- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J, Stelara (ustekinumab) / J&J, Entyvio (vedolizumab) / Takeda
Chasing the Common Variable Immunodeficiency Zebra: Endoscopic/Histopathologic Findings and Treatment (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1138;
A total of 100 procedures were included (Table 1). The most common GI symptoms leading to endo evaluation were diarrhea (45%) and abdominal pain (20%); other indication included nausea (17%), weight loss (14%), vomiting (10%), and rarely (< 10%): hematochezia/rectal bleeding, bloating, anorexia/early satiety, heartburn, dysphagia, iron and vitamin B12 deficiency.
- |||||||||| thyroxine / Generic mfg., hydrocortisone / Generic mfg.
Celiac Disease and Adrenal Insufficiency: A Case of Autoimmune Polyglandular Disease (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1107;
Case Description/ A 39 year old man with Graves status post iodine ablation on levothyroxine and celiac disease presented with 6 days of vomiting, loose stools, and poor oral intake...An ACTH stimulation test demonstrated inadequate stimulation from the adrenal glands which prompted the administration of hydrocortisone...Figure: Figure 1. Illustration of the types of autoimmune polyglandular disorders.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Bleeding From a Rare Omental Gastrointestinal Stromal Tumor Found on Capsule Endoscopy (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1055;
Case Description/ 58 year old male with a history of diabetes mellitus type II, hypertension, recent prolonged hospitalization for d isseminated nocardia infection on long term antibiotics and a Decadron taper presented with several days of epigastric pain, nausea and non-bloody diarrhea...Figure: Figure 1: CT Abdomen and Pelvis with contrast demonstrating a 4 cm circumscribed hyperdense enhancing exophytic solid mass arising from the small bowel in the left lower quadrant. Figure 2: Capsule endoscopy showing a small bowel tumor.
- |||||||||| budesonide / Generic mfg., paracetamol / Generic mfg., duloxetine / Generic mfg.
Autoimmune Hepatitis Presenting Without Autoantibodies: A Diagnostic Challenge (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1011;
Due to concern for liver toxicity, patient’s home tylenol and duloxetine were held without significant improvement in her transaminitis or symptoms...Patient was started on budesonide with resolution of her transaminitis and symptomatic improvement...Atypical autoantibodies that may assist in the diagnosis of AIH when ANA, ASMA, and anti-LKM-1 are negative include atypical perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) and anti-soluble liver antigen/liver pancreas antibody (anti-SLA/LP). Clinicians with a high degree of suspicion for AIH should be aware that it can present without autoantibodies because when absent, appropriate diagnosis and treatment can be delayed.
- |||||||||| Autoimmune Hepatitis Flare Following COVID Vaccination: A Case Series (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1009;
He remained stable on mycophenolate mofetil (MMF) for nine years without any acute flares...He was subsequently hospitalized and required IV solumedrol for seven days...This necessitated up-titration of prednisone and MMF, which normalized her liver enzymes within two months...Her immunosuppressants were up-titrated with an increase in MMF and the addition of cyclosporine...This can be a challenging situation for many clinicians to navigate, as COVID remains a significant threat to patients’ health, and there are many case reports that show that COVID infection itself can precede a flare. Patients with autoimmune liver disease may benefit from closer laboratory evaluation surrounding COVID vaccination.
- |||||||||| prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Autoimmune Enteropathy: A Rare Cause of Small Intestinal Villous Atrophy in Adults (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_1008;
Within days of initiating steroids, her diarrhea had improved and she was transitioned to oral prednisone...Figure 1C. Duodenal biopsy reveals chronic active duodenitis characterized by marked villous blunting, reduced goblet and Paneth cells, neutrophilic and lymphocytic infiltration of deep crypts, and basal layer apoptosis.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
ANCA-Associated Leukocytoclastic Vasculitis With Mesenteric Involvement (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_936;
He was transitioned to prednisone and started on rituximab with significant improvement...Figure: Figure 1. Endoscopic evidence of diffuse erosive duodenopathy interspersed between normal mucosa in the setting of mesenteric vasculitis
- |||||||||| Remicade (infliximab) / Merck (MSD), Mitsubishi Tanabe, J&J
An Unexpected Cause of Abdominal Pain in a Patient With Ulcerative Colitis (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_898;
She was discharged on a prednisone taper and initiated on infliximab infusions with significant improvement in her symptoms...Due to the pro-thrombotic state associated with both diseases, prophylactic anticoagulation can also be considered in the setting of immobilization or hospitalization, and do not necessarily have to be stopped due to bloody diarrhea or anemia [3]. Figure: Fig 1A depicts colonic biopsy demonstrating sickled red blood cells in the lamina propria and capillary Fig 1B and C depict Mayo 3 pancolitis
- |||||||||| dexamethasone / Generic mfg., trimethoprim/sulfamethoxazole / Generic mfg.
Abnormal Liver Enzymes in Thymoma-Associated Multiorgan Autoimmunity (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_777;
He had recently been hospitalized for methicillin-resistant Staphylococcus aureus aspiration pneumonia treated with trimethoprim-sulfamethoxazole (TMP-SMX)...Following multidisciplinary discussion, the patient received antithyroglobulin (ATG) and dexamethasone for TAMA...D. Liver biopsy with interlobular bile ducts surrounded and infiltrated by lymphocytes, monocytes, and a few neutrophils, reflective of a cellular type IV reaction targeting the bile duct epithelium with resultant cholestasis
- |||||||||| budesonide / Generic mfg.
A Rare Presentation of Esophageal Lichen Planus in a Patient With Collagenous Gastritis and Duodenitis: A Case Study (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_721;
A swallowed budesonide slurry markedly improved her dysphagia and helped regain weight...Histological findings of collagenous gastritis and duodenitis. (A) Duodenum depicting signs of villous atrophy and subepithelial collagen deposition with background chronic inflammation; (B) Gastric antrum depicting subepithelial collagen deposition with background chronic inflammation.
- |||||||||| A Rare Case of Ischemic Proctitis in the Setting of COVID-19 (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_663;
She was started on dexamethasone, remdesivir, therapeutic-dose enoxaparin and ceftriaxone...The clots were removed, and after injection with epinephrine, no active bleeding was noted...The treatment of ischemic proctitis is largely supportive but may be challenging when managing transmural rectal ischemia or gangrene, often requiring surgery and proctectomy as the definitive treatment. Figure: Endoscopic imaging showing mucosal necrosis of the rectum (A) with visible blood clots (B); mucosal necrosis extending to the rectosigmoid junction (C) without apparent necrosis of the sigmoid (D).
- |||||||||| fluticasone / Generic mfg.
A Diagnosis That Is Difficult to Swallow: Digging Deeper for Answers (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_585;
Given classic appearance of EOE, he was trialed on empiric fluticasone and budesonide with no improvement in dysphagia...This case represents EP with years of no evidence of squamous cell cancer despite aggressively searching for it, which at least anecdotally suggests a precancerous potential for EP. Figure: A. Initial EGD B. Recent EGD
- |||||||||| Uceris (budesonide rectal foam) / Bausch Health, Dr Falk, Kissei, Ajinomoto
A Case of Tinnitus in a Patient With Ulcerative Colitis on Rectal Mesalamine (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_561;
It is important to recognize this potential complication of mesalamine, and assess these factors prior to prescribing mesalamine, counsel patients, and maintain close follow-up of patients with risk factors, as tinnitus is often easily reversible with mesalamine discontinuation. Further studies are needed to better understand the pharmacokinetics of rectal mesalamine and its role in systemic toxicity.
- |||||||||| prednisone / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
A Case of Idiopathic Hypereosinophilic Syndrome Involving the Gastrointestinal Tract (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_530;
Figure: Biopsy of bronchial mucosa showing dense infiltration of eosinophils beneath the bronchial epithelium (greater than 50 per high power field). The granular pink cells are the eosinophils, largely on the left-hand side of the image (400X magnification, H&E stain).
- |||||||||| dexamethasone / Generic mfg.
Retrospective data, Review, Journal: Dexamethasone and compliance affect TTFields efficacy to glioblastoma patients: a systematic review and meta-analysis. (Pubmed Central) - Sep 4, 2022
And the patients whose compliance of TTFields treatment ≥ 75% (≥ 18 h per day) have a significant lower overall survival risk than the patients whose compliance of TTFields treatment < 75% (HR = 0.57 [95% CI 0.46-0.70]; P < 0.00001).TTFields is a safe and efficient novel treatment modality. The dose of dexamethasone ≤ 4.1 mg of TTFields treatment and the compliance of TTFields treatment ≥ 75%, ≥ 18 h per day are beneficial to the prognosis of the glioblastoma patients.
- |||||||||| dexamethasone / Generic mfg.
Journal: Retinoic acid induces the osteogenic differentiation of cat adipose tissue-derived stromal cells from distinct anatomical sites. (Pubmed Central) - Sep 4, 2022
Thus, the present study aimed to evaluate the functional activity of ADSCs isolated from the subcutaneous and visceral adipose sites (SCAT and VAT, respectively) of the cat, as well as the effects of two osteogenic-inducing conditions-the classic dexamethasone, β-glycerophosphate and ascorbic acid-supplemented media (Dex + β + AAM), and Retinoic Acid-supplemented media (RAM)...In conclusion, different characteristics were found between the two adipose tissue sites-SCAT and VAT, which probably reflect the differences found in the functionality of isolated ADSCs from both tissues. Furthermore, for cat, VAT shows a greater osteogenic-inductive capacity than SCAT, particularly with RAM, which can be of therapeutic relevance for regenerative medicine applications.
- |||||||||| dexamethasone / Generic mfg., galantamine hydrobromide / Generic mfg.
Review, Journal: Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid. (Pubmed Central) - Sep 3, 2022
Direct agonists like nicotine and GTS-1 have also demonstrated anti-inflammatory properties in models of sepsis and acute respiratory distress syndrome, as have acetylcholinesterase inhibitors like Galantamine and Physostigmine...Dexamethasone is the only medication currently in use that has shown to improve clinical outcomes...Nicotine transdermal patch activates CAP and harvests its anti-inflammatory potential by means of an easily administered depot delivery mechanism. It could prove to be a promising, safe and inexpensive additional tool in the currently limited armamentarium at our disposal for management of COVID-19 induced acute hypoxic respiratory failure.
- |||||||||| Rejuveinix (RJX) / Reven Holdings
Journal: Evaluation of the potential of Rejuveinix plus dexamethasone against sepsis. (Pubmed Central) - Sep 3, 2022
The combination of RJX plus DEX was more effective than either agent alone, decreased the inflammatory cytokine responses and associated organ damage, and improved the survival outcome in mice. In the phase I clinical study, RJX plus DEX was well tolerated by COVID-19 patients.
- |||||||||| dexamethasone / Generic mfg.
Journal: Synthesis and cytotoxic activity of ethyl ferulate derivatives as potent anti-inflammatory agents. (Pubmed Central) - Sep 3, 2022
These analyses revealed that most of the synthesized compounds exhibited moderate to high anti-inflammatory activities. In particular, c10 and c23 exerted more pronounced activity than ethyl ferulate or dexamethasone with respect to the suppression of tumour necrosis factor-α production by RAW264.7 cells through the targeting of the NF-κB and MAPK signalling pathways, suggesting that these compounds warrant further investigation.
- |||||||||| hydrocortisone / Generic mfg.
Clinical, Retrospective data, Review, Journal: Vitamin C-based regimens for sepsis and septic shock: Systematic review and meta-analysis of randomized clinical trials. (Pubmed Central) - Sep 3, 2022
The authors' results demonstrate that a local anesthetic cocktail, composed of economical and readily available medications, can provide excellent patient pain control and decrease postoperative opioid use. Further RCTs with higher methodological quality, an increased number of participants and assessing clinically relevant outcomes are needed to provide better decision-making guidance.
- |||||||||| dexamethasone / Generic mfg.
Preclinical, Journal: Acrid and Bitter Chinese Herbs in Decoction Effectively Relieve Lung Inflammation and Regulation of TRPV1/TAS2R14 Channels in a Rat Asthmatic Model. (Pubmed Central) - Sep 3, 2022
SD (Sprague Dawley) rats of asthma were induced by ovalbumin and aluminum hydroxide, then randomly divided into the Normal group, Model group, SGMHD group, Dexamethasone (Dex) group, Guilongkechuangning (GLKC) group, The Acrid Chinese Herbs group (ACH), and The Bitter Chinese Herbs group (BCH)...The acrid Chinese herbs regulate TRPV1, and bitter Chinese herbs regulate the gene and protein expression of TAS2R14, through nerve and immune-inflammatory factors, reduced airway inflammation, reduced airway reactivity, promoted airway remodeling, and the combination of acrid-bitter Chinese herbs can enhance the above effects. This will lay a foundation for further in vivo study of specific compounds of acrid-bitter Chinese herbs.
- |||||||||| diclofenac sodium oral / Generic mfg., hydrocortisone / Generic mfg.
Journal: An unusual presentation of anaphylaxis with severe hypertension: a case report. (Pubmed Central) - Sep 3, 2022
Postural symptoms should alert the clinician to cardiovascular involvement despite elevated supine blood pressure. Early treatment with adrenaline should be considered in these patients with extreme caution.
- |||||||||| Journal: Breast T-Lymphoblastic Lymphoma Presenting as a Single Mass in a Young Female with Family History of Breast Cancer. (Pubmed Central) - Sep 2, 2022
The patient was induced with cyclophosphamide, vincristine sulfate, doxorubicin hydrochloride, and dexamethasone chemotherapy. After two-cycles of chemotherapy, a computed tomography of the thorax showed marked interval decrease in size of anterior mediastinal mass, suggestive of positive treatment response.Here, we report the first well documented case of T-lymphoblastic lymphoma presented as a single breast mass without history of B symptoms and perform an extensive English language literature review.
- |||||||||| dexamethasone / Generic mfg., vancomycin / Generic mfg., deferoxamine / Generic mfg.
Journal: Triple-functional injectable liposome-hydrogel composite enhances bacteriostasis and osteo/angio-genesis for advanced maxillary sinus floor augmentation. (Pubmed Central) - Sep 2, 2022
An in vivo bacteriostasis assay and rabbit maxillary sinus floor augmentation model corroborated the enhanced bacteriostasis and vascularised bone regeneration properties of this functionalised composite. Overall, the favourable injectability to be fit for the minimally invasive procedure, locally sustained release property, and prominent biological functions underscore the clinical potential of Van/DFO/Dex as an ideal bone-grafting material for irregular bone defect repairs, such as maxillary sinus floor augmentation.
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