Biomedical subjects

T Bächle

Publications and source records attributed to T Bächle.

2 recordsLinked to original sources

PubMed2001

[Enteropathy-associated T-cell lymphoma. Manifestation as diet-refractory coeliac disease and ulcerating jejunitis].

HISTORY AND CLINICAL FINDINGS: A 61-year-old woman in poor general health was admitted to hospital because of progressive diarrheo, flatulence, fatigue and weight loss. The patient had a history of coeliac disease with poor dietary compliance over many years. Hence, the present clinical deterioration was unresponsive to a gluten-free diet. INVESTIGATIONS: Laboratory results showed signs of inflammation and malabsorption. The endoscopy of the duodenum revealed a flattened mucosal architecture, as is typical for coeliac disease. Enteroscopy revealed many small jejunal lesions. Histological examination of mucosa showed typical signs of coeliac disease without definite signs of lymphoma. Immunhistochemical analysis showed atypical intraepithelial T-cells, while the molecular biological study revealed a monoclonal T-cell clone, both supporting the diagnosis of an enteropathy associated T-cell lymphoma (EATCL). DIAGNOSIS AND THERAPY: The patient was enrolled in a study on intestinal non-Hodgkin lymphomas and accordingly received 6 courses of CHOP-chemotherapy. Clinical and histological improvement has lasted for over a year. CONCLUSION: Patients with coeliac disease unresponsive to a gluten-free diet or with a deteriorating clinical condition may have an enteropathy-associated T-cell lymphoma. This can manifest itself in the form of an ulcerative jejunitis. In the early stages of disease, immunhistochemical and molecularbiological analyses may lead to the correct diagnosis.

Celiac Disease↗

PubMed2001

[Ulcerative ileocolitis induced by NSAID therapy].

HISTORY AND PHYSICAL EXAMINATION: A 67-year-old woman was admitted to our hospital for spasmodic abdominal pain, diarrhea, and general weakness. She had lost 5 kg of weight over the past few weeks. The patient had a 20-year history of chronic analgetic abuse, mainly consuming over-the-counter nonsteroidal anti-inflammatory drugs (NSAID). EXAMINATION: Laboratory examination was remarkable for a low serum albumin (2.3 g/dl), an increased erythrocyte sedimentation rate of 70 mm/h, and a profound anemia of 8.5 g/dl. Ultrasound of the abdomen showed thickening of the colonic wall and distended colon loops filled with fluid. On colonoscopy several ulcerations from the sigmoid to the ileum were seen. Histologic examination showed a nonspecific ileocolitis. DIAGNOSIS, THERAPY AND CLINICAL COURSE: After cessation of NSAID intake diarrhea stopped within a few days. Abdominal pain resolved, anemia improved and the patient gained weight. A second colonoscopy revealed healing of the colonic ulcerations. Additional examinations regarding differential diagnoses showed no pathological results. Clinical course and subsequent clinical and endoscopic controls revealing further improvement confirmed the diagnosis of an NSAID-induced ileocolitis. CONCLUSION: This patient is a typical example for NSAID-induced colonic ulcerations. It should be recognized that NSAID induce ulcers not only in the upper gastrointestinal tract. A careful drug history may provide the clue for the cause of lower gastrointestinal tract ulcerations.

Abdominal Pain↗