AIM:To compare the results of high-resolution ultrasound(HR-US) and magnetic resonance enterography(MRE) examinations in patients with inflammatory bowel disease(IBD).METHODS:The reports of 250 consecutive cases with ...AIM:To compare the results of high-resolution ultrasound(HR-US) and magnetic resonance enterography(MRE) examinations in patients with inflammatory bowel disease(IBD).METHODS:The reports of 250 consecutive cases with known IBD,who had an MRE and HR-US examination,were retrospectively analyzed.Using a patient-based approach we evaluated morphological disease features such as affected bowel wall,stenosis,abscess and fistula.The comparison between the two modalities was based on the hypothesis,that any pathological change described in any imaging modality was a true finding,as no further standard of reference was available for complete assessment.RESULTS:Two hundred and fifty examinations representing 207 different patients were evaluated.Both modalities assessed similar bowel wall changes in 65% of the examinations,with more US findings in 11% and more MRE findings in 15%.When the reports were analyzed with regard to "bowel wall inflammation",US reported more findings in 2%,while MRE reported more findings in 53%.Stenoses were assessed to be identical in 8%,while US found more in 3% and MRE in 29%(P < 0.01).For abscess detection,US showed more findings in 2%(n = 4) while MRE detected more in 6%(n = 16).US detected more fistulas in 1%(n = 2),while MRE detected more in 13%(n = 32)(P < 0.001).The most common reason for no detected pathology by US was a difficult to assess anatomical region(lesser pelvis,n = 72).CONCLUSION:US can miss clinically relevant pathological changes in patients with IBD mostly due to difficulty in assessing certain anatomical regions.展开更多
We describe the first case of sirolimus-induced drug fever in a female liver transplant recipient, with a history of hepatitis C-induced end-stage liver cirrhosis in 1999. In 2005, six years after transplantation, she...We describe the first case of sirolimus-induced drug fever in a female liver transplant recipient, with a history of hepatitis C-induced end-stage liver cirrhosis in 1999. In 2005, six years after transplantation, she developed calcineurin inhibitor-induced renal function impairment. Immunosuppression was switched from tacrolimus to sirolimus. Two days after the intake of sirolimus, she developed daily fever spikes, but no infectious focus was found. Antibiotic therapy had no influence on the fever. After fourteen days, sirolimus was switched back to tacrolimus and the fever disappeared. In history, the patient developed ciclosporin-induced generalized seizures eleven days after liver transplantation, followed by the development of a motoric speech disorder. Magnetic resonance imaging (MRI) findings were consistent with leucoencephalopathy, therefore immunosuppressive therapy was changed from ciclosporin to tacrolimus and the neurologic symptoms improved significantly. Our case is the first reported case of sirolimus-induced drug fever. In addition, the patient showed the rare occurrence of ciclosporin-induced leukencephalopathy with seizures.展开更多
文摘AIM:To compare the results of high-resolution ultrasound(HR-US) and magnetic resonance enterography(MRE) examinations in patients with inflammatory bowel disease(IBD).METHODS:The reports of 250 consecutive cases with known IBD,who had an MRE and HR-US examination,were retrospectively analyzed.Using a patient-based approach we evaluated morphological disease features such as affected bowel wall,stenosis,abscess and fistula.The comparison between the two modalities was based on the hypothesis,that any pathological change described in any imaging modality was a true finding,as no further standard of reference was available for complete assessment.RESULTS:Two hundred and fifty examinations representing 207 different patients were evaluated.Both modalities assessed similar bowel wall changes in 65% of the examinations,with more US findings in 11% and more MRE findings in 15%.When the reports were analyzed with regard to "bowel wall inflammation",US reported more findings in 2%,while MRE reported more findings in 53%.Stenoses were assessed to be identical in 8%,while US found more in 3% and MRE in 29%(P < 0.01).For abscess detection,US showed more findings in 2%(n = 4) while MRE detected more in 6%(n = 16).US detected more fistulas in 1%(n = 2),while MRE detected more in 13%(n = 32)(P < 0.001).The most common reason for no detected pathology by US was a difficult to assess anatomical region(lesser pelvis,n = 72).CONCLUSION:US can miss clinically relevant pathological changes in patients with IBD mostly due to difficulty in assessing certain anatomical regions.
文摘We describe the first case of sirolimus-induced drug fever in a female liver transplant recipient, with a history of hepatitis C-induced end-stage liver cirrhosis in 1999. In 2005, six years after transplantation, she developed calcineurin inhibitor-induced renal function impairment. Immunosuppression was switched from tacrolimus to sirolimus. Two days after the intake of sirolimus, she developed daily fever spikes, but no infectious focus was found. Antibiotic therapy had no influence on the fever. After fourteen days, sirolimus was switched back to tacrolimus and the fever disappeared. In history, the patient developed ciclosporin-induced generalized seizures eleven days after liver transplantation, followed by the development of a motoric speech disorder. Magnetic resonance imaging (MRI) findings were consistent with leucoencephalopathy, therefore immunosuppressive therapy was changed from ciclosporin to tacrolimus and the neurologic symptoms improved significantly. Our case is the first reported case of sirolimus-induced drug fever. In addition, the patient showed the rare occurrence of ciclosporin-induced leukencephalopathy with seizures.
