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[PMID]:28816966
[Au] Autor:Stampfer L; Deutschmann A; Dür E; Eitelberger FG; Fürpass T; Gorkiewicz G; Heinz-Erian P; Heller I; Herzog K; Hopfer B; Kerbl R; Klug E; Krause R; Leitner E; Mache C; Müller T; Pansy J; Pocivalnik M; Scheuba E; Schneditz G; Schweintzger G; Sterniczky E; Zechner E; Hauer AC; Högenauer C; Hoffmann KM
[Ad] Endereço:aDivision of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz bDivision of General Pediatrics and Adolescent Medicine, Hospital Wels-Grieskirchen, Wels cMicrobiologic Laboratory, Institute of Pathology, General Hospital Hochsteiermark, Leoben dInstitute of Pathology, Medical University Graz, Graz eDivision of Pediatrics and Adolescent Medicine fInstitute of Microbiology, Medical University Innsbruck, Innsbruck gDivision of Pediatrics and Adolescent Medicine, General Hospital Hochsteiermark, Leoben hInstitute of Pathology, Hospital Oberwart, Oberwart iDepartment of Internal Medicine, Medical University Graz jInstitute of Hygiene, Microbiology and Environmental Medicine kDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University Graz lInstitute of Molecular Biosciences, Karl-Franzens University Graz, Graz mDivision of Pediatrics and Adolescent Medicine, Hospital Oberwart, Oberwart nDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University Graz, Graz, Austria.
[Ti] Título:Causes of hematochezia and hemorrhagic antibiotic-associated colitis in children and adolescents.
[So] Source:Medicine (Baltimore);96(33):e7793, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Diseases causing hematochezia range from benign to potentially life-threatening. Systematic pediatric data on the causes of hematochezia are scarce. We studied the underlying causes and long-term outcome of hematochezia in children. We further investigated the relevance of antibiotic-associated hemorrhagic colitis in children, especially if caused by Klebsiella oxytoca.Infants, children, and adolescents with hematochezia were recruited prospectively. Patients were grouped according to age (<1 year, 1-5 years, 6-13 years, >14 years). In addition to routine diagnostics, K oxytoca stool culture and toxin analysis was performed. We collected data on history, laboratory findings, microbiological diagnostic, imaging, final diagnosis, and long-term outcome.We included 221 patients (female 46%; age 0-19 years). In 98 (44%), hematochezia was caused by infectious diseases. Endoscopy was performed in 30 patients (13.6%). No patient died due to the underlying cause of hematochezia. The most common diagnoses according to age were food protein-induced proctocolitis in infants, bacterial colitis in young children, and inflammatory bowel disease in children and adolescents. Seventeen (7.7%) had a positive stool culture for K oxytoca. Antibiotic-associated colitis was diagnosed in 12 (5%) patients: 2 caused by K oxytoca and 2 by Clostridium difficile; in the remaining 8 patients, no known pathobiont was identified.Infections were the most common cause of hematochezia in this study. In most patients, invasive diagnostic procedures were not necessary. Antibiotic-associated hemorrhagic colitis caused by K oxytoca was an uncommon diagnosis in our cohort. Antibiotic-associated colitis with hematochezia might be caused by pathobionts other than C difficile or K oxytoca.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Enterocolite/complicações
Hemorragia Gastrointestinal/etiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Enterocolite Pseudomembranosa/etiologia
Enterocolite Pseudomembranosa/microbiologia
Feminino
Hemorragia Gastrointestinal/microbiologia
Seres Humanos
Lactente
Recém-Nascido
Infecções por Klebsiella/complicações
Klebsiella oxytoca/isolamento & purificação
Masculino
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007793


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[PMID]:28731417
[Au] Autor:Mori F; Sarti L; Barni S; Pucci N; Belli F; Stagi S; Novembre E
[Ad] Endereço:Allergy Unit, Department of Pediatrics, Anna Meyer Children's University Hospital, Florence, Italy.
[Ti] Título:Donkey´s Milk Is Well Accepted and Tolerated by Infants With Cow´s Milk Food Protein-Induced Enterocolitis Syndrome: A Preliminary Study.
[So] Source:J Investig Allergol Clin Immunol;27(4):269-271, 2017.
[Is] ISSN:1018-9068
[Cp] País de publicação:Spain
[La] Idioma:eng
[Mh] Termos MeSH primário: Alérgenos/imunologia
Enterocolite/imunologia
Hipersensibilidade a Leite/imunologia
Leite/imunologia
[Mh] Termos MeSH secundário: Animais
Bovinos
Enterocolite/etiologia
Equidae
Feminino
Cabras
Seres Humanos
Lactente
Masculino
Hipersensibilidade a Leite/complicações
Testes Cutâneos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Allergens)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170722
[St] Status:MEDLINE
[do] DOI:10.18176/jiaci.0167


  3 / 1572 MEDLINE  
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[PMID]:28484157
[Au] Autor:Miyamoto Y; Udaka K; Sekimoto E; Shibata H; Otsuka K; Mori K; Shigekiyo T; Ozaki S
[Ad] Endereço:Medical Education Center, Tokushima Prefectural Central Hospital.
[Ti] Título:Hematopoietic neoplasms accompanied by severe enterocolitis due to Aeromonas species.
[So] Source:Rinsho Ketsueki;58(4):303-308, 2017.
[Is] ISSN:0485-1439
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Aeromonas species are known to be a cause of diarrhea and acute enterocolitis. However, only a few cases have been reported and the pathophysiology of Aeromonas infection has not as yet been clarified. We experienced 2 cases developing severe enterocolitis during the course of hematological malignancies, specifically multiple myeloma and diffuse large B-cell lymphoma. Both patients presented with watery diarrhea that persisted for more than a week, followed by bloody diarrhea. Total colon endoscopy showed multiple ulcers on the mucosa from the sigmoid colon to the rectum, and biopsies from the ulcer revealed infiltration of neutrophils and eosinophils in the mucosa and submucosa. Aeromonas hydrophila and Aeromonas sobria were isolated from stool cultures, respectively. Treatment with oral ciprofloxacin was effective in both patients and clinical symptoms showed significant improvement. These cases raise the possibility of Aeromonas infection as a cause of severe enterocolitis and the importance of making a correct differential diagnosis and appropriate antibiotic treatment in immunocompromised patients including those with hematological malignancies.
[Mh] Termos MeSH primário: Aeromonas/isolamento & purificação
Enterocolite/microbiologia
Infecções por Bactérias Gram-Negativas/complicações
Infecções por Bactérias Gram-Negativas/tratamento farmacológico
Linfoma Difuso de Grandes Células B/complicações
Mieloma Múltiplo/complicações
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/uso terapêutico
Antineoplásicos/uso terapêutico
Ciprofloxacino/uso terapêutico
Diarreia/etiologia
Feminino
Seres Humanos
Linfoma Difuso de Grandes Células B/terapia
Masculino
Meia-Idade
Mieloma Múltiplo/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Antineoplastic Agents); 5E8K9I0O4U (Ciprofloxacin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.11406/rinketsu.58.303


  4 / 1572 MEDLINE  
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[PMID]:28418301
[Au] Autor:Bergevin M; Marion A; Farber D; Golding GR; Lévesque S
[Ti] Título:Severe MRSA Enterocolitis Caused by a Strain Harboring Enterotoxins D, G, and I.
[So] Source:Emerg Infect Dis;23(5):865-867, 2017 05.
[Is] ISSN:1080-6059
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We describe a case of methicillin-resistant Staphylococcus aureus (MRSA) enterocolitis in a healthy adult with previous antibiotic exposure. Colonoscopy revealed diffuse colitis and mild ileitis without ulceration. Stool cultures demonstrated abundant growth of MRSA and absent normal flora. Oral vancomycin treatment was effective and seems to be the consensus choice for therapy.
[Mh] Termos MeSH primário: Enterocolite/diagnóstico
Enterocolite/microbiologia
Enterotoxinas
Staphylococcus aureus Resistente à Meticilina
Infecções Estafilocócicas/diagnóstico
Infecções Estafilocócicas/microbiologia
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Biópsia
Endoscopia Gastrointestinal
Enterocolite/tratamento farmacológico
Enterotoxinas/genética
Expressão Gênica
Seres Humanos
Mucosa Intestinal/patologia
Staphylococcus aureus Resistente à Meticilina/genética
Infecções Estafilocócicas/tratamento farmacológico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Enterotoxins)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.3201/eid2305.161644


  5 / 1572 MEDLINE  
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[PMID]:28390583
[Au] Autor:Manti S; Leonardi S; Salpietro A; Del Campo G; Salpietro C; Cuppari C
[Ad] Endereço:Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, Messina, Italy. Electronic address: saramanti@hotmail.it.
[Ti] Título:A systematic review of food protein-induced enterocolitis syndrome from the last 40 years.
[So] Source:Ann Allergy Asthma Immunol;118(4):411-418, 2017 Apr.
[Is] ISSN:1534-4436
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To provide a complete, exhaustive summary of current literature relevant to food protein-induced enterocolitis syndrome (FPIES). DATA SOURCES: Data have been extracted from PubMed and Science Direct databases. STUDY SELECTIONS: Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, a literature search for peer-reviewed journal articles in English through January 1975 with updates through October 2016 was conducted. Relevant publications were reviewed that included pediatric and adult populations. Information on the study design, sample, intervention, comparators, outcome, timeframe, and risk of bias were abstracted for each article. RESULTS: Of 135 reviewed reports, 52 were included in this systematic review. In accordance with the age at onset, clinical features, and offending foods, it is possible to distiguish different types of FPIES. An immune systemic involvement can occur in patients with FPIES. In addition to the most common causative foods (cow's milk, soy, and rice), any food can potentially cause FPIES. Although specific diagnostic tests are not available, open food challenge remains the gold standard for FPIES diagnosis. Moreover, because of the lack of randomized clinical trials and of use of different adopted methods, confounding factors might mask critical findings, leading to poor knowledge of this pleiotropic clinical entity. CONCLUSION: Multicenter studies are needed to better develop an evidence-based approach to pathophysiology, prevalence, diagnosis, and natural history of the disease.
[Mh] Termos MeSH primário: Alérgenos/imunologia
Proteínas na Dieta/imunologia
Enterocolite/etiologia
Hipersensibilidade Alimentar/complicações
Hipersensibilidade Alimentar/imunologia
[Mh] Termos MeSH secundário: Animais
Proteínas na Dieta/classificação
Enterocolite/diagnóstico
Enterocolite/história
Hipersensibilidade Alimentar/diagnóstico
Hipersensibilidade Alimentar/história
História do Século XX
História do Século XXI
Seres Humanos
Imunidade Celular
Imunidade Humoral
Fenótipo
Síndrome
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Allergens); 0 (Dietary Proteins)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170804
[Lr] Data última revisão:
170804
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170410
[St] Status:MEDLINE


  6 / 1572 MEDLINE  
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[PMID]:28373768
[Au] Autor:Jain A; Lipson EJ; Sharfman WH; Brant SR; Lazarev MG
[Ad] Endereço:Animesh Jain, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC 27599-7080, United States.
[Ti] Título:Colonic ulcerations may predict steroid-refractory course in patients with ipilimumab-mediated enterocolitis.
[So] Source:World J Gastroenterol;23(11):2023-2028, 2017 Mar 21.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: To investigate management of patients who develop ipilimumab-mediated enterocolitis, including association of endoscopic findings with steroid-refractory symptoms and utility of infliximab as second-line therapy. METHODS: We retrospectively reviewed all patients at our center with metastatic melanoma who were treated with ipilimumab between March 2011 and May 2014. All patients received a standard regimen of intravenous ipilimumab 3 mg/kg every 3 wk for four doses or until therapy was stopped due to toxicity or disease progression. Basic demographic and clinical data were collected on all patients. For patients who developed grade 2 or worse diarrhea (increase of 4 bowel movements per day), additional data were collected regarding details of gastrointestinal symptoms, endoscopic findings and treatment course. Descriptive statistics were used. RESULTS: A total of 114 patients were treated with ipilimumab during the study period and all were included. Sixteen patients (14%) developed ≥ grade 2 diarrhea. All patients were treated with high-dose corticosteroids (1-2 mg/kg prednisone daily or equivalent). Nine of 16 patients (56%) had ongoing diarrhea despite high-dose steroids. Steroid-refractory patients received one dose of intravenous infliximab at 5 mg/kg, and all but one had brisk resolution of diarrhea. Fourteen of the patients underwent either colonoscopy or sigmoidoscopy with variable endoscopic findings, ranging from mild erythema to colonic ulcers. Among 8 patients with ulcers demonstrated by sigmoidoscopy or colonoscopy, 7 patients (88%) developed steroid-refractory symptoms requiring infliximab. With a median follow-up of 264 d, no major adverse events associated with prednisone or infliximab were reported. CONCLUSION: In patients with ipilimumab-mediated enterocolitis, the presence of colonic ulcers on endoscopy was associated with a steroid-refractory course.
[Mh] Termos MeSH primário: Corticosteroides/farmacologia
Anticorpos Monoclonais/efeitos adversos
Antineoplásicos/efeitos adversos
Doenças do Colo/tratamento farmacológico
Resistência a Medicamentos
Enterocolite/tratamento farmacológico
Melanoma/tratamento farmacológico
Neoplasias Cutâneas/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Intravenosa
Corticosteroides/efeitos adversos
Corticosteroides/uso terapêutico
Anticorpos Monoclonais/administração & dosagem
Anticorpos Monoclonais/uso terapêutico
Antineoplásicos/administração & dosagem
Antineoplásicos/uso terapêutico
Antígeno CTLA-4/antagonistas & inibidores
Antígeno CTLA-4/imunologia
Doenças do Colo/induzido quimicamente
Doenças do Colo/diagnóstico
Doenças do Colo/imunologia
Colonoscopia
Diarreia/tratamento farmacológico
Diarreia/etiologia
Enterocolite/induzido quimicamente
Enterocolite/diagnóstico
Enterocolite/imunologia
Feminino
Fármacos Gastrointestinais/uso terapêutico
Seres Humanos
Infliximab/uso terapêutico
Ipilimumab
Masculino
Meia-Idade
Prednisona/efeitos adversos
Prednisona/farmacologia
Prednisona/uso terapêutico
Estudos Retrospectivos
Úlcera/induzido quimicamente
Úlcera/diagnóstico
Úlcera/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents); 0 (CTLA-4 Antigen); 0 (Gastrointestinal Agents); 0 (Ipilimumab); B72HH48FLU (Infliximab); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i11.2023


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[PMID]:28333760
[Au] Autor:Wurm P; Spindelboeck W; Krause R; Plank J; Fuchs G; Bashir M; Petritsch W; Halwachs B; Langner C; Högenauer C; Gorkiewicz G
[Ad] Endereço:1Institute of Pathology, Medical University of Graz, Graz, Austria. 2Theodor Escherich Laboratory for Medical Microbiome Research, Medical University of Graz, Graz, Austria. 3Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 4Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 5Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria. 6Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 7BioTechMed, Interuniversity Cooperation, Graz, Austria.
[Ti] Título:Antibiotic-Associated Apoptotic Enterocolitis in the Absence of a Defined Pathogen: The Role of Intestinal Microbiota Depletion.
[So] Source:Crit Care Med;45(6):e600-e606, 2017 Jun.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Antibiotic therapy is a major risk factor for the development of diarrhea and colitis with varying severity. Often the origin of antibiotic-associated gastrointestinal deterioration remains elusive and no specific infectious agents could be discerned. PATIENTS: We represent three cases of intractable high-volume diarrhea associated with combined antibiotic and steroid therapy in critically ill patients not fitting into established disease entities. Cases presented with severe apoptotic enterocolitis resembling acute intestinal graft-versus-host-disease. Microbiologic workup precluded known enteropathogens, but microbiota analysis revealed a severely depleted gut microbiota with concomitant opportunistic pathogen overgrowth. INTERVENTIONS: Fecal microbiota transplantation, performed in one patient, was associated with correction of dysbiosis, rapid clinical improvement, and healing of enterocolitis. CONCLUSIONS: Our series represents a severe form of antibiotic-associated colitis in critically ill patients signified by microbiota depletion, and reestablishment of a physiologic gastrointestinal microbiota might be beneficial for this condition.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Enterocolite/induzido quimicamente
Enterocolite/microbiologia
Microbioma Gastrointestinal/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Enterocolite/terapia
Transplante de Microbiota Fecal/métodos
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002310


  8 / 1572 MEDLINE  
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[PMID]:28221690
[Au] Autor:Chung SM; Kim KH; Kim KO; Kim TN
[Ad] Endereço:Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
[Ti] Título:Hepatobiliary and Pancreatic: Hepatic portal vein gas accompanied by acute enterocolitis improved with non-surgical treatment.
[So] Source:J Gastroenterol Hepatol;32(2):294, 2017 Feb.
[Is] ISSN:1440-1746
[Cp] País de publicação:Australia
[La] Idioma:eng
[Mh] Termos MeSH primário: Enterocolite/complicações
Gases
Fígado/irrigação sanguínea
Fígado/diagnóstico por imagem
Doenças Vasculares Periféricas/diagnóstico por imagem
Doenças Vasculares Periféricas/etiologia
Veia Porta/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Ceco/diagnóstico por imagem
Ceco/patologia
Feminino
Seres Humanos
Íleus/diagnóstico por imagem
Íleus/patologia
Doenças Vasculares Periféricas/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Gases)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1111/jgh.13605


  9 / 1572 MEDLINE  
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[PMID]:28211341
[Au] Autor:Nowak-Wegrzyn A; Jarocka-Cyrta E; Moschione Castro A
[Ad] Endereço:Jaffe Food Allergy Institute, Department of Pediatrics, Division of Allergy and Immunology, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
[Ti] Título:Food Protein-Induced Enterocolitis Syndrome.
[So] Source:J Investig Allergol Clin Immunol;27(1):1-18, 2017.
[Is] ISSN:1018-9068
[Cp] País de publicação:Spain
[La] Idioma:eng
[Ab] Resumo:Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-, cell-mediated food allergy of unknown prevalence and pathophysiology. Onset is typically during the first year of life; seafood-induced FPIES may start in adulthood. Acute FPIES manifests within 1-4 hours after ingestion with repetitive emesis, pallor, and lethargy progressing to dehydration and hypovolemic shock in 15% of cases. Chronic FPIES manifests with intermittent emesis, watery diarrhea, and poor growth progressing to dehydration and hypovolemic shock over a period of days to weeks. Chronic FPIES has been only reported in infants aged less than 3 months fed with cow milk (CM) or soy formula. The most common triggers are CM, soy, rice, and oat. Diagnosis of FPIES relies on recognition of a pattern of clinical symptoms and may be missed owing to the absence of typical allergic symptoms (eg, urticaria, wheezing) and delayed onset in relation to food ingestion. Physician-supervised food challenge is recommended if diagnosis or the trigger food is not clear and to evaluate for resolution. Testing for food-specific IgE is usually negative, although a subset of patients, usually with CM-induced FPIES may develop sensitization to foods. Such atypical FPIES tends to have a more prolonged course. Despite the potential severity of the reactions, no fatalities have been reported, and FPIES has a favorable prognosis. In most cases, FPIES resolves by age 3-5 years, although persistence of CM-induced FPIES and soy FPIES into adulthood has been reported. The first international consensus guidelines on diagnosis and management of FPIES were published in 2017. Given that the pathophysiology of FPIES is poorly understood, there are no diagnostic biomarkers and no therapies to accelerate resolution. These unmet needs warrant future investigations to improve the care of patients with FPIES.
[Mh] Termos MeSH primário: Proteínas na Dieta/efeitos adversos
Enterocolite/imunologia
Hipersensibilidade Alimentar/imunologia
Imunidade Celular
[Mh] Termos MeSH secundário: Pré-Escolar
Proteínas na Dieta/imunologia
Enterocolite/diagnóstico
Enterocolite/epidemiologia
Enterocolite/terapia
Hipersensibilidade Alimentar/diagnóstico
Hipersensibilidade Alimentar/epidemiologia
Hipersensibilidade Alimentar/terapia
Seres Humanos
Testes Imunológicos
Lactente
Prognóstico
Fatores de Risco
Índice de Gravidade de Doença
Síndrome
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Dietary Proteins)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE
[do] DOI:10.18176/jiaci.0135


  10 / 1572 MEDLINE  
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[PMID]:28204866
[Au] Autor:Bergqvist V; Hertervig E; Gedeon P; Kopljar M; Griph H; Kinhult S; Carneiro A; Marsal J
[Ad] Endereço:Department of Gastroenterology, Skane University Hospital, 22185, Lund, Sweden.
[Ti] Título:Vedolizumab treatment for immune checkpoint inhibitor-induced enterocolitis.
[So] Source:Cancer Immunol Immunother;66(5):581-592, 2017 May.
[Is] ISSN:1432-0851
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Immune checkpoint inhibitors (ICPI), such as ipilimumab [anti-cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody] and nivolumab or pembrolizumab [anti-programmed cell death protein-1 (PD-1) antibodies], improve survival in several cancer types. Since inhibition of CTLA-4 or PD-1 leads to non-selective activation of the immune system, immune-related adverse events (irAEs) are frequent. Enterocolitis is a common irAE, currently managed with corticosteroids and, if necessary, anti-tumor necrosis factor-α therapy. Such a regimen carries a risk of serious side-effects including infections, and may potentially imply impaired antitumor effects. Vedolizumab is an anti-integrin α4ß7 antibody with gut-specific immunosuppressive effects, approved for Crohn's disease and ulcerative colitis. We report a case series of seven patients with metastatic melanoma or lung cancer, treated with vedolizumab off-label for ipilimumab- or nivolumab-induced enterocolitis, from June 2014 through October 2016. Clinical, laboratory, endoscopic, and histologic data were analyzed. Patients initially received corticosteroids but were steroid-dependent and/or partially refractory. One patient was administered infliximab but was refractory. The median time from onset of enterocolitis to start of vedolizumab therapy was 79 days. Following vedolizumab therapy, all patients but one experienced steroid-free enterocolitis remission, with normalized fecal calprotectin. This was achieved after a median of 56 days from vedolizumab start, without any vedolizumab-related side-effects noted. The patient in whom vedolizumab was not successful, due to active ulcerative colitis, received vedolizumab prophylactically. This is the first case series to suggest that vedolizumab is an effective and well-tolerated therapeutic for steroid-dependent or partially refractory ICPI-induced enterocolitis. A larger prospective study to evaluate vedolizumab in this indication is warranted.
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/uso terapêutico
Pontos de Checagem do Ciclo Celular/efeitos dos fármacos
Enterocolite/tratamento farmacológico
Fármacos Gastrointestinais/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Anticorpos Monoclonais/uso terapêutico
Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico
Enterocolite/patologia
Feminino
Seres Humanos
Ipilimumab
Neoplasias Pulmonares/tratamento farmacológico
Masculino
Melanoma/tratamento farmacológico
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antibodies, Monoclonal, Humanized); 0 (Gastrointestinal Agents); 0 (Ipilimumab); 31YO63LBSN (nivolumab); 9RV78Q2002 (vedolizumab)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE
[do] DOI:10.1007/s00262-017-1962-6



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