Background: Enteroaggregative Esherichia coli (EAEC) is a bacterium that can cause diarrhea. Enteroaggregative Esherichia coli (EAEC) has been one of important diarrheagenic E. coli. It is necessary to evaluate the role of EAEC in causing diarrhea in children. Objectives: The purposes of this study are to determine the prevalence \r\n', u'of EAEC in children with and without diarrhea and to evaluate the clinical symptoms of diarrhea caused by EAEC. Subjects and method:These 836 children living in Hanoi including 587 children with diarrhea and 249 controls have been selected for the study. Polymerase Chain Reaction in combination with the conventional method have been used to detect EPEe.They were treated at Saint \ufffd?Paul Hospital, Thanh Nhan Hospital and National Hospital of Pediatrics. Results: EAEC strains have been detected with the prevalence of 11.6% in children with diarrhea and of 7.2% in the controls. It shows a correlation of EAEC with diarrhea in children less than 2 years of age. The common clinical symptoms of EPEC diarrhea anT watery diarrhea, sunken, vomiting. Conclusion: Enteroaggregative Esherichia coli are attributable to about 12% of diarrheal cases in children. Watery diarrhea is the most commonly seen symptom. It would be of interest to perform further studies on diarrhea caused by EAEC in children in Hanoi. \r\n', u'
Diarrhea/ pathology ; diet therapy ; Escherichia coli/ pathogenicity

OBJECTIVETo investigate the clinicopathologic features of adult-onset autoimmune enteropathy (AIE).

METHODSA case of adult-onset AIE was described along with a literature review.

RESULTSA 41-year-old male patient was admitted for intractable diarrhea for more than three months despite of any dietary restriction or anti-inflammatory therapy. Fat globule was observed by stool examination and Sudan III staining of the stool was positive. Enteroclysis showed weak movement and few plica of small intestine, while colonoscopy appeared normal. Small bowel biopsies revealed villus atrophy and increased crypt apoptotic bodies and lymphocytic infiltration in deep crypt. Although without significant surface intro-epithelial lymphocytosis, there were a large number of monocytes, lymphocytes, plasmacytes and neutrophilic granulocytes infiltrating in the lamina propria. Morphologically, the colonic mucous was similar to the small intestine although cryptitis and crypt abscess were significant in the former. Serum IgG anti-goblet cell antibody was demonstrated by indirect immunofluorescence. Other causes of diarrhea were excluded on the base of medical history, histopathology and other accessory examinations before the diagnosis of AIE was made. The patient had a complete remission after steroid treatment without recurrence for eight months during the follow-up even after steroid withdrawal for five months.

CONCLUSIONSAIE is exceedingly rare and timely diagnosis is important for successful therapy. Histological differential diagnoses should include ulcerative colitis, celiac disease, lymphocytic colitis, etc. The final diagnosis should be based on histological examination combined with the patient history, clinical manifestation, endoscopy finding and serological testing.

Atrophy ; Biopsy ; Celiac Disease ; pathology ; Colon ; pathology ; Colonoscopy ; Diagnosis, Differential ; Diarrhea ; etiology ; Humans ; Intestinal Mucosa ; pathology ; Intestine, Small ; pathology ; Lymphocytes ; Lymphocytosis ; pathology ; Polyendocrinopathies, Autoimmune ; pathology

This paper describes the first case of common variable immunodeficiency (CVID) and AA amyloidosis. A recently treated tuberculosis, and chronic inflammation induced by frequent respiratory tract infections, were thought to be responsible for the amyloidosis. No other reason for this condition could be detected. Although T cell dysfunction in some CVID patients has been reported, pulmonary tuberculosis is quite rare with this condition. Bacterial or viral agents or evidence in favour of intestinal tuberculosis, which would explain this patient's recurrent diarrhea, were not found. In this case, the response of the attacks of diarrhea to metranidazole and the histologic observation of extensive intestinal amyloid deposition, which is known to decrease intestinal motility, made us conclude that the diarrhea was associated with bacterial overgrowth. In this report, we discuss the association of CVID and tuberculosis to secondary amyloidosis and recurrent diarrhea.
Tuberculosis/*complications ; Male ; Humans ; Diarrhea/etiology ; Common Variable Immunodeficiency/*complications ; Amyloidosis/*etiology/pathology ; Adult

Colonoscopic evaluation has revolutionized the management of colorectal disorders, of which colorectal neoplasia is the most important. Experience with 2000 consecutive colonoscopies was reviewed to determine their clinical significance. The symptoms that patients complained about were anal bleeding, abdominal pain, diarrhea, and constipation. Colonic polyps, colon cancer, and ulcerative colitis were diagnosed by colonoscopy. Colonic polyps were the most common pathology for anal bleeding and constipation. Ulcerative colitis was the most common pathology for diarrhea. Intestinal tuberculosis was the most common pathology for abdominal pain. Colon cancer was the most common pathology for tenesmus. Lymphoid hyperplasia was the most common pathology in patients under 10. Ulcerative colitis was the most common pathology in patients in their 3rd or 4th decade. Colonic polyp was the most common pathology in patients in their 5th, 6th, or 7th decade. Colon cancer was the most common pathology in patients in their of 8th or 9th decade. A colonoscopic polypectomy was performed in 49.5% of the colonoscopies, and an open polypectomy was done in 2.7%. There were no surgical complications from the colonoscopies. As a result of this study, it is concluded that total colonoscopic examination should be performed in patients over 40 who complain about rectal bleeding and tenesmus. To avoid complications and give proper management, it is recommended that colonoscopy be performed by a surgeon.
Abdominal Pain ; Colitis, Ulcerative ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Constipation ; Diarrhea ; Hemorrhage ; Humans ; Hyperplasia ; Pathology ; Tuberculosis

Human astrovirus (HAstV) is a major cause of acute diarrhea among children, resulting in outbreaks of diarrhea and occasionally hospitalization. Improved surveillance and application of sensitive molecular diagnostics have further defined the impact of HAstV infections in children. These studies have shown that HAstV infections are clinically milder (diarrhea, vomiting, fever) than infections with other enteric agents. Among the 8 serotypes of HAstV identified, serotype 1 is the predominant strain worldwide. In addition to serotype 1, the detection rate of HAstV types 2 to 8 has increased by using newly developed assays. HAstV is less common compared with other major gastroenteritis viruses, including norovirus and rotavirus; however, it is a potentially important viral etiological agent with a significant role in acute gastroenteritis. A better understanding of the molecular epidemiology and characteristics of HAstV strains may be valuable to develop specific prevention strategies.
Child ; Diarrhea ; Disease Outbreaks ; Gastroenteritis ; Hospitalization ; Humans ; Mamastrovirus ; Molecular Epidemiology ; Norovirus ; Pathology, Molecular ; Sprains and Strains ; Vomiting

Human astrovirus (HAstV) is a major cause of acute diarrhea among children, resulting in outbreaks of diarrhea and occasionally hospitalization. Improved surveillance and application of sensitive molecular diagnostics have further defined the impact of HAstV infections in children. These studies have shown that HAstV infections are clinically milder (diarrhea, vomiting, fever) than infections with other enteric agents. Among the 8 serotypes of HAstV identified, serotype 1 is the predominant strain worldwide. In addition to serotype 1, the detection rate of HAstV types 2 to 8 has increased by using newly developed assays. HAstV is less common compared with other major gastroenteritis viruses, including norovirus and rotavirus; however, it is a potentially important viral etiological agent with a significant role in acute gastroenteritis. A better understanding of the molecular epidemiology and characteristics of HAstV strains may be valuable to develop specific prevention strategies.
Child ; Diarrhea ; Disease Outbreaks ; Gastroenteritis ; Hospitalization ; Humans ; Mamastrovirus ; Molecular Epidemiology ; Norovirus ; Pathology, Molecular ; Sprains and Strains ; Vomiting

BACKGROUND/AIMS: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain. METHODS: This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included. Capsule endoscopy was used to detect small bowel pathologies in both groups. RESULTS: Sixty-five patients (53.8% female) fulfilled the inclusion criteria and had a mean (±standard deviation) age of 50.9±15.9 years. Clinically significant lesions were detected via capsule endoscopy in 32.5% of the patients in the abdominal pain group and 54.5% of the patients in the diarrhea group. Overall, 48% of patients had small bowel pathologies detected during the capsule endoscopy study. Inflammatory lesions and villous atrophy were the most frequent lesions identified in 16.9% and 15.3% of patients in the abdominal pain and the diarrhea groups, respectively. CONCLUSIONS: Routine use of capsule endoscopy in patients with irritable bowel syndrome should not be recommended. However, in patients with refractory conditions, capsule endoscopy may identify abnormalities.
Abdominal Pain* ; Atrophy ; Capsule Endoscopy* ; Diarrhea ; Humans ; Irritable Bowel Syndrome* ; Methods ; Pathology ; Prospective Studies ; Retrospective Studies

Abnormalities, Multiple ; pathology ; Adolescent ; Alopecia ; pathology ; Bone Diseases, Developmental ; pathology ; Diarrhea ; pathology ; Female ; Follow-Up Studies ; Humans ; Muscle Spasticity ; pathology ; Syndrome

Mast cells (MC) may be one factor influencing the response of visceral afferent nerves to mechanical and chemical stimuli. The aim of this study was to evaluate the degree of infiltration and activity of colonic MC in irritable bowel syndrome (IBS). Biopsy specimens were obtained from the cecum and rectum of 14 diarrhea predominant IBS and 14 normal controls. Electron microscopy was used to determine the number of intact and degranulated colonic MC and to quantify these separately according to the distance between MC and enteric nerves. An increased number of MC in both cecum and rectum in the IBS group in comparison with the control group was demonstrated (p<0.05). Activated MC in close proximity to enteric nerves were significantly increased in both cecum and rectum of the IBS group compared to control group (p<0.005). In addition, activated MC were significantly increased in close proximity to the nerves compared to those in the remote area in both cecum and rectum of the IBS group (p<0.0001). MC were significantly increased and activated in both cecum and rectum of the IBS group compared to controls. MC may play a role in the gut sensory hypersensitivity of IBS.
Adult ; Cecum/pathology ; Cecum/ultrastructure ; Diarrhea/pathology* ; Enteric Nervous System/anatomy & histology* ; Female ; Human ; Irritable Bowel Syndrome/pathology* ; Male ; Mast Cells/ultrastructure* ; Middle Aged ; Rectum/pathology ; Rectum/ultrastructure

BACKGROUND/AIMS: Although normal endoscopic findings are, as a rule, part of the diagnosis of microscopic colitis, several cases of macroscopic lesions (MLs) have been reported in collagenous colitis, but hardly in lymphocytic colitis (LC). The aim of this study was to investigate the endoscopic, clinical, and histopathologic features of LC with MLs. METHODS: A total of 14 patients with LC who were diagnosed between 2005 and 2010 were enrolled in the study. Endoscopic, clinical, and histopathologic findings were compared retrospectively according to the presence or absence of MLs. RESULTS: MLs were observed in seven of the 14 LC cases. Six of the MLs exhibited hypervascularity, three exhibited exudative bleeding and one exhibited edema. The patients with MLs had more severe diarrhea and were taking aspirin or proton pump inhibitors. More intraepithelial lymphocytes were observed during histologic examination in the patients with MLs compared to the patients without MLs, although this difference was not significant. The numbers of mononuclear cells and neutrophils in the lamina propria were independent of the presence or absence of MLs. CONCLUSIONS: LC does not always present with normal endoscopic findings. Hypervascularity and exudative bleeding are frequent endoscopic findings in patients with MLs.
Adult ; Aged ; Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/complications/*pathology ; Colon/pathology ; *Colonoscopy ; Diagnosis, Differential ; Diarrhea/etiology ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male ; Middle Aged ; Retrospective Studies