Immune deficiencies in chronic intestinal pseudo‐obstruction

Forchielli, M L; Mc, Young; Flores, AF; Richardson, Denise; Lo, Chung‐Mau

doi:10.1111/j.1651-2227.1997.tb14811.x

Cited by 12 publications

(11 citation statements)

References 24 publications

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“…Previous reports have shown that some children with chronic intestinal pseudoobstruction may have concomitant immune deficiencies, including IgG, natural killer cell, and other antibody deficiencies [18]. Since two of the patients in this study had a primary diagnosis of intestinal pseudoobstruction, it is possible that an immune deficiency contributed to the increased infection rate in these patients.…”

Section: Discussionmentioning

confidence: 85%

Efficacy of ethanol locks in reducing central venous catheter infections in pediatric patients with intestinal failure

Jones

Hull

Richardson

et al. 2010

Journal of Pediatric Surgery

128

115

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Purpose We sought to determine whether a regimen of 70% ethanol locks could reduce the rate of central venous catheter (CVC) infections in parenteral nutrition-dependent children with intestinal failure. Methods We performed a retrospective review of 23 parenteral nutrition-dependent children in our multidisciplinary intestinal rehabilitation clinic who started ethanol lock therapy between September 2007 and June 2009. The treatment regimen consisted of a 70% ethanol lock instilled 3 times per week in each catheter lumen. The rate of CVC infections before and after initiation of ethanol lock therapy was compared using the Wilcoxon signed ranks test with significance set at P < .05. Results The most common diagnoses leading to intestinal failure were necrotizing enterocolitis (26.1%), gastroschisis (21.7%), and intestinal atresia (14.3%). Ethanol locks were well tolerated with no reported adverse side effects. The infection rate decreased from 9.9 per 1000 catheter days prior to initiation of ethanol locks to 2.1 per 1000 catheter days during therapy (P = .03). Conclusions A regimen of ethanol lock therapy administered three days per week appears to be a safe and effective means of reducing the rate of CVC infections in parenteral nutrition-dependent children with intestinal failure.

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Section: Discussionmentioning

confidence: 85%

Efficacy of ethanol locks in reducing central venous catheter infections in pediatric patients with intestinal failure

Jones

Hull

Richardson

et al. 2010

Journal of Pediatric Surgery

128

115

View full text Add to dashboard Cite

show abstract

“…Neurologische Störungen auf der Ebene des peripheren oder zentralen Nervensystems manifestieren sich in der Regel mit zusätzlichen Symptomen. Die CIPO kann nach neueren Befunden zudem mit Immundefekten assoziiert sein [8]. Bestimmte Erkrankungen wie Amyloidose und Sklerodermie verlaufen bimodal und sind initial durch ein neuropathisches, später ein myopathisches Motilitätsmuster gekennzeichnet [28].…”

Section: ¾Tiologie Und Pathophysiologieunclassified

Die chronische intestinale Pseudoobstruktion: Pathogenese, Diagnostik und Therapie

Keller

Layer

2002

Z Gastroenterol

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Chronic intestinal pseudo-obstruction (CIPO) is a rare disease in which a severe intestinal motility disorder impairs transit of chyme so that patients suffer from symptoms of a mechanical ileus without mechanical obstruction. CIPO may be a primary or secondary disorder due to muscular, neurologic, metabolic or endocrine disorders, but may also occur postinfectiously, postoperatively, following abdominal radiation or be caused by drugs or noxae. In severe cases, the typical history of (repeated) symptoms of mechanical obstruction leading to unsuccessful laparotomies will give key clues for diagnosis. If CIPO is suspected, mechanical obstruction must be searched for carefully by radiologic and endoscopic examinations. Histologic diagnosis usually demands full thickness biopsies of the intestinal wall. Small intestinal manometry allows diagnosis of CIPO even during oligosymptomatic intervals as well as differentiation between neuropathic and myopathic forms of the disease. The main therapeutic goals consist in: 1. Maintenance of an adequate nutritional state by oral and/or enteral nutrition; in severe cases home-parenteral nutrition may be required and particularly in children intestinal transplantation may be the ultima ratio. 2. Reconstitution of intestinal propulsion by prokinetic drugs. 3. Therapy of complications such as bacterial overgrowth and severe pain by antibiotics and specific surgical procedures. Unnecessary laparotomies should be strictly avoided because they may lead to adhesions and markedly complicate the clinical course.

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“…However, continued chemotherapy led to the cessation of symptoms in our patient. Hepatitis, HIV‐infection, Epstein–Barr virus, cytomegalovirus, immunodeficiency and hemolytic anaemia were also excluded as a possible etiologic event of cholecystitis/ cholelithiasis 10 . However, it remains unclear whether gallbladder involvement was of tuberculous origin or an adverse effect of therapy, because only histological examination after cholecystectomy might prove the diagnosis 4,5…”

Section: Discussionmentioning

confidence: 99%