Background/Aims: Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis. In patients with severe HTG (TG level>1000 mg/dL), it may be beneficial to immediately lower the levels of triglyceride (TG) and chylomicrons. In this study, we present one of the largest case series on the use of therapeutic plasma exchange (TPE) for hypertriglyceridemia-induced acute pancreatitis (HTG-AP). Materials and Methods: Overall, 33 patients who were admitted to our clinic for HTG-AP and underwent TPE between January 2007 and July 2017 were included in the study. Clinical data and outcomes and the reduction of triglyceride levels were examined retrospectively. Results: The TG level decreased by 54.4%, and the total cholesterol level decreased by 52.1% after one TPE session. The TG decrease after the second TPE session was found to be 79.4%. There were 20 (60.6%) patients with mild acute pancreatitis, 10 (30.3%) patients with moderetaly severe acute pancreatitis, and 3 (9.1%) patients with severe acute pancreatitis based on the categorization according to the revised Atlanta criteria. Regarding local complications, the acute peripancreatic fluid collection was observed in 13 (39.4%) patients, acute necrotic collection was observed in 1 (3%) patient, walled-off necrosis was observed in 1 (3%) patient, and pancreatic pseudocyst was not observed in any patient. Mortality was not determined in patients with mild and moderately severe acute pancreatitis, and its rate was 33.3% in patients with severe acute pancreatitis. The overall mortality rate was 3%. No significant complications related to TPE were noted. Conclusion: TPE is a safe and helpful therapeutic treatment method for patients with HTG-AP and may be considered particularly in patients with severe acute pancreatitis. Cite this article as: Kandemir A, Coşkun A, Yavaşoğlu İ, et al. Therapeutic plasma exchange for hypertriglyceridemia induced acut pancreatitis: the 33 cases experience from a tertiary reference center in Turkey. Turk J Gastroenterol 2018; 29: 676-83.

A 43-year-old woman was first admitted to the ophthalmology clinic with the complaint of a mass compressing the right eye. Based on clinical and laboratory examinations she was diagnosed as having marginal zone lymphoma (MZL) of the right lacrimal gland in addition to hepatitis C virus (HCV) infection. After the treatment for HCV infection with pegylated interferon plus ribavirin, a radiographic response of the MZL was obtained; she remains in remission through thirty months of clinical follow-up. In this case, the treatment of HCV infection led to regression of MZL suggesting the necessity of testing for HCV infection and treatment of the HCV infection should be highly considered in all HCV-positive patients with MZL's.

Drug-induced liver damage is a frequently encountered clinical table caused by many drugs. Cetirizine is a widely preferred and prescribed antihistaminic agent for allergic disorders due to its non-sedative properties. In view of the literature, we present four cases of hepatotoxicity due to cetirizine use. We conclude that in patients with high levels of liver enzymes of unknown origin, cetirizine as well as other hepatotoxic drugs should be reconsidered.

Background/Aims: This study aimed to investigate the possible positive effects of arbutin in a trinitrobenzene sulfonic acid (TNBS)- induced experimental colitis model, to compare it with mesalazine, which is used in treating inflammatory bowel disease and to observe the effect of its concomitant use. Materials and Methods: Forty Wistar albino species male rats were randomized into 5 groups as control, colitis, colitis+arbutin (Arb), colitis+mesalazine (Mes), and colitis+mesalazine+arbutin (M+A). Proinflammatory cytokines [interleukin (IL)-6, IL-1β, tumor necrosis factor alpha (TNF-α)] and oxidant/antioxidant parameters [malondialdehyde (MDA), superoxide dismutase inhibition (SOD) inhibition, myeloperoxidase (MPO), and catalase, glutathione peroxidase (GPx)] were processed from the samples. Histopathological evaluation evaluated goblet cell reduction, cellular infiltration, and mucosal loss. Results: When the treatment groups and the TNBS group were compared, statistical significance was achieved in MDA, MPO, SOD inhibition, GPx values, IL-6, IL-1β and TNF-α levels. Histopathological evaluation revealed a statistically significant decrease in the mucosal loss value in the group where mesalazine and arbutin were used together compared to the TNBS group. Conclusion: Our study’s results elaborated that using arbutin alone or in combination with mesalazine produced positive effects in colitis-induced rats. Cite this article as: Alemdar MB, Şirinyıldız F, Coşkun A, et al. Investigation of possible positive effects of arbutin application in experimental colitis model. Turk J Gastroenterol. 2024;35(7):523-531.

Tr en Giriş ve Amaç: Üst gastrointestinal sistem maligniteleri tüm dünyada önemli mortalite ve morbidite nedenlerindendir. Tanıda özofagogastroduodenoskopi altın standart işlemdir. Çalışmadaki amacımız endoskopi ünitemizde özofagogastroduodenoskopi işlemi ile tespit ettiğimiz ve biyopsi ile de tanısı kesinleşen üst gastrointestinal sistem malignitelerinin yaş, cinsiyet, lokalizasyon ile histopatolojik tipleri ve işlem öncesi hasta semptomları gibi bazı özelliklerini belirlemekti. Gereç ve Yöntem: Endoskopi ünitemizde özofagogastroduodenoskopi yapılan 7.688 hastadan malignite saptanan 209 (%2,71) vaka çalışmaya alındı. Bulgular: Özofagogastroduodenoskopi işleminde malignite saptanan hastaların 145’i erkek (%69,4), 64’ü kadın (%30,6) olup yaş ortalaması 62,18±12,07 yıldı. Malignitelerin %21,1’i özofagusta, %75,1’i midede ve %3,8’i duodenumda saptandı. Yapılan histopatolojik incelemede, özofagus kanserlerinin %84,1’i squamöz hücreli karsinom, %15,9’u adenokarsinom; mide kanserlerinin %87,9’u adenokarsinom, %3,8’i malign epitelyal tümör, %5,8’i lenfoma, %2,5’i nöroendokrin tümör; duodenum kanserlerinin %87,5’i adenokarsinom, %12,5’i malign epitelyal tümör olarak tespit edildi. Sonuç: Üst gastrointestinal sistem maligniteleri en sık midede, 2. sıklıkta özofagusta saptanmaktadır. Nadirde olsa duodenumda tümör görülebilmektedir. Background and Aims: Upper gastrointestinal tract malignancies are among the major causes of morbidity and mortality worldwide. Esophagogastroduodenoscopy is the gold standard for the diagnosis of upper gastrointestinal tract cancers. The aim of our study was to determine features of upper gastrointestinal tract malignancies including age, gender, localization, histological types and symptoms prior to the procedure in the cases that were identified by in our endoscopy unit and finally diagnosed by biopsy. Materials and Methods: A total of 209 (2.71%) of 7.688 patients who underwent esophagogastroduodenoscopy in our endoscopy unit and who were diagnosed with malignancy were included in the study. Results: Of the patients diagnosed with malignancy by esophagogastroduodenoscopy, 145 were men (69,4%) and 64 were women (30,6%). Mean age was 62.18±12.07 years. In the sample, 21.1% of malignant tumors were detected in the esophagus, 75.1% in the stomach, and 3.8% in the duodenum. Histopathological examination showed that 84.1% of esophageal tumors were squamous cell carcinoma, and 15.9% were adenocarcinoma; 87.9% of gastric tumors were adenocarcinoma, 3.8% were malignant epithelial tumors, 5.8% were lymphoma, and 2.5% were neuroendocrine tumors; 87.5% of duodenal tumors were adenocarcinoma, and 12.5% were malignant epithelial tumors. Conclısions: Upper gastrointestinal tract malignancies are most common in the stomach, and the second most common organ is esophagus. Although rare, tumors can be seen in the duodenum.