Mycophenolate mofetil (MMF) is a new immunosuppressant developed for the prevention and treatment of acute renal rejection after transplantation. Diarrhea is the most frequent side effect observed during treatment with MMF. Its pathogenic mechanisms remain unknown. We describe a case of severe diarrhea due to villous atrophy in a renal transplant recipient during treatment with MMF. The patient was free of symptoms before MMF. Villous atrophy disappeared a few months after MMF withdrawal.

Mucosal lesions in lichen planus (LP) involve mostly mouth and genitals. Extension to oesophagus resulting in stenosis is exceptional (only eight cases have been reported so far). We describe two such cases and recall the clinical findings required to correlate an oesophageal stenosis to LP: age and sex status, associated mucosal LP lesions, location on the upper third of the oesophagus, histological features, flare-up of buccal lesions following dilatation.Systemic steroids are regarded as the best treatment in the case ofoesophageai stenosis due to LP, the efficacy of etretinate is limited, and dilatations should be avoided. Dapsone proved to be efficient in severe erosive buccal LP, and could be considered as a valuable therapeutic alternative.

BackgroundSupplementary observational data in the community setting are required to better assess the predictors of colorectal polyp recurrence and the effectiveness of colonoscopy surveillance under real circumstances.AimThe goal of this study was to identify patient characteristics and polyp features at baseline colonoscopy that are associated with the recurrence of colorectal polyps (including hyperplastic polyps) among patients consulting private practice physicians.Patients and MethodsThis cohort study was conducted from March 2004 to December 2010 in 26 private gastroenterology practices (France). It included 1023 patients with a first-time diagnosis of histologically confirmed polyp removed during a diagnostic or screening colonoscopy. At enrollment, interviews were conducted to obtain data on socio-demographic variables and risk factors. Pathology reports were reviewed to abstract data on polyp features at baseline colonoscopy. Colorectal polyps diagnosed at the surveillance colonoscopy were considered as end points. The time to event was analyzed with an accelerated failure time model assuming a Weibull distribution.ResultsAmong the 1023 patients with colorectal polyp at baseline, 553 underwent a surveillance colonoscopy. The mean time interval from baseline colonoscopy to first surveillance examination was 3.42 (standard deviation, 1.45) years. The recurrence rates were 50.5% and 32.9% for all polyps and adenomas, respectively. In multivariate models, the number of polyps at baseline was the only significant predictor for both polyp recurrence (hazard ratio [HR] 1.19, 95% CI 1.06 to 1.33), and adenoma recurrence (HR 1.17, 95% CI 1.03 to 1.34).ConclusionThe efficacy of surveillance colonoscopy in community gastroenterology practice compared favorably with academic settings. This study provides further evidence that the number of initial colorectal polyps is useful for predicting the risk of polyp recurrence, even in the community setting.

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In order to investigate the contribution of eicosanoids to human oesophageal functions and disorders (gastrooesophageal reflux, GOR and reflux oesophagitis, RO), we have used a selected ion monitoring gas chromatographic/mass spectrometric methodology to quantify the cyclooxygenase and lipoxygenase products biosynthesized in vitro by endoscopic mucosal biopsy specimens. Prostaglandins (PGs) were quantified as MEMOTMS derivatives and HETEs, as hydrogenated methyl ester of tert-butyldimethylsilyl) ether derivatives. PGE2, PGF2 alpha appeared as the major prostanoids, whereas 12HETE seemed to be the major lipoxygenase product. In the case of GOR or RO, biosynthesis of PGE2 was dramatically increased, while no change could be detected for 12HETE. PGE2 increase seems to be related to inflammatory reaction, in which its exact role remains unclear. Moreover, it cannot be excluded that PGE2 is a side product which might be protective to the oesophageal mucosa.