The emergence of anti-TNF agents has revolutionized the management of inflammatory bowel disease, yet a significant proportion of patients experience primary non-response or secondary loss of response due to immunogenicity. As the field of precision medicine advances, genetic predictors such as human leukocyte antigen (HLA) variants are gaining increasing attention. This review provides a comprehensive synthesis of current evidence on the role of HLA genotypes in inflammatory bowel disease susceptibility and disease behavior, with a focus on their mechanistic and clinical relevance in anti-TNF therapy. Special emphasis is placed on HLA-DQA1*05, a validated predictor of anti-drug antibody formation and reduced therapeutic durability. We explore the immunological basis of HLA-mediated immunogenicity, summarize pharmacogenetic and biomarker findings, and discuss how HLA typing may be integrated into treatment algorithms to improve patient stratification and long-term outcomes. As immunogenetics continues to inform clinical decision-making, understanding the interplay between HLA polymorphisms and therapeutic response offers new opportunities for biomarker-guided, personalized care in inflammatory bowel disease.

Celiac disease (CD) is chronic inflammatory disease of the proximal small intestine. It is caused by hypersensitivity to gluten proteins, rays and barley, which damage the intestinal mucous membrane, creating conditions for malabsorption. In addition to intestinal, classic forms of the disease, extraintestinal manifestations may occur. Aphthae in the oral cavity, defects of the enamel, caries, delayed tooth erupting, atrophic glossitis and angular cheilitis are some of them. Serological examination of patients with minimal symptoms and in patients with extraintestinal and atypical gastrointestinal symptoms would improve the timely diagnosis. By careful dental examination of the cavity with a special focus on these changes, we can contribute to early diagnosis of the CD. The education of patients about oral manifestations of CD can improve the quality of life of these patients.

Follicular lymphoma is the most common indolent non-Hodgkin’s lymphoma and is usually initially detected in lymph nodes. Primary extranodal NHL is most commonly primarily localized in the gastrointestinal tract. We present one unusual case of ileum FL with ascites as the first clinical sign. The 73-year-old female patient was presented to the emergency department for evaluation of mild abdominal pain and abdominal swelling that had been going on for three days followed by bloating and occasional pain in the spine. The abdominal contrast-enhanced CT revealed the contrast stagnation in the distal part of the ileum. The ileum wall about 11 cm in length was thickened up to 2.9 cm and the tumor mass infiltrated all layers of ileum mesenteric lymphadenopathy up to 2 cm in diameter and significant ascites. On the upper ileum wall, the vegetative mass was described 3 cm in diameter. The patient had an emergent laparotomy with the ileocolic resection and latero-lateral ileocolic anastomosis. The microscopy finding of terminal ileum and the regional lymph nodes showed domination of cleaved cells with irregular nuclei which correspond to centrocytes. There were 0–15 large non-cleaved cells corresponding to centroblast in the microscopy high-power field. The final diagnosis was follicular lymphoma, the clinical stage 2E and histological grade by Berard and Mann criteria 1–2.

Link Video https://youtu.be/BI914kzH1pw The most common gastrointestinal symptoms in hemodialysis patients are dyspepsia, anorexia, nausea, abdominal pain, bloating, diarrhea, and constipation. This review aimed to outline current attitudes regarding complications of the upper digestive tract in patients undergoing chronic hemodialysis. A systematic review was conducted using the PubMed, MEDLINE, and Google Scholar databases, which were searched using the keywords: Complications, Upper Parts, Digestive Tract, and Hemodialysis. Hemodialysis patients have a reduced risk of Helicobacter pylori infection because studies have determined its protective effect on preventing the occurrence of gastroesophageal reflux disease. Likewise, a positive correlation was found between Helicobacter pylori infection and extra-gastrointestinal symptoms. Disorders of the upper part of the gastrointestinal tract in patients with chronic kidney disease can be seen as gastroesophageal dysmotility and mucosal lesions, with an increased tendency towards bleeding from the gastrointestinal tract.

The aim of this study was to evaluate the efficacy of endoscopic polypectomy as a therapeutic treatment for malignant alteration of colorectal polyps. In a 5-year research, 89 patients were included, who were tested and treated at the University Clinical Center Kragujevac, Kragujevac, Serbia, with the confirmed presence of malignant alteration polyps of the colon by colonoscopy, which were removed using the method of endoscopic polypectomy and confirmed by the histopathological examination of the entire polyp. After that, the same group of patients was monitored endoscopically within a certain period, controlling polypectomy locations and the occurrence of a possible remnant of the polyp, in the period of up to 2 years of polypectomy. We observed that, with an increasing size of polyps, there is also an increase in the percentage of the complexity of endoscopic resection and the appearance of remnant with histological characteristics of the invasive cancer. The highest percentage of incomplete endoscopic resection and the appearance of remnant with histological characteristics of the invasive cancer were shown at malignant altered polyps in the field of tubulovillous adenoma. Eighteen patients in total underwent the surgical intervention. In conclusion, our data support the high efficacy of endoscopic polypectomy for the removal of the altered malignant polyp.

Extraintestinal manifestations of Crohn's disease and ulcerative colitis were observed in almost half of the patients. They should be distinguished from secondary illnesses and complications. The most commonly affected organs are joints, skin, eyes, liver, gallbladder, urogenital and hematopoietic system. Eye manifestations are, although rare, an important form of morbidity, with possible blindness. The prevalence is higher in women and if the bowel disease is diagnosed at younger age, but lower than in children. Considering the great impact on the life quality, sometimes higher than gastrointestinal symptoms are, the goal is to show the importance of recognition and clinical and diagnostic approach to some ophthalmic entities. Symptomology of the most common changes, iritis, episcleritis and scleritis is nonspecific, and therefore the clinical evaluation is potentially underestimated both from the patient's and from the doctor's point of view. Ophthalmologic examination should be more frequent and an integral part of care for patients with inflammatory bowel disease. It is necessary to be well aware of the possible symptoms on the eye diseases, because they can precede inflammatory bowel disease. Treatment and adequate control of basic systemic disease contribute to the control of eye disease.