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Volume 73 - 2010 - Fasc.2 - Reviews

Autoimmune pancreatitis and extrapancreatic manifestations of IgG4-related sclerosing disease

In a review of the literature concerning autoimmune pancreati- tis we had special interest for the concept of IgG4-related pa- thology as a systemic disease with several clinical manifestations. In general, IgG4-positivity can not only be found in the pancreas, but also at the level of the kidneys, extrahepatic biliary ducts, gall- bladder, lungs, salivary glands, lacrimal glands, retroperitoneal tissue, ureters, prostate, meninges and lymph nodes. IgG4 seems to be a central key player in the pathophysiology of this disease. (Acta gastroenterol. belg., 2010, 73, 239-246).


Risk for relapse of alcohol use after liver transplantation for alcoholic liver disease : A review and proposal of a set of risk assessment criteria

Background : Liver transplantation for end stage alcoholic liver disease is becoming an increasingly frequent procedure. Within this context assessing the risk on relapse in alcohol use is a major issue. However, up to now, there is a clear lack in validated criteria that can be used to assess future relapse risk. Method : Literature review based upon Medline search identify- ing all new studies that have been published after the latest meta- analysis on this subject (2007-2009). Results : Five new original studies were identified. They provide new evidence for the prospective validity of different criteria ; pre- transplant abstinence duration, diagnosis of alcohol dependence versus abuse, level of social support, additional psychiatric co morbidity. Conclusions : These criteria seem promising as to the prediction of relapse in alcohol after livertransplantation. Based upon these results a new comprehensive assessment scale is proposed. (Acta gastroenterol. belg., 2010, 73, 247-251).


Retroperitoneal, mesenteric and multifocal fibrosis : review of their aetiopatho- genesis. A possible role of adipocytes as in Crohn's disease ?

First observed during an autopsy by Simpson in 1867 as a cause of hydronephrosis, retroperitoneal fibrosis became a medical topic after the detailed report of two cases by Ormond in 1948. Initially considered to be chiefly an urological disease, it appeared progres- sively that it could possibly be a systemic disease because of its occasional association with inflammatory fibrosing processes in other sites of the body or with clinical and biological manifestations of hypersensitivity or autoimmunity. Mesenteric panniculitis and mesenteric fibrosis may occur independently or, occasionally, in association with retroperitoneal fibrosis. One third of the cases of retroperitoneal fibrosis can be attributed to specific causes. That the other cases (idiopathic retroperitoneal fibrosis) could be mani- festations of an immunological (systemic) process with vasculitis is generally accepted. The authors present a survey of the various possible morphological aspects of the disease and a review of its aetiopathogenesis. Idiopathic retroperitoneal fibrosis is usually characterized by an overproduction of fibro-inflammatory tissue ; however in few cases as well as in mesenteric panniculitis, extensive development of fatty tissue may also occur. The authors suggest that an initial proliferation of adipocytes, considered to account for the fat hyperplasia adjacent to Crohn's ileitis, could also play a role in the pathogenesis of the inflammatory fibrosing process in some cases of mesenteric and retroperitoneal fibrosis. (Acta gastroenterol. belg., 2010, 73, 252-260).