Összefoglaló közlemények / Reviews

DOI: 10.33570/CEUJGH.5.2.129

The role of gut microbiome in the pathogenesis and progression of alcoholic and non-alcoholic fatty liver disease

Bán Orsolya1, Lisziewicz Julianna dr., Nyúl Dóra1,3, Peták István dr.2, Tordai Attila dr.3, Baffy György dr.4, Schwab Richárd dr.1

1MIND Klinika Kft.;
2Oncompass Medicine Zrt.;
3Semmelweis Egyetem, Kórélettani Intézet, Budapest;
4VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
Correspondence: mailbox@schwab.hu

The epidemic of fatty liver disease is closely linked to the rapidly growing prevalence of obesity and associated metabolic disorders. In contrast to earlier concepts, alcoholic and non-alcoholic fatty liver disease significantly overlap, share many features, and may be viewed as a spectrum of disease. Recent studies of the gut microbiome not only improve our understanding of the pathogenesis but also lead to early recognition of progressive forms of fatty liver disease. Alterations of the gut microbiome associated with inflammatory changes and damage of the intestinal barrier, represent novel targets for both treatment and prevention strategies. Medical interventions should focus on eliminating causative factors rather than treating symptoms of disease. This objective can be achieved by using nutrition therapy, lifestyle modifications and targeted probiotics. Future clinical trials evaluating these approaches may facilitate the development of specific treatment guidelines.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 3

Klinikai kérdések / Clinical questions

DOI: 10.33570/CEUJGH.5.2.135

Efficacy and therapeutic mechanism of mesenchymal stem cell therapy in the management of perianal fistulizing Crohn’s Disease

Bor Renáta dr., Fábián Anna dr., Farkas Klaudia dr., Bálint Anita dr., Szántó Kata dr., Rutka Mariann dr., Milassin Ágnes dr., Nagy Ferenc dr., Tóth Tibor dr., Molnár Tamás dr., Szepes Zoltán dr.

Szegedi Tudományegyetem, I. sz. Belgyógyászati Klinika, Szeged, Magyarország
Correspondence: bor.reni86@gmail.com.

Perianal fistula formation is common and therapy-resistant complication of Crohn's Disease with a lifetime prevalence of 21-23%. Biological treatment represents a great breakthrough in their treatment; however, the rate of complete fistula closure can be achieved in only 22-36% of cases during the one-year treatment. Mesenchymal stem cell transplantation is a new, complementary therapeutic alternative in the management of conventional combined surgical and drug resistant fistulas. Its most important advantage is that it not only inhibits the inflammation, but also directly promotes the regeneration process of damaged tissue. The allogeneic adipose tissue derived mesenchymal stem cells (darvadastrocel) therapy has become available in Hungary therefore, our review article aims to summarize the effectiveness and therapeutic mechanism of stem cell transplantation in the management of perianal fistulizing Crohn's Disease.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 3

Esetismertetések / Case reports

DOI: 10.33570/CEUJGH.5.2.142

Drug induced acute pancreatitis

Dunás-Varga Veronika dr.1, Hegyi Péter dr.2, Izbéki Ferenc dr.1, Szakács Zsolt dr.2, Varjú Péter dr.3, Gajdán László dr.1

1Fejér Megyei Szt. György Egyetemi Oktató Kórház, I. sz. Belgyógyászat, Székesfehérvár
2Pécsi Tudományegyetem, Általános Orvostudományi Kar, Transzlációs Medicina Központ, Pécs
3Pécsi Tudományegyetem, Klinikai Központ, I. sz. Belgyógyászati Klinika, Pécs
Correspondence: dunasvveronika@gmail.com

Acute pancreatitis is one of the most common gastrointestinal disorders requiring hospital treatment. In Hungary 20-50 cases (per year per 100,000 inhabitant) are registered. Drug Induced Acute Pancreatitis is a rarely occurring and difficult to diagnose entity because it has no specific clinical features that make it easy to distinguish between more common etiologies. The median time between the administration of the drug and the onset of symptoms of pancreatitis can range from a few days to a few months, but may also occur with persistent medication. Our case study is about a young female patient who has been diagnosed with drug-induced pancreatitis by re-challenge.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 3

Esetismertetések / Case reports

DOI: 10.33570/CEUJGH.5.2.145

From mesenteric panniculitis to acute abdomen

Orbán-Szilágyi Ákos dr.1, Horváth Miklós dr.1, Gyökeres Tibor dr.1, Szepesy Gábor dr.2, Szabó Tamás dr.3, Árva Ilona dr.4, Süveges Erzsébet dr.5, Herszényi László dr.1

1MH EK, Gasztroenterológiai Osztály, Budapest;
2Affidea, Diagnosztika Radiológia, Budapest;
3MH EK, Általános Sebészeti Osztály, Budapest;
4MH EK, Intenzív terápiás ellátás, Budapest;
5Országos Haemophilia Központ, Budapest
Correspondence: szakoos@gmail.com

The role of imaging modalities are essential in the differential diagnosis of acute abdominal pain but the limitations of the radiological methods can complicate the diagnosis of the disease. Our aim is to draw attention to the possibility that mesenterial panniculitis, a common radiological finding, can mimic more serious, life-threatening illnesses. We report the cases of two middle-aged male patients who had been first admitted to our Department with the diagnosis of mesenterial panniculitis while one having superior mesenterial venous thrombosis, and the other having multiple abdominal arterial occlusions causing the acute abdominal pain. In the case of imaging studies that are not relevant to the clinical picture, revision of the radiological findings is absolutely warranted.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 3

Esetismertetések / Case reports

DOI: 10.33570/CEUJGH.5.2.149

The use of extracorporal immunomodulatory treatments in acute gastroenterological disorders

Földi Ildikó dr.1, Dávida László dr.1, Tornai István dr.1, Palatka Károly dr.1, Papp Mária dr.1, Altorjay István dr.1, Balla József dr.2, Székely Borbála dr.3, Husi Kata dr.3, Kerekes György dr.3

Debreceni Egyetem Klinikai Központ, Belgyógyászati Intézet,
1Gasztroenterológiai Tanszék,
2Nephrológiai Tanszék,
3Belgyógyászati Intenzív Osztály
Correspondence: foldi.ildiko@med.unideb.hu

Among acute, life-threatening gastroenterological disorders, severe acute pancreatitis and acute liver failure are high-mortality diseases, and their treatment remains a challenge today. In both cases, significant cell damage occurs and, in addition, frequently associated infections may result in an excessive immune response, a “cytokine storm”. Since attempts to control this condition using medication therapy have not been successful enough, extracorporal techniques are more often preferred. Of cytokine absorbers, CytoSorb is the most widely used agent globally, which can also be combined with other extracorporeal organ replacement treatments. This paper presents our current therapeutic options and experiences based on two cases.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2019 | VOLUME 5, ISSUE 3