Radiation proctitis laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Radiation proctitis}} | {{Radiation proctitis}} | ||
{{CMG}} {{AE}} | {{CMG}} {{AE}} [[User:Rekha|Rekha, M.D.]], {{MIR}} | ||
==Overview== | ==Overview== | ||
The laboratory findings in a patient with acute radiation proctitis can be within reference range however, in case of chronic injury anemia, | The laboratory findings in a patient with acute radiation proctitis can be within reference range however, in case of chronic injury [[anemia]], [[leukocytosis]], deranged [[LFTs]] and electrolyte abnormalities can be seen. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
The initial [[Diagnosis|diagnostic]] workup for radiation proctitis includes the following:<ref name="pmid23560564">{{cite journal| author=Webb GJ, Brooke R, De Silva AN| title=Chronic radiation enteritis and malnutrition. | journal=J Dig Dis | year= 2013 | volume= 14 | issue= 7 | pages= 350-7 | pmid=23560564 | doi=10.1111/1751-2980.12061 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23560564 }}</ref> | The initial [[Diagnosis|diagnostic]] workup for radiation proctitis includes the following:<ref name="pmid23560564">{{cite journal| author=Webb GJ, Brooke R, De Silva AN| title=Chronic radiation enteritis and malnutrition. | journal=J Dig Dis | year= 2013 | volume= 14 | issue= 7 | pages= 350-7 | pmid=23560564 | doi=10.1111/1751-2980.12061 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23560564 }}</ref><ref name="pmid8677984">{{cite journal| author=Babb RR| title=Radiation proctitis: a review. | journal=Am J Gastroenterol | year= 1996 | volume= 91 | issue= 7 | pages= 1309-11 | pmid=8677984 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8677984 }}</ref> | ||
* A [[complete blood count]] shows | * A [[complete blood count]] shows | ||
** [[Anemia]], in case of chronic injury and rectal bleeding | ** [[Anemia]], in case of chronic injury and rectal bleeding | ||
** Elevated white blood cell count due to small-bowel obstruction and intra-abdominal sepsis because of bowel perforation or necrosis in chronic injury | ** Elevated white blood cell count due to small-bowel obstruction and intra-abdominal sepsis because of bowel perforation or necrosis in chronic injury | ||
* ESR | * [[Erythrocyte sedimentation rate|ESR]] | ||
* Serum albumin | * Serum albumin | ||
* [[Electrolyte]] studies and [[Renal function|renal function tests]] are done, as chronic [[diarrhea]] may be associated with | * [[Electrolyte]] studies and [[Renal function|renal function tests]] are done, as chronic [[diarrhea]] may be associated with | ||
| Line 19: | Line 18: | ||
** Pre-renal failure | ** Pre-renal failure | ||
* [[Liver function tests]] | * [[Liver function tests]] | ||
* Stool culture, to rule out parasites and infectious causes. | * [[Stool culture]], to rule out parasites and infectious causes. | ||
* Stool ''C. difficile'' toxin | * Stool ''C. difficile'' toxin | ||
* [[C-reactive protein]] can be measured, with an elevated level being an indication of inflammation. | * [[C-reactive protein]] can be measured, with an elevated level being an indication of inflammation. | ||
* | * [[Sexually transmitted disease|Sexually transmitted infections]] testing, particularly in homosexual male or patients with severe rectal symptoms including urgency and [[tenesmus]]. | ||
* Fecal biomarkers (fecal calprotectin and fecal lactoferrin) are rapid and inexpensive noninvasive tests, which used diagnosis and follow-up of treatment of radiation proctitis however these are not specific for may be elevated in a range of organic conditions.<ref name="DandinAkin2013">{{cite journal|last1=Dandin|first1=Özgür|last2=Akin|first2=Mehmet Levhi|last3=Balta|first3=Ahmet Ziya|last4=Yücel|first4=Ergün|last5=Karakaş|first5=Dursun Özgür|last6=Demirbaş|first6=Sezai|last7=Özdemir|first7=Sevim|last8=Haholu|first8=Apdullah|title=The Efficacy of Probiotic (Lactobacillus rhamnosus GG) and 5-ASA (Aminosalicylic Acid) in the Treatment of Experimental Radiation Proctitis in Rats|journal=Indian Journal of Surgery|volume=77|issue=S2|year=2013|pages=563–569|issn=0972-2068|doi=10.1007/s12262-013-0923-3}}</ref> | * Fecal biomarkers (fecal calprotectin and fecal lactoferrin) are rapid and inexpensive noninvasive tests, which used diagnosis and follow-up of treatment of radiation proctitis however these are not specific for may be elevated in a range of organic conditions.<ref name="DandinAkin2013">{{cite journal|last1=Dandin|first1=Özgür|last2=Akin|first2=Mehmet Levhi|last3=Balta|first3=Ahmet Ziya|last4=Yücel|first4=Ergün|last5=Karakaş|first5=Dursun Özgür|last6=Demirbaş|first6=Sezai|last7=Özdemir|first7=Sevim|last8=Haholu|first8=Apdullah|title=The Efficacy of Probiotic (Lactobacillus rhamnosus GG) and 5-ASA (Aminosalicylic Acid) in the Treatment of Experimental Radiation Proctitis in Rats|journal=Indian Journal of Surgery|volume=77|issue=S2|year=2013|pages=563–569|issn=0972-2068|doi=10.1007/s12262-013-0923-3}}</ref> | ||
Latest revision as of 23:53, 6 November 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rekha, M.D., Mahshid Mir, M.D. [2]
Overview
The laboratory findings in a patient with acute radiation proctitis can be within reference range however, in case of chronic injury anemia, leukocytosis, deranged LFTs and electrolyte abnormalities can be seen.
Laboratory Findings
The initial diagnostic workup for radiation proctitis includes the following:[1][2]
- A complete blood count shows
- Anemia, in case of chronic injury and rectal bleeding
- Elevated white blood cell count due to small-bowel obstruction and intra-abdominal sepsis because of bowel perforation or necrosis in chronic injury
- ESR
- Serum albumin
- Electrolyte studies and renal function tests are done, as chronic diarrhea may be associated with
- Hypokalemia
- Hypomagnesemia
- Pre-renal failure
- Liver function tests
- Stool culture, to rule out parasites and infectious causes.
- Stool C. difficile toxin
- C-reactive protein can be measured, with an elevated level being an indication of inflammation.
- Sexually transmitted infections testing, particularly in homosexual male or patients with severe rectal symptoms including urgency and tenesmus.
- Fecal biomarkers (fecal calprotectin and fecal lactoferrin) are rapid and inexpensive noninvasive tests, which used diagnosis and follow-up of treatment of radiation proctitis however these are not specific for may be elevated in a range of organic conditions.[3]
References
- ↑ Webb GJ, Brooke R, De Silva AN (2013). "Chronic radiation enteritis and malnutrition". J Dig Dis. 14 (7): 350–7. doi:10.1111/1751-2980.12061. PMID 23560564.
- ↑ Babb RR (1996). "Radiation proctitis: a review". Am J Gastroenterol. 91 (7): 1309–11. PMID 8677984.
- ↑ Dandin, Özgür; Akin, Mehmet Levhi; Balta, Ahmet Ziya; Yücel, Ergün; Karakaş, Dursun Özgür; Demirbaş, Sezai; Özdemir, Sevim; Haholu, Apdullah (2013). "The Efficacy of Probiotic (Lactobacillus rhamnosus GG) and 5-ASA (Aminosalicylic Acid) in the Treatment of Experimental Radiation Proctitis in Rats". Indian Journal of Surgery. 77 (S2): 563–569. doi:10.1007/s12262-013-0923-3. ISSN 0972-2068.