Introduction. Among the acute hepatic porphyrias, a small percentage of patients, predominantly female, present with recurrent cyclic attacks of acute intermittent porphyria (AIP) that occurs more than three times a year, and sometimes at intervals of less than a month. In women, the attacks are typically related to menstrual cycle, requiring several days of hospitalization and administration of heme arginate. For these patients, the prophylactic heme arginate therapy may be the optimal treatment modality. Case Report. We present a 40-year-old female patient who has been suffering from porphyria for seventeen years. The first attack occurred in 2003, presenting with severe neurological symptoms, requiring the use of heme arginate Normosang?, which resulted in a favorable therapeutic response. In 2004 and 2007, gonadorelin analogue Zoladex? (goserelin) was used, but without beneficial effects on the course of the disease. In 2008, a preventive administration of heme arginate was initiated. The patient received heme arginate in the early phase of symptoms, every month in the premenstrual phase of the cycle, which resulted in milder symptoms, full recovery within 24 hours, lower doses of Normosang? (1-2 ampoules) and fewer hospital days (1-2 days) per month. This regimen has significantly improved the patient's quality of life and reduced the risk of potential adverse effects. Conclusion. Preventive use of Normosang? is the optimal therapeutic modality in patients with frequent, recurrent severe attacks that are unresponsive to other therapeutic regimens. As a result, patients have a better quality of life due to an effective, short-term, targeted treatment regimen.

Introduction. Syphilis rarely affects anorectal region. The symptoms are nonspecific and are commonly disregarded in our country. Therefore, they pose a difficulty both for a diagnosis and for a treatment.We presented a patient with the clinical, laboratory, endoscopic and histological characteristics of rectal siphilis who was initially suspected to have inflammatory bowel disease. Case report. A 29-year-old man was hospitalized with a suspected inflammatory bowel disease, with symptoms such as frequent bloodstained diarrhea, lower abdominal pain and a loss of appetite. The physical examination showed maculopapular skin rash on the body. The ileocolonoscopic examination revealed finely granulated rectal mucosa, the loss of vascular pattern, and at 3 cm from the anal verge, an exulcerated submucosal lesion 1.2 cm in diameter, with two smaller, similar looking lesions. The histological examination of biopsies showed diffuse inflammatory-cell infiltration, with cryptitis, Paneth cell metaplasia with granuloma without caseous necrosis, which was highly suggestive of Crohn's disease. The Treponema

In case of irresponsiveness to the conventional therapy by proton pump inhibitors, repeated esophagoscopy and histopathological analyses of esophagus mucosa biopsy can point to the diagnosis of eosinophilic esophagitis, and a good therapeutic response to topical corticosteroids can be regarded as the clinical confirmation of the diagnosis.