Volume 82 - 2019 - Fasc.2 - Letters
Comment on the history of Acta Gastro-Enterologica Belgica
I read with interest the article of T. Moreels et al. in the last issue of Acta Gastro-Enterologica Belgica on the history of the Journal (1). It was suggested that I was designated as the first Flemish Editor-in-Chief by the 'Vlaamse Vereniging voor Gastro-enterologie' (VVGE). In fact, before 2009 the Acta was a part of the "Société Belge de Gastro-Entérologie" (SRBGE). The intention to make the Acta again the Journal of the whole Belgian gastroenterological community was already prepared earlier by the Editors Jean Henrion, Olivier Le Moine and Pierre Deprez. According to the former statutes of the SRBGE, the Deputy Editor and Editor-in-Chief had to be member of the Board of the SRBGE. As I was member of that Society since 1995, as were many Flemish gastroenterologists, I was asked by Jean Henrion and Olivier Le Moine, to apply for the Board of the SRBGE. Although being Flemish, I was elected by the members of the SRBGE in 2005 and served there for 8 years. During 4 years I was Deputy Editor. In 2009 I succeeded Pierre Deprez as Editor-in-Chief, for 2 years, according to the statutes the newly created non-profit organization Acta Gastro-Enterologica Belgica.
Campylobacter fetus-induced cellulitis in a Crohn's disease patient under anti- TNFalpha maintenance therapy
A 54-year-old female patient presented to the emergency department with a tender and swollen left leg, subsequent to a fall. Shortly after, she had developed fever with shivering. Her medical history included type 2 diabetes, Crohn's disease for 40 years, obesity and alcoholic liver cirrhosis. For the Crohn's disease, she was treated with azathioprine (2,5 mg/kg once daily) and anti- TNFalpha therapy (infliximab 5 mg/kg every 4 weeks, based on trough l335evels) for several years. A week before admission she suffered from nausea, vomitus and diarrhea. The patient had no recent history of travelling, nor of eating improperly cooked meat or unpasteurized milk.
Is Ustekinumab the best treatment option in patients with Crohn's disease and coexistent multiple sclerosis?
Crohn's Disease (CD) and Multiple Sclerosis (MS) are chronic diseases associated with an aberrant immune response upon an environmental trigger in genetically susceptible hosts. We present the case of a young patient with known MS diagnosed with new onset CD. Due to his young age, extended disease (Montreal A2L1,4B1) and smoking habits he was considered candidate for immunosuppression therapy but developed acute pancreatitis 2 weeks after azathioprine administration. Subsequently, ustekinumab was initiated. The patient showed clinical and biochemical response within the first 2 months of therapy and achieved mucosal healing (Simple Endoscopic Score for Crohn's Disease of 0 compared to 6 at baseline) at 12 months of therapy. No clinical episodes of MS or new lesions on MRI have developed 17 months after treatment commencement.
Results of a screening campaign for hepatitis C viral infection in a Brussels hospital : do we need to go further?
We read with attention the letter of Xavier Verhelst in the last issue of Acta Gastro-Enterologica Belgica evaluating the results of a screening campaign in Lendelede (1). Patients undergoing blood examination were offered anti-HCV screening, further HCV RNA evaluation and hepatology consultation if indicated. During one year, 560 patients were screened in a single center. Of those, 5 patients (0.9%) had antibodies against HCV. Positive RNA was evidenced in 3 patients (0.5%) and two of them were referred for antiviral treatment. Thanks to those data, the authors highlight the need of screening campaigns for HCV infection in Belgium (1).
We also performed a screening campaign for HCV infection in our hospital. We proposed an HCV screening through a simple finger-stick test without any questionnaire to people (patients, visitors or health care providers) who were present in the main hall of our academic hospital during one day (April 25, 2018).
Of 200 volunteers who had been tested during one day, 3 were positive (1.5%). All three patients (one woman and two men) explained that they were already aware of their status (one patient with a previous failure of interferon therapy, one with a previous effective antiviral treatment and another who did not provide any further information). All were middle-age people (50-60 years). There were no newly diagnosed cases and no subsequent antiviral treatment.
