Weronika WalęCik-Kot

Inflammation and gut dysbiosis are increasingly recognized as important contributors to the pathophysiology of Parkinson’s disease (PD). Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic strategy aimed at restoring gut microbial balance and modulating inflammatory pathways. The aim of the study was to evaluate the effect of single fecal microbiota transplantation on systemic and gut-related inflammatory biomarkers in patients with PD. This exploratory analysis was conducted as part of the randomized, double-blind, placebo-controlled EFFACE-PD study. Fifty-nine participants with PD were randomized to receive either donor-derived FMT or placebo. Serum levels of IL-18 and calprotectin were measured using ELISA before intervention and 3 months after the procedure. Ferritin, leukocyte count, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio (NLR) were assessed at baseline and after twelve months. No statistically significant between-group differences in changes in inflammatory biomarker concentrations were observed. Broader inflammatory markers, including ferritin and leukocyte parameters, also did not differ significantly between groups. We conclude that single FMT did not induce significant changes in systemic inflammatory biomarkers in this exploratory cohort of PD patients. Larger studies with standardized inflammatory assessments are needed to clarify the immunomodulatory effects of FMT in PD.

Aim: Our aim is to describe how an intramural hematoma can mimic a pancreatic head tumor and to highlight the importance of multimodal diagnosis in patients with obstructive jaundice. Material and methods: The diagnostic workup included computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS) with biopsy. Case report: A 65-year-old patient was referred for assessment of obstructive jaundice and endoscopic retrograde cholangiopancreatography (ERCP). Initial presentation included hematemesis, anemia, cholestasis, and coagulopathy. Imaging (MRCP, CT) showed dilation of intra- and extrahepatic bile ducts and pancreatic duct, suggesting obstruction at the pancreatic head. CT also revealed a heterogeneous mass in the duodenum. ERCP demonstrated duodenal stenosis due to external compression and distal bile duct narrowing, and a self-expandable metal stent (SEMS) was inserted. Endoscopic ultrasound with biopsy revealed an intramural duodenal hematoma without malignant features. The patient’s medical history was significant for multiple comorbidities and previous anticoagulation therapy. Summary: Follow-up imaging demonstrated complete regression of the hematoma, confirming its benign nature. The observed clinical course was consistent with spontaneous resolution; consequently, there was no need for surgical intervention. Intramural duodenal hematoma is a rare but important condition that may mimic pancreatic head tumors causing obstructive jaundice. Early detection using imaging techniques is critical to accurately establish the diagnosis. Early recognition facilitates conservative treatment and helps avoid unnecessary highly invasive surgical procedures.

Groove pancreatitis is a rare form of chronic pancreatitis affecting the pancreaticoduodenal groove, leading to ductal stenosis and symptoms like abdominal pain, vomiting, and jaundice. It often coexists with cystic dystrophy of the duodenal wall (CDDW), marked by duodenal wall thickening and cyst formation. We report a case of a 36-year-old male with persistent abdominal pain and a history of acute pancreatitis, diagnosed with CDDW via MRI. Despite multiple endoscopic interventions, ductal access was challenging due to inflammation and conservative management with proton pump inhibitors and pancreatic enzymes provided symptom relief. Diagnostic tools include MRI, endoscopy, and EUS were administered. Management of groove pancreatitis still remains a challenge consisting of treatment ranging from conservative methods to surgical intervention for refractory cases, emphasizing a cautious, stepwise approach and lifestyle changes.

Background: Migraine headaches and celiac disease are widespread problems affecting millions of patients worldwide. Celiac disease is an autoimmune disease in which the consumption of gluten leads to the development of an abnormal immune response in the intestines and the atrophy of intestinal villi. The most characteristic clinical symptoms of celiac disease are gastrointestinal symptoms. Nevertheless, manifestations of the nervous system, including migraines, are also sometimes noted. A gluten-free diet is the only effective therapeutic approach for patients with celiac disease. It reduces symptoms and halts the progression of the disease. Neurological symptoms, including migraines, are frequent extraintestinal manifestations. In this study we aim to elaborate on current knowledge concerning both coexisting of migraines and celiac disease as well as effect of gluten free diet on headaches in patients with celiac disease, gluten intolerance and healthy individuals Results: Headaches, especially migraines, are more common in patients suffering from celiac disease. Numerous studies indicate that a gluten-free diet may help in the treatment of headaches and is also an effective way to stop the progression of celiac disease. Conclusion: Migraine headaches are quite common in patients with celiac disease, and a gluten-free diet may help alleviate them. The findings suggest the need for increased awareness of the co-occurrence of these two conditions. A gluten-free diet is the only effective treatment for celiac disease and can stop progression of the disease. Further research is needed to determine the potential benefits of such a diet in patients with gluten intolerance or healthy individuals.