Burstiner LS, Santharam Y, Mikulas C
… +4 more, Agrawal A, Mathew R, Senada P, Ghali MP
Case Rep Gastroenterol
· 2025 · PMID 41064555
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INTRODUCTION: Kratom is an herbal preparation - generally an extract, capsule, chew, or smoking substrate - made from the leaves of a tropical tree () that is indigenous to Southeast Asia. Its physiological effects are c...INTRODUCTION: Kratom is an herbal preparation - generally an extract, capsule, chew, or smoking substrate - made from the leaves of a tropical tree () that is indigenous to Southeast Asia. Its physiological effects are complex and dose dependent: low doses mimic stimulants, while higher doses have sedative and analgesic effects. Although injury and failure of various organs have been reported with kratom use across multiple case study analyses, gastrointestinal involvement has been rarely documented. CASE PRESENTATION: We present a 26-year-old female with no past medical history, no risk factors for intestinal ischemia, and an addiction to the commercial substance, kratom, who presented for 1 day of bright-red bloody diarrhea and bilious vomiting, and several weeks of intermittent sharp abdominal pain. Colonoscopy showed decreased mucosa vascular pattern in watershed areas of the colon and a splenic flexure that was so ulcerated it could not be safely traversed. CONCLUSION: Given the lack of concomitant risk factors and comorbidities, as well as the timing of her symptoms beginning well before she started any medications, our most likely patient developed ischemic colitis due to her kratom use. This is further supported by her repeat colonoscopy 2 months after quitting kratom, which showed complete resolution. We would advise vigilance for possible bowel ischemia in those using kratom, a substance on which there is currently limited knowledge.
Case Rep Gastroenterol
· 2025 · PMID 41064554
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INTRODUCTION: As an osmotic laxative, lactulose offers superior palatability and comparable bowel-cleansing efficacy to PEG, making it suitable for resource-limited settings, but its hypertonicity may potentially increas...INTRODUCTION: As an osmotic laxative, lactulose offers superior palatability and comparable bowel-cleansing efficacy to PEG, making it suitable for resource-limited settings, but its hypertonicity may potentially increase the risk of intussusception in susceptible individuals (such as children with intestinal polyps). CASE PRESENTATION: This first reported case describes a 2-year-old boy with intermittent hematochezia who developed acute descending colonic intussusception confirmed by CT within hours of receiving lactulose (20 mL) for bowel preparation. Laparoscopic reduction and subsequent colonoscopy identified a large pedunculated juvenile polyp (25 × 28 mm) as the pathological lead point, which was endoscopically resected. The temporal link between lactulose administration and symptom onset, combined with its known pharmacological effects, strongly suggests lactulose-induced hyperperistalsis precipitated intussusception by mechanically displacing the occult polyp. CONCLUSION: This highlights a novel risk of osmotic laxatives in children with undiagnosed intestinal polyp.
Yambe K, Tsujinaka S, Miura T
… +4 more, Nakamura Y, Nakano T, Shibata C, Katayose Y
Case Rep Gastroenterol
· 2025 · PMID 41064553
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INTRODUCTION: Paraganglioma is an extra-adrenal pheochromocytoma that requires surgical resection with strict perioperative management because of its catecholamine-producing nature. We report a case of successful laparos...INTRODUCTION: Paraganglioma is an extra-adrenal pheochromocytoma that requires surgical resection with strict perioperative management because of its catecholamine-producing nature. We report a case of successful laparoscopic resection of a large retroperitoneal paraganglioma in an older patient. CASE PRESENTATION: An 80-year-old man was diagnosed with hypertension during a routine health checkup. Elevated plasma metanephrine and normetanephrine levels, along with radiological findings of a 6.5-cm tumor with I-metaiodobenzylguanidine accumulation anterior to the aorta, confirmed the diagnosis of retroperitoneal paraganglioma. Surgical resection was planned accordingly. Preoperative optimization with a selective α1 blocker was conducted over 2 months, and intravenous saline infusion was administered the day before surgery. Laparoscopic exploration revealed a tumor on the dorsal side of the small bowel mesentery, extending dorsally and caudally to the third portion of the duodenum. En bloc resection was performed using a six-port approach. Intraoperatively, systolic blood pressure transiently spiked to 170 mm Hg during tumor manipulation but was controlled with an intravenous bolus of phentolamine mesylate. Post-resection hypotension was effectively prevented by the continuous infusion of low-dose noradrenaline. Postoperatively, the blood pressure remained well controlled without medication, and no surgical complications occurred. Histopathological examination confirmed the diagnosis of a paraganglioma. CONCLUSION: This case highlights the importance of precise diagnosis, meticulous perioperative planning and management, and minimally invasive surgery in the successful treatment of large retroperitoneal paragangliomas in older patients.
Zhu J, Sui X, Shu P
… +5 more, Sui Z, Ma D, Zhang J, Wang X, Hu Q
Case Rep Gastroenterol
· 2025 · PMID 41064552
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INTRODUCTION: Biliary tract stones are a common clinical condition. The primary clinical symptoms include intermittent pain in the right upper quadrant and upper abdomen. During acute episodes, the pain may become persis...INTRODUCTION: Biliary tract stones are a common clinical condition. The primary clinical symptoms include intermittent pain in the right upper quadrant and upper abdomen. During acute episodes, the pain may become persistent. A small number of patients may also present with jaundice. CASE PRESENTATION: An 80-year-old male was admitted to the hospital due to right upper quadrant pain persisting for over 12 h. Examination revealed that the patient had common bile duct stones with cholangitis, as well as gallbladder stones with cholecystitis. The patient's biliary anatomy showed the cystic duct opening into an accessory right hepatic duct, which formed a low confluence with the common hepatic duct to become the common bile duct. Surgical intervention was therefore performed. We managed the stones in this anatomically complex biliary configuration by placing a C-tube through the cystic duct, performing primary closure of the accessory right hepatic duct, and placing a T-tube in the common hepatic duct. CONCLUSION: The patient recovered well postoperatively. By placing the C-tube and performing primary closure of the accessory right hepatic duct, we reduced the incidence of bile leakage and concurrently lowered the risk of soft tissue infection at the incision site and intra-abdominal infection. Furthermore, the placement of a C-tube offers an alternative approach for managing accidental bile duct injury during biliary surgery.
Case Rep Gastroenterol
· 2025 · PMID 41064551
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INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is the standard treatment for common bile duct (CBD) stones. However, in 10-15% of cases involving large or multiple stones, this ap...INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is the standard treatment for common bile duct (CBD) stones. However, in 10-15% of cases involving large or multiple stones, this approach is inadequate. Advanced techniques such as lithotripsy, dilation, balloon extraction, or surgery may be required. CASE PRESENTATION: We present 2 post-cholecystectomy patients with large (>1.5 cm), multiple impacted CBD stones. Initial ERCP attempts, including sphincterotomy and 15-mm balloon dilation, failed to clear the stones. As a bridging strategy, two plastic stents (10 Fr and 7 Fr) were placed, and ursodeoxycholic acid therapy was started. On re-evaluation at 50 and 80 days, stone clearance was achieved using simple balloon extraction - without lithotripsy or cholangioscopy - using the same tools as the initial ERCP. CONCLUSION: Double plastic stent placement can serve as an effective interim measure for complex CBD stones, facilitating complete clearance in subsequent ERCP with standard equipment.
van der Laan IN, Homs MYV, Madsen EVE
… +1 more, Lammers WJ
Case Rep Gastroenterol
· 2025 · PMID 41064550
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INTRODUCTION: Endoscopic ultrasound-guided gastroenterostomy is an emerging treatment for malignant gastric outlet obstruction, with high clinical and technical success rates and reported complication risks around 10%. H...INTRODUCTION: Endoscopic ultrasound-guided gastroenterostomy is an emerging treatment for malignant gastric outlet obstruction, with high clinical and technical success rates and reported complication risks around 10%. However, the long-term risks associated with the presence of a metal stent remain unclear. CASE PRESENTATION: We present the case of a 35-year-old male with duodenal carcinoma and peritoneal metastases, treated with endoscopic ultrasound-guided gastroenterostomy because of gastric outlet obstruction, who developed a delayed jejunal perforation 10 months after the procedure. The perforation, likely related to the lumen-apposing metal stent, was resected. Thereafter, the patient recovered and resumed immunotherapy with no measurable disease on follow-up computed tomography. CONCLUSION: This report describes a case with a delayed jejunal perforation 10 months after endoscopic ultrasound-guided gastroenterostomy in a patient with metastatic duodenal carcinoma with complete treatment response to immunotherapy. We advise stent removal once the duodenal obstruction has resolved, given the potential risk of complications associated with prolonged stents in place.
Pan FY, Leong R, Gupta S
… +2 more, Fuchs T, Kariyawasam V
Case Rep Gastroenterol
· 2025 · PMID 41064549
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INTRODUCTION: Patients with longstanding ulcerative colitis (UC) face an increased risk of colorectal cancer, necessitating regular surveillance. Chronic inflammation frequently leads to submucosal fibrosis, making the r...INTRODUCTION: Patients with longstanding ulcerative colitis (UC) face an increased risk of colorectal cancer, necessitating regular surveillance. Chronic inflammation frequently leads to submucosal fibrosis, making the resection of non-lifting lesions difficult with standard techniques like endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). CASE PRESENTATION: We present a 76-year-old UC patient with a splenic flexure adenoma that was unresectable via EMR/ESD. Given the high surgical risk, the OVESCO system was used, achieving clear margins and avoiding colectomy. CONCLUSION: This case highlights full-thickness resection devices as a minimally invasive alternative for challenging polyps in UC, preserving bowel function while avoiding major surgery or stoma formation.
Toritani K, Kimura H, Maebashi M
… +7 more, Imanishi K, Homma M, Kurimura K, Haruyama S, Nakamori Y, Kunisaki R, Endo I
Case Rep Gastroenterol
· 2025 · PMID 41064548
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INTRODUCTION: Pneumonia is a leading cause of postoperative mortality in elderly patients with ulcerative colitis (UC), and close attention should be paid to the possibility of pneumonia (PJP) in patients with immunosup...INTRODUCTION: Pneumonia is a leading cause of postoperative mortality in elderly patients with ulcerative colitis (UC), and close attention should be paid to the possibility of pneumonia (PJP) in patients with immunosuppression. We present the case of a patient with severe PJP that was challenging to diagnose because of postoperative sepsis complications in an elderly patient with acute severe ulcerative colitis (ASUC) with immunosuppression. CASE PRESENTATION: A 70-year-old man was transferred to our hospital and was diagnosed with ASUC. The patient underwent laparoscopic subtotal colectomy for prednisolone and granulocyte and monocyte adsorptive apheresis-resistance UC 22 days after transfer. On postoperative day (POD) 9, the central venous catheter (CVC) was removed because CVC-related blood stream infection (CRBSI) was suspected. On POD 12, fluconazole was administered for sepsis due to CRBSI, and a septic pulmonary embolism was suspected. The patient's hypoxemia worsened; trimethoprim-sulfamethoxazole was administered because PJP was suspected on POD 19; however, ventilatory support was started on POD 21. PJP was diagnosed based on bronchoalveolar lavage on POD 25, and high-dose prednisolone therapy was initiated. The patient was weaned off the ventilator on POD 27 and was discharged home on POD 54. Proctectomy and stapled ileal pouch-anal anastomosis were performed at 10 months postoperatively, and the patient is currently alive at 1 year and 6 months after surgery. CONCLUSION: Postoperative hypoxemia in elderly patients with ASUC should be considered in the differential diagnosis of PJP, even during the treatment of sepsis.
Case Rep Gastroenterol
· 2025 · PMID 41064547
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INTRODUCTION: Glucagon-like peptide-1 receptor agonists such as liraglutide have revolutionized the management of type 2 diabetes and obesity. CASE PRESENTATION: We present a case of a 30-year-old woman who developed dru...INTRODUCTION: Glucagon-like peptide-1 receptor agonists such as liraglutide have revolutionized the management of type 2 diabetes and obesity. CASE PRESENTATION: We present a case of a 30-year-old woman who developed drug-induced liver injury (DILI) to liraglutide, confirmed on histology, with resolution on cessation of liraglutide over 6 months. CONCLUSION: DILI secondary to liraglutide appears to be a rare but an important adverse effect.
Kerkham AL, Weltman MD, Jennings Z
… +1 more, Liem H
Case Rep Gastroenterol
· 2025 · PMID 41064546
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INTRODUCTION: Disseminated histoplasmosis is a rare cause of granulomatous, cholestatic liver disease. It can also manifest with gastrointestinal (GI) tract involvement, usually with ulceration or mucosal thickening, but...INTRODUCTION: Disseminated histoplasmosis is a rare cause of granulomatous, cholestatic liver disease. It can also manifest with gastrointestinal (GI) tract involvement, usually with ulceration or mucosal thickening, but is rarely reported as a cause of mass lesions in the GI tract. It is also very rare for disseminated histoplasmosis to present in an immunocompetent host. CASE PRESENTATION: We present a case of cholestatic liver disease and a small bowel mass in a 50-year-old male that has not previously been described in an immunocompetent host. CONCLUSION: Timely diagnosis requires a high index of suspicion, particularly if there has been exposure to high-risk environments such as contaminated soils, as delayed diagnosis is associated with significant mortality.
Case Rep Gastroenterol
· 2025 · PMID 41064545
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INTRODUCTION: Acute-on-chronic liver failure (ACLF) associated with multi-organ failure has a high mortality burden. The mechanisms are thought to be driven by hyperactive inflammatory and immune responses triggered by m...INTRODUCTION: Acute-on-chronic liver failure (ACLF) associated with multi-organ failure has a high mortality burden. The mechanisms are thought to be driven by hyperactive inflammatory and immune responses triggered by microbial and nonmicrobial factors. Therapeutic plasma exchange (TPE) is a potential alternative to liver transplant that improves survival. CASE PRESENTATION: A 56-year-old man with Child-Pugh C11 alcoholic liver cirrhosis was admitted to the intensive care unit for grade 3 ACLF, precipitated by severe alcoholic hepatitis (albumin 29, bilirubin 414, ALP 133, ALT 40, AST 128, Na 123, creatinine 487, INR 1.82) with MELD score of 39. He required inotropic support and renal replacement therapy. The patient was started on antibiotics and steroids for Maddrey Discriminant Function (MDF) score of 67.9. However, there was no improvement with Lille score 0.958 (<0.45) on day 7; hence, steroids were discontinued. The patient was not a liver transplant candidate due to alcoholism and poor social support. He was commenced on a trial of TPE and completed 3 cycles with standard volume plasma replacement resulting in clinical and biochemical improvement. He was discharged from hospital with 90-day survival at outpatient review. CONCLUSION: This highlights that TPE is a potential treatment option in alcoholic ACLF patients who would otherwise be at high risk of mortality at 1 month. TPE reduces systemic inflammatory reactions and modulates the adaptive immune response. This is especially important given organ scarcity and limited transplant options for those without social support.
Case Rep Gastroenterol
· 2025 · PMID 41064544
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INTRODUCTION: Reactive intravascular plasmablastic/immunoblastic proliferation (RIVPIP) is rarely reported. RIVPIP may histologically mimic aggressive intravascular lymphoma, especially in the context of an old patient p...INTRODUCTION: Reactive intravascular plasmablastic/immunoblastic proliferation (RIVPIP) is rarely reported. RIVPIP may histologically mimic aggressive intravascular lymphoma, especially in the context of an old patient presenting with concurrent indolent lymphoma and tuberculosis, and easily lead to erroneous diagnosis. CASE PRESENTATION: A 79-year-old female presenting with upper abdominal discomfort, weight loss, hypoproteinemia, and polyserosal effusions underwent a gastric endoscopy examination. Biopsy revealed that the lamina propria was infiltrated by a large number of uniformly small-sized lymphocytes (CD20+/PAX5+) with lymphoepithelial lesions and epithelioid granuloma. Notably, vascular lumens were filled and distended by abundant large-sized plasmablasts or immunoblasts (CD79α+/MUM1+/CD20-/CD138-/PAX5-/CD30-/Bcl-2-/Bcl-6-/C-myc-). These intravascular large lymphoid cells demonstrated high proliferative activity (Ki67 >80%) without immunoglobulin light chain restriction or EBV association (EBER-ISH negative). Furthermore, PCR revealed monoclonal rearrangements in IgH, IgK, and IgL genes. The patient had a history of endoscopic gastric biopsy 2 months ago. Retrospective analysis of a prior biopsy identified conspicuous caseating necrosis, epithelioid granuloma, multinucleated giant cells with suspicious positivity for acid-fast staining, highly suggestive of tuberculosis. Based on two biopsy specimens and systemic symptoms, the case was finally diagnosed as gastric MALT lymphoma and tuberculosis with extensive RIVPIP. CONCLUSION: We present an unusual case of RIVPIP with severe systemic symptoms due to concurrent gastric MALT lymphoma and tuberculosis, emphasizing a potential diagnostic pitfall for clinical pathologists in distinguishing RIVPIP from the aggressive intravascular lymphoma. A comprehensive evaluation of clinical manifestations, pathological morphology, immunophenotype and gene analysis is required to make the precise diagnosis.
Kato Y, Matsuda H, Kikukawa T
… +5 more, Isihara A, Matsuda Y, Miyashita S, Nishikawa M, Uenishi T
Case Rep Gastroenterol
· 2025 · PMID 41064543
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INTRODUCTION: Here, we report a case of gastric cancer associated with autosomal dominant polycystic kidney disease (ADPKD). CASE PRESENTATION: A 73-year-old woman with chronic renal failure due to polycystic kidneys, wh...INTRODUCTION: Here, we report a case of gastric cancer associated with autosomal dominant polycystic kidney disease (ADPKD). CASE PRESENTATION: A 73-year-old woman with chronic renal failure due to polycystic kidneys, who was undergoing hemodialysis treatment three times a week for 1 month, was admitted to our hospital because of anemia. She reported that her mother had suffered from polycystic kidney disease. Gastrointestinal fiberscopy revealed a type 1 cancerous lesion in the lesser curvature of the antrum. Histopathological analysis of gastric tumor biopsy specimens revealed differentiated tubular adenocarcinoma. Abdominal computed tomography revealed multiple cysts in the liver, cystic lesions on both kidneys, and thickening of the gastric wall. A laparoscopic distal gastrectomy with lymph node dissection was performed. CONCLUSION: Reports of the association between gastric cancer and ADPKD are exceptionally uncommon. Especially, no cases of laparoscopic distal gastrectomy for gastric cancer with ADPKD have been previously reported. To our knowledge, this is the first report of laparoscopic surgery for gastric cancer with ADPKD and multiple liver cysts.
Misawa N, Higurashi T, Inoue K
… +6 more, Suzuki H, Tamura S, Yoneda M, Hori C, Yamanaka S, Nakajima A
Case Rep Gastroenterol
· 2025 · PMID 41064542
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INTRODUCTION: Immune-mediated colitis (IMC) is a common and potentially severe immune-related adverse event of immune checkpoint inhibitors (ICIs). Although corticosteroids and biologics are standard treatments, some cas...INTRODUCTION: Immune-mediated colitis (IMC) is a common and potentially severe immune-related adverse event of immune checkpoint inhibitors (ICIs). Although corticosteroids and biologics are standard treatments, some cases remain refractory. Tofacitinib, a Janus kinase inhibitor, has shown promise in refractory IMC; however, evidence regarding its treatment effects remains limited. CASE PRESENTATION: Here, we present a case of pembrolizumab-induced IMC and duodenitis refractory to corticosteroids, infliximab, and vedolizumab. The patient was successfully treated after receiving a 30-day course of tofacitinib, which resulted in rapid symptom resolution and mucosal healing. No recurrence of colitis was observed 3 months after treatment cessation. CONCLUSION: As ICIs are increasingly used, the incidence of refractory IMC and other immune-related toxicities is expected to rise. This case highlights the need for further studies to establish the optimal use of tofacitinib in refractory IMC and duodenitis.
Ongay J, Candel I, Bitton A
… +3 more, Afif W, Bessissow T, Lakatos PL
Case Rep Gastroenterol
· 2025 · PMID 41064541
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INTRODUCTION: Secukinumab is an interleukin (IL)-17A inhibitor approved for psoriatic arthritis (PsA) and ankylosing spondylitis (AS). Its use has been reported to be associated with inflammatory bowel disease (IBD) flar...INTRODUCTION: Secukinumab is an interleukin (IL)-17A inhibitor approved for psoriatic arthritis (PsA) and ankylosing spondylitis (AS). Its use has been reported to be associated with inflammatory bowel disease (IBD) flare and new onset. CASE PRESENTATION: We report a case of a 56-year-old woman with longstanding ulcerative colitis (UC) in remission, who developed a severe UC flare after initiating secukinumab for refractory PsA. She presented with extensive ulcerations, systemic inflammation needing hospitalization, and change of treatment to risankizumab. CONCLUSION: This case highlights the emerging evidence of IL-17A blockade in IBD, potentially leading to adverse events, and adds to the growing body of evidence regarding the management of such complications with novel therapeutic approaches in severe cases. Physicians should be aware of this possibility when using IL-17A blockade in patients with pre-existing IBD.
Rushford A, Abasszade JH, Tan B
… +2 more, Kanapathipillai R, Bell SJ
Case Rep Gastroenterol
· 2025 · PMID 41064540
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INTRODUCTION: Spontaneous fungal peritonitis is a less common yet serious complication of liver cirrhosis with high mortality rates. Awareness of spontaneous fungal peritonitis may improve patient outcomes by increasing...INTRODUCTION: Spontaneous fungal peritonitis is a less common yet serious complication of liver cirrhosis with high mortality rates. Awareness of spontaneous fungal peritonitis may improve patient outcomes by increasing early identification and treatment. CASE PRESENTATION: We present a case of a 66-year-old female who was admitted to an Australian tertiary hospital with abdominal tenderness and distension on a background of Child-Pugh C liver cirrhosis secondary to increased alcohol intake. Ascitic fluid culture identified the fungus as the causative pathogen of spontaneous fungal peritonitis. CONCLUSION: We outline appropriate investigations, and management in treating spontaneous fungal peritonitis, a rare pathogen in spontaneous peritonitis complicating cirrhosis.
Kalifu B, Meng Y, Aishanjiang K
… +5 more, Ma C, Tian GL, Wang JG, Ma ZG, Chen X
Case Rep Gastroenterol
· 2025 · PMID 41040424
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INTRODUCTION: Immune checkpoint inhibitors (ICIs) are widely used to treat various cancers but can induce immune-related adverse events (irAEs) in patients. Herein, we report the case of a 68-year-old patient with hepato...INTRODUCTION: Immune checkpoint inhibitors (ICIs) are widely used to treat various cancers but can induce immune-related adverse events (irAEs) in patients. Herein, we report the case of a 68-year-old patient with hepatocellular carcinoma who developed an overlapping syndrome of irAEs after receiving ICIs. CASE PRESENTATION: The patient received transcatheter arterial chemoembolization for hepatocellular carcinoma, followed by immunotherapy of 200 mg of camrelizumab every 3 weeks and 12 mg of lenvatinib mesylate daily. After receiving the second dose of camrelizumab treatment, the patient developed gradually worsening left eyelid ptosis and general weakness. One week later, the patient developed bilateral eyelid ptosis and suffocated while drinking water. Unfortunately, the patient was eventually diagnosed as ICI-related myocarditis, myositis, transaminitis, and myasthenia gravis based on a series of physical examinations. Subsequently, the patient was actively provided life support and symptomatic treatment. His symptoms greatly improved after treatment with methylprednisolone sodium succinate 40 mg once daily intravenously for 7 days, with gradually decreasing doses. CONCLUSIONS: IrAEs are common after ICI treatment. After ICI treatment initiation, close monitoring, early detection, and treatment of irAEs is required to improve clinical outcomes.
Zhao Q, Yu HT, Wang QY
… +2 more, Zhang W, Dong WZ
Case Rep Gastroenterol
· 2025 · PMID 40880679
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INTRODUCTION: Colonic pseudolipomatosis is a rare benign lesion with distinct endoscopic and histological features. The etiology and pathogenesis of colonic pseudolipomatosis have not been fully clarified and are still c...INTRODUCTION: Colonic pseudolipomatosis is a rare benign lesion with distinct endoscopic and histological features. The etiology and pathogenesis of colonic pseudolipomatosis have not been fully clarified and are still controversial to some extent. It is particularly noteworthy that this lesion must be differentiated from real pathological entities to avoid further unnecessary auxiliary examinations and overtreatments. CASE PRESENTATION: We report a case of a 61-year-old woman who underwent regular postoperative follow-ups of rectal cancer. The colonoscopy showed multiple slightly elevated whitish plaques with irregular shapes in almost all of the colon. The plaques were biopsied to further define the focal nature. Further histopathological examination revealed numerous scattered or clustered adipocyte-like vacuoles in lamina propria. Immunohistochemistry results were negative for anti-CD34 and anti-protein S-100, supporting the diagnosis of pseudolipomatosis. CONCLUSION: Colonic pseudolipomatosis is a rare and benign self-limiting condition that should not be mistaken for a pathological entity, especially active inflammation or malignant tumor. Endoscopic lesions commonly regress spontaneously without complications and appropriate management is necessary because it requires no further investigations or treatments.
Spitofsky NR, Huang AA, Jalalian A
… +2 more, Gallagher S, Fink S
Case Rep Gastroenterol
· 2025 · PMID 40880678
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INTRODUCTION: We present the first published case of turmeric-associated drug-induced liver injury (DILI) accompanied by significant ferritin elevation. CASE PRESENTATION: Our patient, a 59-year-old female with DILI caus...INTRODUCTION: We present the first published case of turmeric-associated drug-induced liver injury (DILI) accompanied by significant ferritin elevation. CASE PRESENTATION: Our patient, a 59-year-old female with DILI caused by long-term ingestion of oral turmeric supplements, presented with painless jaundice on an annual exam. The patient's liver function tests exhibited a hepatocellular pattern and hyperferritinemia (>2,000 ng/dL). Additional testing was negative except for heterozygosity for the H63D allele associated with hemochromatosis. A liver biopsy indicated acute hepatitis without fibrosis or stainable iron. CONCLUSION: Upon discontinuation of the supplement, liver enzymes normalized within a month. This case highlights the potential for hepatotoxicity and hyperferritinemia from curcumin toxicity, particularly when combined with additives like black pepper that enhance its bioavailability. Awareness of this phenomenon, particularly in heterozygous carriers of hemochromatosis, is crucial for diagnosis and optimal management.