Reviewer's report
Title:Chronic calcium pyrophosphate crystal inflammatory arthritis induced by
extreme hypomagnesemia in short bowel syndrome
Version: 1Date:9 July 2012
Reviewer: Jeremy Nightingale
Reviewer's report:
This interesting case report is of a patient who has hypomagnesaemia secondary
to malabsorption due to a short bowel (jejuno-colic anastomosis due to trauma)
and various food intolerances, and who also has joint pains due to calcium
pyrophosphate. It is proposed that the hypomagnesaemia causes the joint
problems because treatment of hypomagnesaemia (in addition to low vitamins D
&,B12, calcium and zinc) allowed the oral steroid dose to be reduced as
symptoms improved.
Minor points
P3 metabolic problems occur if less than 200 cm and no colon. Not 300-350 cm
as stated.
P4 what is gonarthritis?
P4 Underweight - what was BMI at this time?
P5 What is adynamia?
P5 The magnesium resorption test is interesting (P5). Please specify how it is
done.
P6 I am surprised breath hydrogen was not raised usually it is very high at rest in
jejunum-colon patients so the test cannot be performed.
P6 As gut length is 185 cm anastomosed to half the colon, I am very surprised by
the hypomagnesaemia. The authors justify it with the additional food
intolerances.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Chronic calcium pyrophosphate crystal inflammatory arthritis induced by
extreme hypomagnesemia in short bowel syndrome
Version: 1Date:9 July 2012
Reviewer: Jeremy Nightingale
Reviewer's report:
This interesting case report is of a patient who has hypomagnesaemia secondary
to malabsorption due to a short bowel (jejuno-colic anastomosis due to trauma)
and various food intolerances, and who also has joint pains due to calcium
pyrophosphate. It is proposed that the hypomagnesaemia causes the joint
problems because treatment of hypomagnesaemia (in addition to low vitamins D
&,B12, calcium and zinc) allowed the oral steroid dose to be reduced as
symptoms improved.
Minor points
P3 metabolic problems occur if less than 200 cm and no colon. Not 300-350 cm
as stated.
P4 what is gonarthritis?
P4 Underweight - what was BMI at this time?
P5 What is adynamia?
P5 The magnesium resorption test is interesting (P5). Please specify how it is
done.
P6 I am surprised breath hydrogen was not raised usually it is very high at rest in
jejunum-colon patients so the test cannot be performed.
P6 As gut length is 185 cm anastomosed to half the colon, I am very surprised by
the hypomagnesaemia. The authors justify it with the additional food
intolerances.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Chronic calcium pyrophosphate crystal inflammatory arthritis induced by
extreme hypomagnesemia in short bowel syndrome
Version: 1Date:9 July 2012
Reviewer: Jeremy Nightingale
Reviewer's report:
This interesting case report is of a patient who has hypomagnesaemia secondary
to malabsorption due to a short bowel (jejuno-colic anastomosis due to trauma)
and various food intolerances, and who also has joint pains due to calcium
pyrophosphate. It is proposed that the hypomagnesaemia causes the joint
problems because treatment of hypomagnesaemia (in addition to low vitamins D
&,B12, calcium and zinc) allowed the oral steroid dose to be reduced as
symptoms improved.
Minor points
P3 metabolic problems occur if less than 200 cm and no colon. Not 300-350 cm
as stated.
P4 what is gonarthritis?
P4 Underweight - what was BMI at this time?
P5 What is adynamia?
P5 The magnesium resorption test is interesting (P5). Please specify how it is
done.
P6 I am surprised breath hydrogen was not raised usually it is very high at rest in
jejunum-colon patients so the test cannot be performed.
P6 As gut length is 185 cm anastomosed to half the colon, I am very surprised by
the hypomagnesaemia. The authors justify it with the additional food
intolerances.
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
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