Acute Liver Injury as a Manifestation of Secondary Syphilis

Shah, Jamil MD1; Lingiah, Vivek MD2; Niazi, Mumtaz MD2; Olivo-Salcedo, Raquel MD2; Pyrsopoulos, Nikolaos MD, PhD, MBA, FACP, AGAF, FAASLD, FRCP2; Galan, Mark MD, MS3; Shahidullah, Abul MD4

doi : 10.14309/crj.0000000000000668

October 2021 - Volume 8 - Issue 10 - p e00668

In the United States, the incidence of new cases of syphilis has been rising. The number of cases of primary and secondary syphilis has continued to increase almost every year over the past 2 decades. Secondary syphilis has a variety of clinical manifestations. A frequently overlooked presentation is that of syphilitic hepatitis, which should be part of the differential diagnosis for patients with elevated liver enzymes, a maculopapular rash, and/or risk factors for contracting syphilis. In this study, we report a rare and unusual case of a man with a remote history of syphilis infection who developed acute liver injury.

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Often Overlooked Diagnosis: Median Arcuate Ligament Syndrome as a Mimicker of Crohn's Disease

Becker, Erica MD, MPH1; Mohammed, Turab MD1; Wysocki, John MD2

doi : 10.14309/crj.0000000000000675

October 2021 - Volume 8 - Issue 10 - p e00675

Median arcuate ligament syndrome occurs when the celiac artery and/or the celiac plexus nerves is compressed by the median arcuate ligament during expiration causing a variety of gastrointestinal symptoms. Here, we present a case of median arcuate ligament syndrome in a persistently symptomatic 35-year-old man that presented as a mimicker of Crohn's disease. Symptomatology, computed tomography angiography, and abdominal ultrasound Doppler were consistent with celiac artery compression syndrome. After surgical decompression of the ligament and removal of the celiac ganglion, he reported a definitive relief of abdominal pain and resolution of symptoms.

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Gastrointestinal Dysmotility Is a Significant Feature in 2 Siblings With a Novel Inositol 1,4,5-Triphosphate Receptor 1 (ITPR1) Missense Variant

Butler Tjaden, Naomi E. MD, PhD1,2,3; Chiou, Eric H. MD2,4; Pillai, Nishitha R. MBBS, FACMG2,5,6; Schady, Deborah A. MD7; Chumpitazi, Bruno P. MD, MPH2,4,8

doi : 10.14309/crj.0000000000000676

October 2021 - Volume 8 - Issue 10 - p e00676

We present 2 siblings with a novel type 1 inositol 1,4,5-triphosphate receptor (ITPR1) missense variant who exhibit gastrointestinal dysmotility (chronic constipation and gastroparesis). ITPR1 is expressed in the cerebellum and interstitial cells of Cajal. Periodic release of calcium by ITPR1 initiates pacemaker currents, resulting in smooth muscle contraction. ITPR1 mutations are known to be associated with neurologic syndromes, and these variants have not previously been associated with significant gastrointestinal manifestations in humans. Using whole-genome sequencing, in silico prediction software, biopsy samples, and manometry, the identified novel ITPR1 variant is likely pathogenic and may have neurogastroenterology implications.

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Venobiliary Fistula Caused by Total Parenteral Nutrition Catheter

Talari, Mridula P. MBBS1; Yarra, Pradeep MD, MPH1; Grigorian, Alla Y. MD1

doi : 10.14309/crj.0000000000000671

October 2021 - Volume 8 - Issue 10 - p e00671

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Endoscopic Ultrasonography–Guided Noninvasive Diagnosis of a Branch-Duct Intraductal Papillary Mucinous Neoplasm in a Heterotopic Pancreas

Ponz de Leon Pisani, Ruggero MD1; Vanella, Giuseppe MD1; Petrone, Maria Chiara MD1

doi : 10.14309/crj.0000000000000673

October 2021 - Volume 8 - Issue 10 - p e00673

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Bleeding Pseudoaneurysm of the Inferior Pancreaticoduodenal Artery as an Endoscopic Retrograde Cholangiopancreatography Complication

Rim, Daniel MD1; Yu, Qi MD2; Cieslak, John MD3; Wang, Weizheng MD2

doi : 10.14309/crj.0000000000000695

October 2021 - Volume 8 - Issue 10 - p e00695

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