Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious ...health problems in this region. Thus, the Asian Organization for Crohn’s and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web- based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommenda-during anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment. (Intest Res 2018;16:4-16)
Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious ...health problems in this region. Thus, the Asian Organization for Crohn’s and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web- based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment. (Intest Res 2018;16:17-25)
A case of acute radiation enteritis Minowa, Shintaro; Saito, Daisuke; Okabe, Naota ...
JOURNAL OF THE KYORIN MEDICAL SOCIETY,
10/2018, Letnik:
49, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Acute radiation enteritis is often self-limiting and reversible as long as radiotherapy ceases within a short period. Colonoscopy is thus rarely performed and the endoscopic findings have not been ...fully investigated. We encountered a case of acute radiation enteritis in which colonoscopy was performed. The patient was a 68-year-old man with prostatic cancer under hormone therapy. Back pain due to metastasis to the pelvic area developed, and radiotherapy was adopted. However, watery diarrhea began 4 days after the initiation of radiotherapy. Colonoscopy revealed mucosal erythema, edema, and epithelial friability with mucus adhesion in the sigmoid colon. Biopsied specimens showed shedding of superficial epithelium, atrophy of crypts, and infiltration of inflammatory cells into the lamina propria. On the basis of endoscopic and histopathological findings as well as the clinical pictures, acute radiation enteritis was diagnosed. Symptoms gradually improved after radiotherapy was suspended. Follow-up colonoscopy confirmed recovery to normal-appearing intestinal mucosa. When symptoms suggestive of colitis develop shortly after initiating radiotherapy, colonoscopy together with histopathological examination should be actively performed to achieve definitive diagnosis of acute radiation enteritis.
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