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Spyglass single-operator peroral cholangioscopy seems promising in the evaluation of primary sclerosing cholangitis-related biliary strictures.
[cholangiocarcinoma]
Abstract
Early
diagnosis
of
dysplastic
changes
and
exclusion
of
cholangiocarcinoma
(
CCA
)
in
patients
with
primary
sclerosing
cholangitis
(
PSC
)
remain
a
major
clinical
challenge
.
Although
SpyGlass
single
-operator
cholangioscopy
(
SOC
)
appears
effective
in
diagnostics
of
indeterminate
biliary
strictures
,
there
are
only
few
studies
on
its
safety
in
PSC
-related
strictures
.
Objective
.
The
aim
of
this
study
was
to
assess
the
clinical
feasibility
of
SOC
and
directed
biopsies
,
flow
cytometry
,
and
brush
cytology
in
PSC
patients
.
Materials
and
methods
.
Eleven
consecutive
patients
(
median
age
45
years
,
5
females
)
undergoing
SOC
for
progression
of
PSC
in
a
single
tertiary
center
were
included
in
a
prospective
observational
study
.
Results
.
Brush
sample
and
directed
biopsies
were
successfully
acquired
from
strictures
in
all
cases
.
Samples
were
adequate
for
cytological
and
histological
diagnosis
in
9
(
82
%
)
and
10
patients
(
91
%
)
,
respectively
.
There
were
two
cases
of
pancreatitis
.
In
one
patient
,
flow
cytometry
showed
aneuploidy
,
which
resulted
in
closer
follow-up
.
Conclusions
.
SpyGlass
SOC
and
directed
biopsies
seem
to
offer
a
feasible
and
promising
method
in
evaluation
of
PSC
-related
strictures
.
However
,
the
long
-term
prognostic
value
it
adds
to
cytology
and
flow
cytometry
remains
to
be
assessed
in
future
trials
.
Diseases
Validation
Diseases presenting
"early diagnosis"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
alexander disease
allergic bronchopulmonary aspergillosis
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
classical phenylketonuria
coats disease
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cutaneous mastocytosis
cystinuria
dentin dysplasia
dentinogenesis imperfecta
dracunculiasis
erdheim-chester disease
erythropoietic protoporphyria
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
hirschsprung disease
holt-oram syndrome
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
kabuki syndrome
kallmann syndrome
kindler syndrome
krabbe disease
locked-in syndrome
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
omenn syndrome
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
primary effusion lymphoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
typhoid
von hippel-lindau disease
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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