- |||||||||| Breztri Aerosphere (budesonide/formoterol fumarate/glycopyrronium) / AstraZeneca
Enrollment closed, Real-world evidence, Patient reported outcomes, Real-world: RECORD: REported Outcomes in COPD With Trixeo in Real worlD in Germany (clinicaltrials.gov) - Jul 31, 2023
P=N/A, N=466, Active, not recruiting,
Not yet recruiting --> Recruiting | Trial primary completion date: May 2023 --> May 2028 Recruiting --> Active, not recruiting
- |||||||||| Empliciti (elotuzumab) / AbbVie, BMS, relatlimab (BMS-986016) / BMS, renvistobart (BMS-986207) / BMS
Enrollment closed, Enrollment change, Trial primary completion date, Immuno-oncology: Immuno-Oncology Drugs Elotuzumab, Anti-LAG-3 and Anti-TIGIT (clinicaltrials.gov) - Jul 31, 2023
P1/2, N=14, Active, not recruiting,
Recruiting --> Active, not recruiting Recruiting --> Active, not recruiting | N=104 --> 14 | Trial primary completion date: Dec 2024 --> Dec 2023
- |||||||||| hydrocortisone / Generic mfg.
Journal: Glucocorticoid dysfunction in children with severe malaria. (Pubmed Central) - Jul 30, 2023
Interestingly, hydrocortisone induced increased levels of cAMP in AC, but not in clinical malaria patients. Altogether, this study shows that patients with SM have increased cortisol levels, but also a decreased sensitivity to GCs, which may clearly contribute to the severity of disease.
- |||||||||| dexamethasone / Generic mfg.
A Case of Eosinophilic Gastrointestinal Disease Presenting as Eosinophilic Ascites (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4616;
Given her peripheral eosinophilia, eosinophilic ascites and marked elevation of eosinophils within the small and large bowel, she was diagnosed with EGID and subsequently started on dexamethasone with significant symptomatic improvement and normalization of her peripheral eosinophilia...Figure: Coronal computed tomography image with intravenous and oral contrast showing moderate volume ascites, significant bowel wall thickening, submucosal edema, and mucosal hyperenhancement most prominently involving the distal small bowel and ascending/transverse colon (A,B). Terminal ileum (C) and sigmoid colon (D) biopsies with hematoxylin and eosin stain (200x magnification), demonstrating acute inflammation with markedly increased eosinophils.
- |||||||||| Sclerosing Mesenteritis: A Rare Cause of Abdominal Pain (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4602;
Tamoxifen was not recommended given her young age, she was unable to tolerate azathioprine due to medication side effects, and her condition was compounded by norovirus infection making her high risk for cyclophosphamide...Accurate diagnosis is based on having a high index of suspicion. Since undiagnosed sclerosing mesenteritis can lead to serious sequelae such as intestinal obstruction, early diagnosis and expedited treatment are key to successful outcomes.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), Opdivo (nivolumab) / Ono Pharma, BMS, Yervoy (ipilimumab) / Ono Pharma, BMS
Recognition of Delayed-Onset Immune Checkpoint Inhibitor-Mediated Hepatotoxicity Treated With Budesonide: A Case Study Factoring in Pharmacokinetics of Immunotherapies (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4497;
Case Description/ A 58-year-old woman with a history of metastatic stage IV melanoma, treated with radiation, prior pembrolizumab (discontinued due to severe immune-mediated colitis), and then ipilimumab/nivolumab, was evaluated for unexplained elevations of liver enzymes...The patient was started on induction steroids with oral budesonide 9 mg/d with taper to 6 mg/d and 3 mg/d, for total of 42 days, and adjunct ursodiol 1000 mg/d, which yielded adequate liver biochemical remission...(B) Liver biopsy (H&E) showing marked architectural remodeling with areas of parenchymal collapse, mixed moderate portal inflammation with foci of lobular inflammation, endotheliitis, and evidence of mild bile duct injury. Abbreviations: ICI: immune checkpoint inhibitors; DIRE: delayed immune-related adverse event; ULN: upper limit of normal; AST: aspartate aminotransferase; ALT: alanine aminotransferase; ALP: alkaline phosphatase; GGT: gamma-glutamyl transferase.
- |||||||||| Bosulif (bosutinib) / Pfizer
Budesonide Can Successfully Treat Bosutanib-Induced Autoimmune Hepatitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4446;
This case highlights both a rare drug-induced autoimmune phenomenon, and the importance of individualizing treatment plans based on patient-specific factors. Figure: Figure 1: Trend in Liver Enzymes with Treatment
- |||||||||| DRESS Syndrome in the Setting of Spontaneous Bacterial Peritonitis Prophylaxis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4429;
He was treated with intravenous methylprednisolone during hospitalization and discharged on prolonged oral prednisone taper along with trimethoprim-sulfamethoxazole for SBP prophylaxis...Most common drugs implicated include allopurinol, antiepileptic agents, sulfonamides, vancomycin, and anti-tuberculosis agents...This case highlights the fact DRESS syndrome can occur with any drug and to be mindful of antibiotic side effect profile when prescribing ciprofloxacin for SBP prophylaxis. Figure: A. Trunk with diffuse maculopapular rash B. Back with diffuse maculopapular rash
- |||||||||| remdesivir / Generic mfg., dexamethasone / Generic mfg.
Multiorgan Failure Including Acute Liver Failure from Hemophagocytic Lymphocytosis Secondary to HIV and COVID-19 (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4390;
Bone marrow aspirate smears reveal increased macrophages with increased phagocytic activity - phagocytosed red cells and platelets (arrowhead) and neutrophils (arrow) (B-D; Wright-Giemsa stain, 1000x). The insets show iron stained smears highlighting iron-laden macrophages with ingested hematopoietic cells (Iron stain, 1000x).
- |||||||||| methylprednisolone sodium succinate / Generic mfg.
A Rare Case of Secondary Hemophagocytic Lymphohistiocytosis in a Young Female (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4384;
She was started on high-dose steroids (Solumedrol 125 mg every 8 hours) with improvement in her pancytopenia and liver enzymes...The predominant pattern of injury seen in this specimen is lobular hepatitis, with an associated sinusoidal infiltrate composed of histiocytes and lymphocytes (Hematoxylin & eosin stain at 100X magnification). B) The same specimen is observed at 400X magnification, revealing red blood cells, leukocytes, and cell fragments within the cytoplasm of histiocytes, suggestive of hemophagocytic activity.
- |||||||||| Severe Hepatocellular Transaminitis Due to Disseminated HSV-1, EBV Co-infection, and Secondary HLH in a Young Immunocompetent Man (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4374;
Given his elevated transaminases, ferritin and triglycerides, along with fevers, HLH was suspected and IV dexamethasone was started on hospital day two, as well as N-acetylcysteine (NAC)...He was discharged on oral acyclovir and a prednisone taper, and at four-week follow up labs had normalized, and the HSV-1 PCR was undetectable...With early treatment, this patient made a full recovery. Figure: Evaluation of a Young Healthy Adult with Severe Hepatocellular Transaminitis
- |||||||||| thyroxine / Generic mfg., hydrocortisone / Generic mfg.
Rare Case of Severe Jaundice in Panhypopituitarism Patient (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4342;
This case can remind clinicians of the importance of evaluating pituitary and endocrine disorder in patients with presentation of hyperbilirubinemia and transaminitis. Figure: Figure shows thin hair in the scalp and loss of hair in the eyebrows
- |||||||||| Stelara (ustekinumab) / J&J
A Fatal Case of Bilateral Extremity Necrotizing Fasciitis in a Patient With Crohn's Disease on Biologic Therapy Presenting Initially as Anasarca (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4159;
Case Description/ A 49 year old female was admitted with two months of worsening of chronic, pitting lower extremity edema attributed to third-spacing with history of CD s/p Ileocolectomy for stricture at time of diagnosis treated with multiple biologic therapies recently switched to Ustekinumab one month prior...The colonoscopy preparation led to GI distress so the patient was given IV methylprednisolone and developed tachycardia and new leg pain and swelling...There is hepatic steatosis identified. There is no evidence of venous thrombosis in the lower limbs IVC or the portal venous system
- |||||||||| prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg., azathioprine / Generic mfg.
Myositis as an Extra-Intestinal Manifestation of Ulcerative Colitis: A Case Report and Literature Review (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4154;
She was diagnosed with a UC flare and initially treated with intravenous methylprednisolone with incremental improvement...She was then put on intravenous fluids and started on prednisone...Some have thought therapy for IBD, including glucocorticoids or azathioprine, may be responsible for muscle injury...Despite its rarity, myositis with elevated CK could lead to further complications if not managed appropriately. Thus, providers should be wary of myositis as an extraintestinal manifestation in patients with new-onset IBD, acute exacerbations, or even during remissions.
- |||||||||| Entyvio (vedolizumab) / Takeda
Microscopic to Macroscopic: A Case Highlighting Progression Along an Inflammatory Bowel Disease Spectrum (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4153;
Her diarrhea was refractory to budesonide therapy...The patient was treated with prednisone and Vedolizumab...The progression of MC to UC should be on the differential diagnosis when considering a patient whose symptoms remain refractory to conventional therapy, as has been highlighted by our case report. Figure: 1A) Crypt dropout (red bracket); prominent ganglion cells demonstrated by large cells within the lamina propria and submucosa with abundant foamy, eosinophilic cytoplasm (red stars) (10x objective (100x magnification), H&E) 1B) Severe scarring with congestion and a decreased mucosal vascular pattern with nodularity in the descending colon on subsequent colonoscopy 1C) Chromoscopy demonstrating decreased mucosal uptake of methylene blue in setting of severe scarring with congestion throughout the colon 1D) Polypoid colonic mucosa with low-grade dysplasia demonstrated by crowded, hyperchromatic, pencillate nuclei (red arrow; 10x objective (100x magnification), H&E)
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J
An Unusual Pulmonary Presentation of Inflammatory Bowel Disease (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4150;
Figure: 1A) Crypt dropout (red bracket); prominent ganglion cells demonstrated by large cells within the lamina propria and submucosa with abundant foamy, eosinophilic cytoplasm (red stars) (10x objective (100x magnification), H&E) 1B) Severe scarring with congestion and a decreased mucosal vascular pattern with nodularity in the descending colon on subsequent colonoscopy 1C) Chromoscopy demonstrating decreased mucosal uptake of methylene blue in setting of severe scarring with congestion throughout the colon 1D) Polypoid colonic mucosa with low-grade dysplasia demonstrated by crowded, hyperchromatic, pencillate nuclei (red arrow; 10x objective (100x magnification), H&E) He was presumed to have community acquired pneumonia and treated with azithromycin...He was treated with IV methylprednisolone, Infliximab, and IV antibiotics...This presentation was a diagnostic challenge until his Crohn
- |||||||||| pantoprazole / Generic mfg., valacyclovir / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Herpes Esophagitis Triggered by Low Dose Steroids During the Initial Induction Therapy for New Onset Ulcerative Colitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4146;
HSV was treated with valacyclovir, and his dysphagia improved...In summary, low dose steroids can also trigger Herpes infection in immunocompetent UC patients. It is very important to obtain additional medical history or risk stratification and initiate an early Endoscopy with biopsy to make a diagnosis, then to start antiviral treatment earlier.
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J
Successful Multidisciplinary Treatment of the Rare Pathology of Vulvar Crohn (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4142;
Due to inadequate response after 6 weeks of treatment, she was started on infliximab and completed three infusions at weeks 0, 2, 6 with subsequent resolution of all cutaneous lesions...Available surgical approaches may include incision and drainage of abscesses, local resection of the lesion, vulvectomy, excision of pedunculated tags, and/or laser treatment of lymphangiectasias. Figure: Photograph of the vagina at the time of diagnosis showing vulvar edema and erythema, ulcerations of the inferior vulva that extended to the buttocks and introitus with erythema and superficial erosions
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Entyvio (vedolizumab) / Takeda, Humira (adalimumab) / AbbVie
A Functional Medicine Program for Patients With Inflammatory Bowel Disease and Improvement in Fecal Calprotectin Levels (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_4121;
She achieved symptomatic improvement on tofacitinib, but serial colonoscopies showed persistent inflammation in the rectum and ascending colon...Previous therapy included mesalamine enemas...These cases show improvement in fecal calprotectin. A larger, prospective design with other measures of inflammation is needed to further investigate this effect.
- |||||||||| dexamethasone / Generic mfg., indomethacin / Generic mfg.
Danger in Disguise! A Case Series of SupplementInduced GI Bleed (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3973;
At Wks 40 The product label listed indomethacin and betamethasone...The FDA released 2 warnings this year on AK causing GIB via unlisted diclofenac and dexamethasone...Panel A: Patient #3
- |||||||||| triamcinolone acetonide topical / Generic mfg.
Upper Endoscopy Images in Graft-vs-Host Disease (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3906;
She was started on prednisone, topical triamcinolone, and magic mouthwash outpatient but symptoms worsened...Recognition and adequate sampling by endoscopists can aid in the proper diagnosis and treatment of these patients. Figure: Sloughing of esophageal mucosa was observed upon introduction of the endoscope
- |||||||||| Darzalex (daratumumab) / J&J
Dysgeusia: An Unusual Presentation for Gastrointestinal Amyloidosis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3896;
AL amyloidosis with GI involvement carries a worse prognosis making it crucial to keep a high suspicion for this condition for an early diagnosis and treatment. Figure: Figure A: Upper Endoscopy findings of nonspecific erythema of gastric body Figure B: An H&E stain at 100x with amorphous pink material deposited between gastric glands Figure C: A Congo red stain (100x) with congophilic pattern of amyloid deposition between gastric glands
- |||||||||| Clinical, Endoscopic and Histologic Features of Common Variable Immunodeficiency (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3869;
A total of 147 procedures were included (Table 1). The most common GI symptoms leading to endo evaluation were diarrhea (50%) and abdominal pain (29%); other indication included nausea (23%), weight loss (17%), vomiting (14%), and rarely (<10%): hematochezia/rectal bleeding, bloating, anorexia/early satiety, heartburn, dysphagia, iron and vitamin B12 deficiency.
- |||||||||| budesonide / Generic mfg.
A Rare Presentation of Eosinophilic-Appearing Lymphocytic Esophagitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3831;
He was prescribed PPI therapy and oral budesonide in applesauce...A) Upper third of esophagus showing eosinophilic esophagitis and stenosis. B) Middle third of esophagus showing eosinophilic esophagitis.
- |||||||||| Humira (adalimumab) / AbbVie
Lichen Planus: A Rare Cause of Dysphagia in a Young Man (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3823;
Both MTX and subsequent adalimumab were discontinued as they were ineffective for his cutaneous lesions...Biopsies again revealed intraepithelial lymphocytosis and he was started on oral topical fluticasone...Accurate diagnosis of esophageal lichen planus is crucial given its therapeutic and prognostic implications. A high index of suspicion is necessary especially when the patient does not fit classic demographics.
- |||||||||| Carafate (sucralfate) / AbbVie
Reliance on Clinical Judgment to Target Immunohistochemical Stain Use for Diagnosis of HSV Esophagitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3812;
As part of her IVF, the patient had completed a 10-day course of dexamethasone 2mg daily six weeks prior to presentation...The patient was started on a proton pump inhibitor and sucralfate...The patient was started on a 10-day course of valacyclovir with eventual resolution of symptoms following treatment...Compared with routine hematoxylin and eosin (H&E) staining, IHC is more sensitive and can identify more infected cells. IHC stains should primarily be employed in cases where histopathologic findings are ambiguous and clinical suspicion remains high.
- |||||||||| fluticasone / Generic mfg.
Esophageal Leukoplakia: A Rare Cause of Esophageal Stricture (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3807;
Pt was started on topical swallowed fluticasone and scheduled for repeat EGD for dilation...Currently, there are no established guidelines for post-ablation surveillance in cases of leukoplakia. Figure: Patchy white plaques seen in esophagus on EGD examination consistent with esophageal leukoplakia
- |||||||||| Unveiling the Uncommon: Lichenoid Esophagitis Secondary to Steven Johnson Syndrome (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3792;
In this report, we describe the case of a 47-year-old female who developed LE due to Steven Johnson syndrome (SJS) as a result of sulfasalazine (SSZ) therapy...Soon after due to poor tolerance to hydroxychloroquine and methotrexate, her rheumatologist started her on SSZ...During the last 2 EGDs, intralesional corticosteroid injections in addition to oral fluticasone were trailed which the patient responded to well and showed improvement of her dysphagia...Further research is needed to better understand the pathogenesis and optimal treatment of this rare condition. Figure: Fig illustrates acute esophagitis and a severe benign intrinsic stenosis that measures 1 cm in length.
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron
An Unusual Case of Esophageal Thickening (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3779;
His home medications included omeprazole and cetirizine...The patient was started on prednisone taper which was later switched to swallowed fluticasone...Treatment options include elimination diets, PPI, topical glucocorticoids, and dupilumab, which was recently approved by the FDA...Diseases of the Esophagus 2016;29:681-683. Figure: Figure 1: (A) At presentation, endoscopic ultrasound (EUS) from the distal esophagus showing thickened esophageal wall (10 mm), specifically layer 3 (submucosa), and (B) follow-up EUS after initiation of treatment showing improvement in esophageal wall thickness.
- |||||||||| Dupixent (dupilumab) / Sanofi, Regeneron
High-Dose Budesonide Improves PPI-Refractory NarrowCaliber Fibrostenotic Eosinophilic Esophagitis: A Case Report (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3756;
Prior to dupilumab, management of treatment-refractory narrow-caliber EoE was serial esophageal dilations, with concomitant risks...He was started on high-dose esomeprazole twice daily...Though steroids can prevent progression to fibrostenotic disease, they have not had a clear role in treating established disease. This case, therefore, suggests a role for oral viscous budesonide in treating fibrostenotic EoE that should be further characterized.
- |||||||||| budesonide / Generic mfg.
Alpha Gal Allergy Associated With Eosinophilic Gastroenteritis, Coincidence or Coexistence? (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3636;
This case, therefore, suggests a role for oral viscous budesonide in treating fibrostenotic EoE that should be further characterized. Based on biopsy findings, the patient was started on a budesonide taper...It is unclear whether it is directly associated alpha-gal; however, our patient
- |||||||||| Benlysta (belimumab) / GSK
Treatment of Refractory Lupus Intestinal PseudoObstruction with the Euro-Lupus Protocol (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3616;
The Euro-lupus protocol, consisting of 6 cycles of low-dose cyclophosphamide, is classically used to treat severe lupus manifestations such as nephritis...She received treatment with daily intravenous (IV) methylprednisolone transitioned to pulse dose steroids followed by a one-week course of IV azathioprine and one time dose of IV belimumab but remained refractory with persistent abdominal distention and high NG output...To date, there are no reports of its use in the treatment of lupus IPO. Our case thus highlights its potential as a therapy in lupus IPO unresponsive to traditional therapies.
- |||||||||| prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Belatecept-Induced Colitis in a Patient with Graft Rejection (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3605;
She was on prednisone and Belatecept due to renal transplant but developed chronic graft rejection requiring dialysis...After a partial response to IV methylprednisolone 60 mg, a higher dose resulted in clinical resolution...Figure: Image 1. Belatecept-induced colitis: A. CT scan showing colonic wall thickening with adjacent fat stranding in the ascending colon (red arrow indicates wall thickening and fat stranding); B. Flexible sigmoidoscopy showing Mayo grade 1 disease in the sigmoid colon with reduced vascular pattern, erythema and mild friability; C. Rectal biopsy (8x) with crypt dropout and regenerative changes (black arrows indicate areas of crypt dropout); D.Colonic biopsy (20x) showing chronic active colitis with regenerative changes, scattered apoptotic epithelial cells and minimal lamina propria lymphoplasmocytic infiltrate (black circle highlights abundant apoptosis).
- |||||||||| Invasive Listeria Gastroenteritis Leading to Bacteremia and a CNS Abscess (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3600;
Case Description/ A 64-year-old male with lupus nephritis on prednisone and mycophenolate presented due to word-finding difficulty and headaches...He regained expressive speech and was discharged on IV ampicillin and bactrim, along with oral dexamethasone and keppra for seizure prophylaxis...Figure: Images A and B depict the intra-axial peripherally enhancing lesion centered in the medial posterior left frontal lobe surrounded by vasogenic edema with some areas of tubular appearance measuring approximately 1.6 x 1.9 x 2.2 cm. There is minimal mass effect and no midline shift seen.
- |||||||||| Aimovig (erenumab-aooe) / Amgen, Novartis
Pan-Colitis Secondary to Calcitonin Gene-Related Peptide (CGRP) Antagonist for Migraines (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3591;
The patient was started on IV methylprednisolone BID, along with dicyclomine...She continued to improve after 3 days of IV steroids and was discharged with tapered prednisone...In terms of the pathophysiology, this suggests that Erenumab may not only cause direct cytotoxicity via mucosal damage, but it may also contribute to colonic ischemia. Figure: Figure A and B: Patient
- |||||||||| bortezomib / Generic mfg., dexamethasone / Generic mfg., lenalidomide / Generic mfg.
Cecum Plasmacytoma (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3584;
Given the potential for gastrointestinal EMPs to mimic other colon neoplasms, providers should be made aware of their unique presentation, particularly in the setting of plasma cell neoplasms, as they are associated with a worse prognosis. Figure: Figure 1a- Computed Tomography of the Abdomen (coronal view) demonstrating multiple hyperdense mesenteric masses in the right hemiabdomen with the largest conglomerate mass measuring 8.9 x 6.9 cm seen contiguous with the cecum (yellow arrow) Figure 1b- The colonoscopy revealed a large fungating, ulcerated mass occupying the entirety of the cecum (yellow arrow).
- |||||||||| Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma, Dupixent (dupilumab) / Sanofi, Regeneron
Novel Use of an Interleukin-4 and Interleukin-13 Monoclonal Antibody to Treat Refractory Eosinophilic Colitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3550;
A trial of Xifaxan for possible IBS-D was initiated with no effects...Prednisone and Solumedrol were ineffective...We report a novel use of dupilumab to successfully treat refractory eosinophilic colitis. Randomized controlled trials are needed to establish the optimal therapeutic approach.
- |||||||||| Invanz (ertapenem) / Merck (MSD)
Unusual Presentation of Ectopic ACTH from Pancreatic Neuroendocrine Tumor (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3444;
The patient was then readmitted with fever secondary to ESBL bacteremia for which he was treated with ertapenem...Subsequent serum ACTH levels decreased dramatically, and the patient was started on hydrocortisone...Despite the rarity of ACTH-producing pancreatic NETs, early diagnosis and prompt treatment are more likely to yield favorable outcomes. Figure: (Image A) PET/CT Ga dotatate scan with 1.8x2.4x1.7cm mass in the pancreas
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD), BCA101 / Biocon
Immune-Mediated Cholangiopathic Toxicity: A Case of Immunotherapy-Related Sclerosing Cholangitis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3390;
He was later switched to prednisone and mycophenolate mofetil as outpatient, and his liver enzymes slowly improved to ALT 49, AST 65, and ALP 193...No guidelines specific to treating IMCp exist. Evidence suggests IMCp is often steroid-refractory and early use of adjunctive therapies may be needed.
- |||||||||| pantoprazole / Generic mfg., budesonide / Generic mfg.
A Collagenous Conundrum (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3305;
There is no Helicobacter pylori, intestinal metaplasia or atrophy identified. The overall features are consistent with collagenous gastritis.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Cerebellar Involvement as a Rare Manifestation of Gastric Cancer Metastasis (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3294;
Case Description/ A 69-year-old male with a history of GERD on omeprazole initially presented with progressively worsening dysphagia...Adjuvant immunotherapy with nivolumab was started...The patient was discharged on a dexamethasone taper, with plans for a repeat MRI in 2 months...Our patient will need close monitoring with imaging, and regular follow-ups were recommended. Figure: Figure 1: EGD showing a 35 cm circumferential mass at the gastroesophageal junction Figure 2: Brain MRI showing lesion involving the cerebellar vermis
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Gastrointestinal Amyloidosis: A Rare Cause of Chronic Diarrhea (Exhibit Hall) - Jul 29, 2023 - Abstract #ACG2023ACG_3165;
Figure: Figure 1. Small bowel pathology with increased plasma cellularity with staining positive for amyloid P consistent with amyloidosis.
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