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  1. Article: Crohn's Disease-Like Features in a Patient With IgE and Selective IgG1 and IgG3 Deficiency.

    Drygiannakis, Ioannis / Theodoraki, Eirini / Tsafaridou, Maria / Koutroubakis, Ioannis

    Cureus

    2023  Volume 15, Issue 2, Page(s) e34655

    Abstract: We report a 19-year-old male with congenital, combined deficiency of immunoglobulin (Ig) E and 2/4 ...

    Abstract We report a 19-year-old male with congenital, combined deficiency of immunoglobulin (Ig) E and 2/4 subclasses of IgG (G1, G3) and chronic diarrhea. He presented at six years of age with chronic recurrent diarrhea responsive to immunoglobulin treatment. Initially, it was considered of infectious origin. However, at the age of 14 years, ileocolonoscopy and magnetic resonance enterography (MRE) were performed, and they showed a mild, limited, non-specific, terminal ileitis with increased eosinophil count on histology. A diagnosis of possible eosinophilic gastroenteritis was made, and budesonide was administered with temporary relief. However, at the age of 19 years, repeat ileocolonoscopy showed multiple ulcers in the terminal ileum and aphthous ulcers in the cecum, and repeat MRE demonstrated extensive ileal involvement. Esophagogastroduodenoscopy demonstrated the involvement of the upper GI tract with aphthous ulcers. Subsequently, gastric, ileal, and colonic biopsies revealed Ziehl-Neelsen-negative, non-caseating granulomas. We hereby report the first case of IgE and selective IgG1 and IgG3 deficiency complicated with Crohn's disease-like extensive GI involvement.
    Language English
    Publishing date 2023-02-05
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.34655
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  2. Article ; Online: Bariatric Nutritional Intervention in Obese Patients with Compensated Liver Cirrhosis: A Four-Year Prospective Study.

    Kalaitzakis, Zacharias E / Giahnakis, Emmanuel / Koutroubakis, Ioannis E / Mouzas, Ioannis A / Kalaitzakis, Evangelos

    Digestive diseases and sciences

    2024  Volume 69, Issue 4, Page(s) 1467–1478

    Abstract: Background: Obesity and liver cirrhosis represent significant health challenges, often leading to various complications.: Aims: This prospective study aimed to investigate the impact of a four-year bariatric intervention, focusing on adherence to the ...

    Abstract Background: Obesity and liver cirrhosis represent significant health challenges, often leading to various complications.
    Aims: This prospective study aimed to investigate the impact of a four-year bariatric intervention, focusing on adherence to the Mediterranean Diet, on anthropometric, hematologic, and biochemical parameters in obese patients with compensated liver cirrhosis. Additionally, the study evaluated the concurrent contribution of weight loss to these health indicators.
    Methods: The study involved 62 patients with compensated liver cirrhosis (mean age 65.87 ± 6 years) and 44 healthy controls (mean age 59.11 ± 8 years), all with a BMI > 30 kg/m
    Results: Anthropometric parameters, including weight, BMI, waist and hip circumference, percentage of fat mass, and handgrip strength, exhibited significant improvements (p < 0.05), particularly within the first year of the intervention. Liver function tests and lipid profiles of the patients also showed significant enhancements (p < 0.05). Hematological and biochemical indices, such as hematocrit and ferritin, experienced discreet improvements in the patient cohort (p < 0.05).
    Conclusions: This study highlights the potential of a structured bariatric intervention rooted in the Mediterranean diet to positively influence the health of obese patients with compensated liver cirrhosis. The observed improvements in anthropometric, biochemical, and hematologic parameters, particularly within the first year of the intervention, suggest the importance of dietary modifications in managing the health of this patient population.
    MeSH term(s) Humans ; Middle Aged ; Aged ; Prospective Studies ; Hand Strength ; Body Mass Index ; Obesity/epidemiology ; Liver Cirrhosis ; Weight Loss ; Bariatrics
    Language English
    Publishing date 2024-02-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-023-08223-6
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  3. Article: Recent Advances in the Optimization of Anti-TNF Treatment in Patients with Inflammatory Bowel Disease.

    Orfanoudaki, Eleni / Foteinogiannopoulou, Kalliopi / Theodoraki, Eirini / Koutroubakis, Ioannis E

    Journal of clinical medicine

    2023  Volume 12, Issue 7

    Abstract: Despite the evolution in inflammatory bowel disease (IBD) management during the last 20 years owing to the advent of new advanced therapies, anti-TNF agents still remain the cornerstone of therapy for both Crohn's disease and ulcerative colitis. However, ...

    Abstract Despite the evolution in inflammatory bowel disease (IBD) management during the last 20 years owing to the advent of new advanced therapies, anti-TNF agents still remain the cornerstone of therapy for both Crohn's disease and ulcerative colitis. However, this does not only secure favorable outcomes for patients considering the progressive disease character and the high likelihood of primary or secondary loss of response. Therefore, trying to reach a better treatment approach and maximize the benefits anti-TNF agents offer, optimization strategies should be examined. It has been indicated that optimizing treatment with anti-TNF enhances drug efficacy and has been associated with improved disease outcomes and a complication-free disease course. From this perspective, we aim to provide an overview of currently available data and recent advances in the practices of anti-TNF treatment optimization. Special focus has been given to the role of therapeutic drug monitoring (TDM), as well as the utility of combining anti-TNF with an immunomodulator and the treat-to-target approach.
    Language English
    Publishing date 2023-03-23
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12072452
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  4. Article: Solid extraintestinal malignancies in patients with inflammatory bowel disease.

    Mala, Anastasia / Foteinogiannopoulou, Kalliopi / Koutroubakis, Ioannis E

    World journal of gastrointestinal oncology

    2022  Volume 13, Issue 12, Page(s) 1956–1980

    Abstract: Malignancies constitute the second cause of death in patients with inflammatory bowel diseases (IBD), after cardiovascular diseases. Although it has been postulated that IBD patients are at greater risk of colorectal cancer compared to the general ... ...

    Abstract Malignancies constitute the second cause of death in patients with inflammatory bowel diseases (IBD), after cardiovascular diseases. Although it has been postulated that IBD patients are at greater risk of colorectal cancer compared to the general population, lately there has been evidence supporting that this risk is diminishing over time as a result of better surveillance, while the incidence of extraintestinal cancers (EICs) is increasing. This could be attributed either to systemic inflammation caused by IBD or to long-lasting immunosuppression due to IBD treatments. It seems that the overall risk of EICs is higher for Crohn's disease patients and it is mainly driven by skin cancers, and liver-biliary cancers in patients with IBD and primary sclerosing cholangitis. The aims of this review were first to evaluate the prevalence, characteristics, and risk factors of EICs in patients with IBD and second to raise awareness regarding a proper surveillance program resulting in early diagnosis, better prognosis and survival, especially in the era of new IBD treatments that are on the way.
    Language English
    Publishing date 2022-01-13
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2573696-6
    ISSN 1948-5204
    ISSN 1948-5204
    DOI 10.4251/wjgo.v13.i12.1956
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  5. Article ; Online: Recent Advances in the Optimization of Anti-TNF Treatment in Patients with Inflammatory Bowel Disease

    Eleni Orfanoudaki / Kalliopi Foteinogiannopoulou / Eirini Theodoraki / Ioannis E. Koutroubakis

    Journal of Clinical Medicine, Vol 12, Iss 2452, p

    2023  Volume 2452

    Abstract: Despite the evolution in inflammatory bowel disease (IBD) management during the last 20 years owing to the advent of new advanced therapies, anti-TNF agents still remain the cornerstone of therapy for both Crohn’s disease and ulcerative colitis. However, ...

    Abstract Despite the evolution in inflammatory bowel disease (IBD) management during the last 20 years owing to the advent of new advanced therapies, anti-TNF agents still remain the cornerstone of therapy for both Crohn’s disease and ulcerative colitis. However, this does not only secure favorable outcomes for patients considering the progressive disease character and the high likelihood of primary or secondary loss of response. Therefore, trying to reach a better treatment approach and maximize the benefits anti-TNF agents offer, optimization strategies should be examined. It has been indicated that optimizing treatment with anti-TNF enhances drug efficacy and has been associated with improved disease outcomes and a complication-free disease course. From this perspective, we aim to provide an overview of currently available data and recent advances in the practices of anti-TNF treatment optimization. Special focus has been given to the role of therapeutic drug monitoring (TDM), as well as the utility of combining anti-TNF with an immunomodulator and the treat-to-target approach.
    Keywords biologics ; Crohn’s disease ; immunomodulators ; therapeutic drug monitoring ; ulcerative colitis ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Etiology of Anemia and Risk Factors of Mortality among Hospitalized Patients: A Real-Life Retrospective Study in a Tertiary Center in Greece.

    Ioannou, Petros / Papazachariou, Andria / Tsafaridou, Maria / Koutroubakis, Ioannis E / Kofteridis, Diamantis P

    Hematology reports

    2023  Volume 15, Issue 2, Page(s) 347–357

    Abstract: Anemia is a prominent global health issue with a wide variety of causes and can be associated with decreased quality of life, increased hospitalization, and higher mortality, especially in older individuals. Therefore, studies further shedding light on ... ...

    Abstract Anemia is a prominent global health issue with a wide variety of causes and can be associated with decreased quality of life, increased hospitalization, and higher mortality, especially in older individuals. Therefore, studies further shedding light on the causes and the risk factors of this condition should be performed. The aim of the present study was to examine the causes of anemia in hospitalized patients in a tertiary hospital in Greece and identify risk factors related to higher mortality. In total, 846 adult patients with a diagnosis of anemia were admitted during the study period. The median age was 81 years, and 44.8% were male. The majority of patients had microcytic anemia, with the median mean corpuscular volume (MCV) being 76.3 fL and the median hemoglobin being 7.1 g/dL. Antiplatelets were used by 28.6% of patients, while 28.4% were using anticoagulants at the time of diagnosis. At least one unit of packed red blood cells (PRBCs) was transfused in 84.6% of patients, and a median of two PRBCs was used per patient. A gastroscopy was performed in 55%, and a colonoscopy was performed in 39.8% of patients in the present cohort. Anemia was considered to be multifactorial in almost half the cases, while the most commonly identified cause was iron deficiency anemia, more commonly with positive endoscopic findings. Mortality was relatively low, at 4.1%. Multivariate logistic regression analysis identified higher B12 levels and longer duration of hospital stay to be independently positively associated with mortality.
    Language English
    Publishing date 2023-06-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2586645-X
    ISSN 2038-8330 ; 2038-8322
    ISSN (online) 2038-8330
    ISSN 2038-8322
    DOI 10.3390/hematolrep15020036
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  7. Article: Abdominal aortic calcification in patients with inflammatory bowel disease: does anti-tumor necrosis factor α use protect from chronic inflammation-induced atherosclerosis?

    Mantaka, Aikaterini / Galanakis, Nikolaos / Tsetis, Dimitrios / Koutroubakis, Ioannis E

    Intestinal research

    2022  Volume 20, Issue 4, Page(s) 495–505

    Abstract: Background/aims: Abdominal aortic calcium (AAC) deposition has been suggested as a marker of early atherosclerosis. There is no published data on the evaluation of AAC in inflammatory bowel disease (IBD).: Methods: AAC was quantified by computed ... ...

    Abstract Background/aims: Abdominal aortic calcium (AAC) deposition has been suggested as a marker of early atherosclerosis. There is no published data on the evaluation of AAC in inflammatory bowel disease (IBD).
    Methods: AAC was quantified by computed tomography or enterography scans performed in 98 IBD patients and 1:1 age and sex matched controls. AAC deposition was correlated with IBD characteristics, disease activity or severity parameters, laboratory tests and cardiovascular disease (CVD) risk factors.
    Results: Moderate-severe grade of AAC was found in 35.7% of IBD patients compared to 30.6% of controls (P= 0.544). IBD with CVD and ulcerative colitis patients had significantly higher rates of more severe atherosclerotic lesions (P= 0.001 and P= 0.01, respectively). AAC deposition was similarly distributed in age groups ( < 45, 45-64, and ≥ 65 years) among patients and controls. Multivariate analysis after excluding CVD risk confounders for non-CVD patients found extensive disease (P= 0.019) and lifetime steroids (P= 0.04) as independent risk factors for AAC. Anti-tumor necrosis factor α (TNF-α) use was negatively associated with AAC deposition in non-CVD IBD patients (odds ratio, 0.023; 95% confidence interval, 0.001-0.594; P= 0.023).
    Conclusions: More than one-third of IBD patients have moderate to severe AAC. Better control of inflammation with anti-TNF-α agents seems to protect IBD patients from ACC deposition and subsequent atherosclerosis.
    Language English
    Publishing date 2022-08-08
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 3018469-1
    ISSN 2288-1956 ; 1598-9100
    ISSN (online) 2288-1956
    ISSN 1598-9100
    DOI 10.5217/ir.2022.00017
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  8. Article ; Online: Correction to: Effect of antinuclear antibodies on pharmacokinetics of anti‑TNF therapy in patients with inflammatory bowel disease.

    Theodoraki, Eirini / Orfanoudaki, Eleni / Foteinogiannopoulou, Kalliopi / Andreou, Nikolaos-Panagiotis / Gazouli, Maria / Koutroubakis, Ioannis E

    International journal of colorectal disease

    2022  Volume 37, Issue 3, Page(s) 647–648

    Language English
    Publishing date 2022-01-28
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-022-04100-2
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    In stock of ZB MED Cologne/Königswinter

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  9. Article ; Online: The relationship between coagulation state and inflammatory bowel disease: current understanding and clinical implications.

    Koutroubakis, Ioannis E

    Expert review of clinical immunology

    2015  Volume 11, Issue 4, Page(s) 479–488

    Abstract: Inflammatory bowel disease (IBD) is associated with a hypercoagulable state and subsequently with an increased risk for venous thromboembolism (VTE). VTE in IBD is characterized by a high recurrence rate and is associated with the disease activity. ... ...

    Abstract Inflammatory bowel disease (IBD) is associated with a hypercoagulable state and subsequently with an increased risk for venous thromboembolism (VTE). VTE in IBD is characterized by a high recurrence rate and is associated with the disease activity. Acquired endothelial dysfunction, abnormalities of platelets, activation of coagulation system and impaired fibrinolysis are the main changes in the coagulation state in IBD. The development of VTE in IBD has been considered to be the result of multiple interactions between acquired and inherited risk factors. The treatment of VTE in IBD patients is recommended to be similar and to follow the same protocols as for non-IBD patients. In the clinical practice, the management of IBD patients and especially the hospitalized patients should include thromboprophylaxis.
    MeSH term(s) Animals ; Blood Coagulation ; Blood Coagulation Disorders/blood ; Blood Coagulation Disorders/epidemiology ; Blood Platelets/physiology ; Gene-Environment Interaction ; Humans ; Inflammatory Bowel Diseases/blood ; Inflammatory Bowel Diseases/epidemiology ; Risk ; Thrombolytic Therapy ; Venous Thromboembolism/blood ; Venous Thromboembolism/epidemiology
    Language English
    Publishing date 2015-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1586/1744666X.2015.1019475
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  10. Article ; Online: Keeping on the High Quality of Health Care in Greek Inflammatory Bowel Disease Patients in the SARS-CoV-2 Era.

    Foteinogiannopoulou, Kalliopi / Orfanoudaki, Eleni / Koutroubakis, Ioannis E

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2020  Volume 18, Issue 10, Page(s) 2380–2381

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Greece ; Humans ; Inflammatory Bowel Diseases ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Standard of Care
    Keywords covid19
    Language English
    Publishing date 2020-05-12
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2020.04.076
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