in relationship with the phagocytes described in the brain with malignant lymphoma.
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PMID:Immunoblastic sarcoma of the B-cell type in the CSF. Light- and electronmicroscopic study of the malignant cells and unusual macrophages. 697 56

We compared the diagnostic accuracy of a new immunological marker of celiac sprue (CS), the antijejunum antibody (JAB), with that of antigliadin (AGA) and antiendomysium (EmA) antibodies. One hundred untreated adults with biopsy-proven CS, 52 healthy controls, and 57 patients with inflammatory bowel disease, lymphoma of the small bowel, Whipple's disease, and irritable bowel syndrome were investigated. Only JAB and EmA were detected at a similar titer in all patients with untreated CS but in no controls (100% sensitivity and specificity). Sensitivity of AGA was, respectively, 55% for IgA and 78% for Ig class, with a 100 and 82% specificity. The differences in frequencies between both EmA and JAB with IgA and IgG AGA were highly significant. We conclude that JAB and EmA provide a reliable noninvasive screening test for clinically significant gluten-sensitive enteropathy. The lower cost of IgA-JAB is a major advantage, owing to the different availability of the lower third of the esophagus and jejunum from primates. The sensitivity and specificity of the two tests are almost identical, but we find interpreting EmA easier than JAB especially when the titer is low.
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PMID:Comparison of serum anti-gliadin, anti-endomysium, and anti-jejunum antibodies in adult celiac sprue. 788 70

Hydrogen breath tests (H2 BT) have been used extensively to investigate intestinal disaccharidase deficiencies. A potentially useful test for assessing intestinal absorptive function, the H2 BT with D-xylose (H2 BT-D-xylose), has received scant attention. We report here the results of our investigation of this test in 45 patients. Fifteen patients had proved malabsorption that was due to nontropical sprue in nine, and to lymphoma, Whipple's disease, or giardiasis in the remainder. Nine patients had small-bowel bacterial overgrowth secondary to either postsurgical sequelae or intestinal dysmotility. Twenty-one patients with irritable bowel syndrome and 21 healthy individuals served as control groups. All participants ingested 25 g of D-xylose, and alveolar breath samples were obtained thereafter at 30 min intervals for 5 hr. Breath H2 was measured by chromatography. Basal H2 production, peak change (delta) and area under the curve (AUC) were calculated. Simultaneously, 5-hr urinary excretion of D-xylose was measured by colorimetry and served as the reference test. In healthy individuals, D-xylose ingestion increased H2 production (delta = 5.8 +/- 1.4 ppm, P < 0.001). Changes were similar in patients with the irritable bowel syndrome. In contrast, the increase was of a much greater magnitude in the malabsorption group (delta = 49.9 +/- 7.2 ppm, P < 0.001 vs healthy controls). AUC analysis yielded comparable results. Test performance analysis showed that, in malabsorption the H2 BT-D-xylose had a sensitivity index of 0.86, which was identical to that of the urinary D-xylose test. Specificity was 1 and 0.95, respectively; and predictability 1 and 0.93, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Potential usefulness of hydrogen breath test with D-xylose in clinical management of intestinal malabsorption. 842 44


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