Browsing by Author "Ivanovski, Tamara Knežević (57201942973)"

Introduction/Aim. Anemia is a common extraintestinal manifestation of inflammatory bowel diseases (IBDs). Recognizing and treating anemia in patients with IBD is vital for improving the quality of life and reducing complications. The aim of this study was to assess the effectiveness and safety of the liposomal iron formulation in the treatment of anemia in patients with Crohn's disease and ulcerative colitis. Method. Among 447 patients in the state of clinical remission of ucerative colitis and Crohn's disease treated with biological therapy, there were 37 patients with confirmed sideropenic anemia (Hb 10 g/dl – 12 g/l, ferritin less than 100) who received a liposomal iron pyrophosphate preparation at the dose of 30 mg daily for one month. Parameters such as hemoglobin level, hematocrit, ferritin, and mean corpuscular volume (MCV) were monitored, along with anemia symptoms, and correlated with the onset of therapy; quality of life was also assessed. Statistical analysis was performed using the SPSS program.Results. The application of liposomal iron over one month resulted in a statistically significant increase in hemoglobin levels, averaging 3 g/dL (p = 0.021). A significant increase in hemoglobin was observed in patients in endoscopic remission, almost 10 g/dL (p = 0.008). Additionally, there was an average increase in ferritin levels by almost 2 ng/mL (p = 0.514) and hematocrit by 0.006% (p = 0.126), although these increases did not reach statistical significance. Analyzing the results based on the type of IBD, greater efficacy was observed in patients with ulcerative colitis, showing a significant increase in hemoglobin of 8 g/dL (p = 0.012) compared to patients with Crohn's disease. Two patients reported abdominal discomfort and diarrhea (5.4%) as adverse effects.Conclusion. Our results suggest that 8.3% of IBD patients in clinical remission have anemia and liposomal iron is an effective and safe option for treating anemia in patients. Further research is needed to evaluate the long-term effectiveness and safety of liposomal iron in this patient population. © 2024 University of Nis, Faculty of Medicine. All rights reserved.

Introduction. Mucormycosis is a life-threatening opportunistic infection whose incidence has significantly risen during the last two decades. The gastrointestinal form is very rare, with the stomach as the most common site of infection, followed by the colon and ileum. Risk factors include uncontrolled diabetes mellitus, corticosteroid use, and organ transplantation. We report a patient with a history of rheumatoid arthritis who has developed gastrointestinal mucormycosis. To the best of our knowledge, this is the first such case reported in the literature. Case report. A 53-year-old female patient with a prior medical history of rheumatoid arthritis was admitted to the hospital due to persisting diarrhea. Physical examination revealed diffuse abdominal tenderness to palpation without meteorism and peritoneal signs. Laboratory results demonstrated systemic inflammation, so antibiotic therapy was administered. Abdominal computed tomography findings revealed inflammation of the rectum and the left colon. Colonoscopy findings were indicative of Crohn’s disease. Additionally, the patient had developed profuse rectal bleeding and consequently underwent emergency surgery. Subtotal colectomy with ileostomy and partial gastrectomy was performed. The patient’s condition rapidly worsened after the operation, and she died due to multi-organ failure. Histologic findings of resection specimens discovered chronic active colitis and extensive gastric necrosis associated with dense mixed inflammatory infiltration and numerous non-septate and 90-degree branching hyphae. Diagnosis of invasive gastric mucormycosis was obtained, but unfortunately, several days after the patient’s death. Conclusion. It is very important to obtain high awareness among clinicians of this deadly infection to achieve a prompt diagnosis and effective therapy. © The Author(s) 2022.