Background and Aim: The histological diagnosis of autoimmune hepatitis (AIH) is challenging. A new consensus recommendation was provided by the International AIH Pathology Group to address the problems in the histological diagnosis. The purpose of this study is to compare the 2008 ‘simplified’ criteria for AIH with the ‘consensus recommendation’ of 2022 in terms of diagnostic sensitivity. Materials and Methods: A retrospective analysis was conducted on pathological specimens of patients diagnosed with Autoimmune Hepatitis (AIH) between 2010 and 2022. Out of 188 patients enlisted, 88 were selected based on exclusion criteria. The specimens were examined by two experienced hepatopathologists and a resident pathologist. All specimens were analyzed using both the “simplified” criteria and the new consensus recommendations. Results: Out of a total of 78 patients, the 2022 consensus recommendations raised the diagnostic category of 16 patients (20.5%) to a higher level. Six patients who were previously diagnosed as “atypical” were now considered “possible AIH”, while 10 patients with a “compatible” diagnosis were elevated to “likely AIH” category. No patients were found to fall into a lower diagnostic category according to the new recommendations. A significant difference in diagnostic sensitivity was observed between the 2008 criteria and the 2022 consensus report (p

Although Crohn’s disease (CD) affects the intestines, it is known to be a systemic disease rather than being limited to the intestines. Extra intestinal manifestations (EIMs) accompanying CD are reported at rates varying from 6 to 53%. While EIM negatively affects the quality of life of some patients, some EIMs, such as primary sclerosing cholangitis and thromboembolism, can be life-threatening. Although more than one EIM can occur simultaneously, the development of one EIM increases the probability of developing another EIM. There are few studies on how EIMs affect each other. The aim of this study was to examine the frequency of EIMs accompanying CD and their interactions with each other. This study included patients with CD who were under regular follow-up from March 1986 to October 2011. Accompanying EIMs and the time of development were recorded. The frequency of EIMs and their associations with each other were investigated. In total, 336 patients with CD (55.4% male) with a mean follow-up duration of 7.54 years (range, 6 months–25.4 years) were evaluated. At the time of CD diagnosis, 21.1% of the patients had at least one EIM, and at the end of the 25-year follow-up period, the prevalence of EIMs was 47.3%. The prevalence of multiple EIMs was 12.2% and 22.9% at the onset of CD and at the 25-year follow-up, respectively. Oral, joint 9.2%, respectively) were the most common EIMs. The development and skin involvement (32.4%, 24.7%, and of peripheral arthritis was significantly associated with axial spondiloarthropathy, skin involvement, ocular involvement, oral ulcers, and vascular thromboembolism (p < 0.05). There was a significant relationship between oral ulcers and peripheral arthritis, axial arthritis, skin involvement, ocular involvement, liver involvement and thromboembolism (p < 0.05). No significant relationship was detected between neurological involvement and any other EIMs. The development of EIMs in patients with CD may trigger the development of other EIMs during the course of the disease.

Background and Aim: Inflammatory bowel disease (IBD), which comprises ulcerative colitis (UC) and Crohn’s disease (CD), is characterized by chronic inflammation and fluctuating disease activity. This study aimed to evaluate serum tryptophan (TRP) and its metabolites as potential biomarkers for predicting disease activation in comparison to fecal calprotectin (FC). Methods: This prospective study included 115 patients (77 with UC and 38 with CD). Disease activity was assessed based on clinical and endoscopic findings. Serum TRP levels and their metabolites were measured using liquid chromatography–tandem mass spectrometry (LC-MS/MS), whereas FC levels were analyzed using an enzyme-linked immunosorbent assay (ELISA). Results: Serum TRP levels ≤ 11,328.41 ng/mL predicted disease activation with 72.1% sensitivity and 62.7% specificity, whereas FC levels ≥ 89.60 µg/g showed 84.2% sensitivity and 67.6% specificity. The TRP-to-C-reactive protein (CRP) ratio (TRP/CRP) demonstrated superior diagnostic accuracy, with an area under the curve (AUC) of 0.847. Conclusions: The TRP/CRP ratio is a novel and comprehensive approach for predicting disease activation in IBD patients. Although FC remains the gold standard, TRP and its metabolites provide valuable complementary insights. Further research is required to validate these findings in larger cohorts.

Success in eradication of H. pylori is decreasing due to increasing resistant strains. In particular, side-effects due to 4-agent treatment multiple drug use are observed and treatment compliance decreases. The aim of this study was to evaluate the efficacy, reliability, and side-effect profile of the combination of amoxicillin and rabeprazole with gemifloxacin, which is a new generation quinolone, in the treatment of H. pylori infection. This study was conducted on 71 naive patients who received H. pylori eradication. All the patients were administered treatment of Amoxicillin (1000 mg twice a day) + Gemifloxacin (320 mg once a day) + rabeprazole (20 mg twice a day) for 7 days. Drug compliance and treatment tolerance were evaluated after finishing the treatment. At 1 month after the end of the treatment, H. pylori eradication was evaluated in all the patients by examining H. pylori antigen in the feces. In the evaluation after treatment, H. pylori eradication was obtained in 63 (88.7%) patients and eradication was not obtained in 8 (11.3%) patients. The treatment was not completed by 2 patients because of side-effects and noncompliance, so after exclusion of these 2 patients, successful H. pylori eradication was obtained in 63 (91.3%) of 69 patients who completed the treatment. Side-effects were seen in a total of 9 (12.7%) patients. Diarrhea, bloating, abdominal pain, and nausea-vomiting were seen in some patients, but no reflux, constipation, skin rash, listlessness-fatigue, headache, dizziness, palpitations, dry mouth, or weight loss was seen in any patient. In regions with high resistance to clarithromycin and metronidazole in particular, the combination of gemifloxacin with amoxicillin and rabeprazole can be considered for use in first-stage treatment as both the efficacy and tolerability are high.

Amyloid A (AA) amyloidosis is best managed by elimination of the underlying cause. However, no cause could be identified in 6–19% of cases [ 1, 2]. Moreover, the frequency of AA amyloidosis of unknown aetiology has been known to increase and may exceed that of AA amyloidosis secondary to rheumatoid arthritis, the most common known cause in the Western world [ 2]. No standard treatment exists for AA amyloidosis of unknown aetiology. Given their efficacy in AA amyloidosis caused by rheumatic diseases, two cytokine inhibitors, anakinra and tocilizumab, were tested in human patients with this condition. Anakinra, a recombinant interleukin-1 (IL-1) receptor antagonist, proved effective and was well tolerated in a small cohort of 11 patients [ 3]. The effect of tocilizumab, a monoclonal antibody against IL-6 receptor, was either unassessable or unfortunate in three patients [ 4]. Previous unsuccessful trials with two tumour necrosis factor-α (TNF-α) inhibitors, etanercept and adalimumab, and abatacept, a co-stimulation inhibitor, were mentioned in patients treated with anakinra [ 3] and tocilizumab [ 4]. No human data were available for other cytokine inhibitors, including canakinumab, an IL-1β inhibitor.