We found the prevalence of 2 important cutaneous manifestations to be 9.3% in IBD in Turkish patients. EN was found to be more common in Crohn's disease and is associated with an active episode of bowel disease and peripheral arthritis. In addition, PG was connected with uveitis and peripheral arthritis.
To the EditorEndoscopic retrograde cholangiopancreatography (ERCP) has become one of the most important techniques for diagnosis and treatment of choledocholithiasis. It is usually combined with sphincterotomy for the extraction of bile duct stones by using standard balloon or basket catheter, although papillary balloon dilatation has also been used in this setting. However, in approximately 10-15% of patients, bile duct stones are still present after the application of these standard extraction techniques. The most common etiology of unsuccessful applications is due to challenging access to the bile duct, large stone size ([15 mm in diameter), impacted stones in the bile duct, intrahepatic stones or cystic duct [1]. The presence of such factors restricting the ability to extract stones has led to the application of additional procedures for stone clearance. Mechanical lithotripsy, intraductal shock-wave lithotripsy, extracorporeal shock-wave lithotripsy, biliary stenting, and chemical dissolution are methods for removal of difficult stones. There are limited data regarding the effectiveness of these methods [2].In this study, we report extraction techniques for bile duct stones and the rate of endoscopic balloon dilatation of the patients who underwent ERCP in our department. A retrospective review of therapeutic ERCP was performed between 2003 and 2005 by using a database linked to the endoscopy reporting system.A series of 875 patients in our institute who underwent ERCP procedures was evaluated retrospectively. Common duct stones were identified in 316 patients (36.1%). In 292 (92.4%) of the 316 patients the stones were successfully removed by standard endoscopic sphincterotomy and balloon or basket extraction techniques. A total of five patients (1.6%) with large stones or stones at the distal side of biliary stenosis were treated by stent insertion. Mechanical lithotripsy was performed in 11 patients (3.5%). Dilatation with a large-diameter balloon was applied in the remaining eight patients (five females and three males; mean age 71.8 years) (2.5%) with large bile duct stones or limited sphincterotomy because of anatomical variants. Esophageal/pyloric/colonic wire-guided balloon dilatation catheters (Boston Scientific Microvasive, USA) were used; the diameters used 15-18 mm. After papillary balloon dilation, the stones were retrieved in seven patients. Bleeding (hemorrhage) occurred in only one case, in whom endoscopic dilation with a 18 mm diameter balloon for removal of bile duct stones had failed while extending endoscopic sphincterotomy and the patient was treated surgically.Ersoz et al. retrospectively reviewed the removal of bile duct stones by dilatation with a large-diameter balloon (10-20 mm) after adequate endoscopic sphincterotomy in 58 patients in whom standard basket/balloon extraction techniques had failed. In addition, results showed that I. Koruk
Although Behçet's disease (BD) is a kind of systemic disease, renal involvement is rare, especially IgA nephropathy (IgAN). Renal manifestations in BD range from mild urinary abnormalities to glomerulonephritis with persistent renal failure, which includes minimal change disease, proliferative glomerulonephritis, rapidly crescentic glomerulonephritis, renal amyloidosis and IgA nephropathy. Amyloidosis seems to be the most common type of renal lesion in BD, and several cases of nephrotic syndrome secondary to amyloidosis have been documented. Co-occurrence of BD and IgA nephropathy has only been reported in only few cases. We describe two patients with the rare association of BD and IgAN. We suggested that it is important to periodically perform renal function assessment in patients with BD, through urinalysis and measurement of serum creatinine for detecting any abnormality and providing an early adequate treatment.
OBJECTIVEAnemia is a major clinical problem in patients receiving dialysis therapy and has a substantial impact on morbidity and mortality. Iron metabolism is impaired in chronic kidney disease. Hepcidin functions as a key regulator of iron metabolism. The aims of this study were to compare the serum pro‐hepcidin levels in patients with either peritoneal dialysis (PD) or hemodialysis (HD) and control subjects and to evaluate pro‐hepcidin and C‐reactive protein (CRP), iron parameters, and hemoglobin levels in PD and HD patients with normal serum CRP levels.METHODSWe studied 85 PD patients, 43 HD patients on regular follow‐up, and a control group that was comprised of 41 volunteers in this cross‐sectional study. Pro‐hepcidin and CRP were studied using commercially available kits. Iron status was assessed by measuring serum iron, transferrin saturation, and ferritin.RESULTSPro‐hepcidin levels were significantly higher in dialysis patients than the control subjects (p < .001). Hemodialysis patients had higher pro‐hepcidin levels than PD patients; but, this difference was not statistically significant (393.4 ± 157.3 versus 361.3 ± 40.1, p = .19). There were no correlations between pro‐hepcidin levels and CRP, and hemoglobin level and iron parameters in PD and HD patients.CONCLUSIONThe present results suggest that dialysis therapy is associated with elevated pro‐hepcidin levels and not directly related to CRP, indices of iron metabolism, or hemoglobin levels. Peritoneal dialysis patients have relatively lower pro‐hepcidin levels than HD patients, but larger‐scale studies are needed to confirm the possibility of impact on various dialytic modalities.
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