I was wondering if anyone could help me out I'm a bit confused after reading some of the posts on here. I'm not sure what is going on I had a colonoscopy/endoscopy(ill post the results below) done last spring that found several site of inflammation... Shortly after I lost insurance coverage until recently. about
two months ago I had a calprotectin, crp, and sed/rate test done. The calprotectin was 603 but the crp and sed/rate were normal... I also have a lot of food allergies and take a proton pump inhibitor. Could it be possible that the allergies combined with the ppi could cause such a high calprotectin level? Symptoms I'm experiencing are pain after eating 1-2 hours, random pain right abdomen, severe pain with bowel movement in rectum(no joke this crap hurts literally), diarrhea that is on and off with the harder stools having mucus/blood, and blood when I wipe. I apologize as my grammar is pretty crap.
***Forgot to mention that my GI prescribed sulfasalazine but that didnt work and now im on uceri****
FINAL PATHOLOGIC DIAGNOSIS:
A. Duodenal biopsy:
Duodenal mucosa with intact villous architecture with
increased chronic inflammation of the lamina propria, see
comment.
Negative for intraepithelial lymphocytosis or sprue-like
injury.
Negative for foveolar metaplasia or Whipple's disease
(Alcian blue/PAS stain).
Negative for luminal parasites, dysplasia or malignancy.
B. Gastric biopsy:
Antral and body type gastric mucosa with no significant
abnormality.
Negative for H. pylori, confirmed by immunostain.
Negative for significant inflammation, intestinal
metaplasia, dysplasia or malignancy.
C. Distal esophagus, biopsy:
Squamous epithelium with reactive changes and increased
intraepithelial eosinophils (up to 15/hpf), see comment.
Negative for Candida or other fungal organisms (Alcian
blue/PAS)
Negative for dysplasia or malignancy.
D.Mid esophagus, biopsy:
Squamous epithelium with reactive changes and increased
intraepithelial eosinophils (up to 19/hpf), see comment.
Negative for Candida or other fungal organisms (Alcian
blue/PAS)
Negative for dysplasia or malignancy.
E. Small bowel, terminal ileum, biopsy:
Small bowel mucosa with minimal acute inflammation and focal
pseudopyloric metaplasia (see comment).
Negative for granulomas, dysplasia or maligancy.
F. Colon, random biopsy:
Focal active colitis, see comment.
COMMENTS:
Comment part A: Expansion of lamina propria with mononuclear
cells in absence of villous blunting or intraepithelial
lymphocytosis is a nonspecific finding and may be associated
with infection, inflammatory/immune regulated disorders
(psoriasis), IBD.
Comment part C, D: The esophageal biopsies shows squamous
epithelium with reactive changes (spongiosis, elongated
fibrovascular papilla) and increased eosinophils
(15/hpf-distal, 19/hpf-mid. The findings are etiologically
nonspecific and can be seen in setting of GERD and/or
eosinophilic esophagitis, among other causes. Other causes
of increased eosinophils may include collagen vascular
diseases, hypereosinophilic syndromes, fungal infections,
photodynamic therapy, drug hypersensitivity and allergies.
Comment part E: The biopsy shows small bowel mucosa with
preserved villous architecture , focal acute inflammation of
surface epithelium and focal pseudopyloric metaplasia. These
features suggest name mild chronic active ileitis which may
be seen with inflammatory bowel disease (Crohn's), chronic
NSAID/medication injury, chronic infection.
Comment part F: The biopsies show predominantly unremarkable
colonic mucosa. A focal fragments shows focal active colitis
characterized by focal cryptitis/crypt abscesses. Although
bowel preparation artifact cannot be entirely excluded,
infection, drug injury (especially NSAIDs) and early Crohns
disease are among the major differential diagnoses.
CLINICAL HISTORY:
Signs, symptoms, medications and previous diagnoses:
Diarrhea
Endoscopic findings: A. R/O sprue. Erythematous mucosa in
terminal ileum, biopsy. Entire examined colon is normal,
biopsy. Distal rectum and anal verge are normal on
retroflexion view. Esophageal mucosal changes suspicious for
eosinophilic esophagitis, biopsy. Z line, 46 cm from
incisors. Normal stomach, biopsy. Erythematous duodenopathy,
biopsy.
SPECIMENS:
A. Duodenal bx
B. Gastric bx
C. Distal esophagus bx
D. Mid esophagus bx
E. Terminal ileum bx
F. Random colon bx
Post Edited (Dillin David) : 9/17/2017 11:45:52 PM (GMT-6)