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What is short bowel syndrome? Short bowel syndrome occurs when a large part of the small intestine has had to be removed during an operation. This situation may arise following an interruption of the blood supply to the intestine (rather like an “infarction” affecting this part of the body) or, among other causes, as a result of a chronic inflammatory disease such as Crohn’s disease. When too large a part of the intestine is missing, the body is no longer able to absorb the water, nutrients and vitamins essential for its proper functioning. In some cases, a stoma has also been created: this is a surgically created opening from the intestine onto the skin through which stools are evacuated into an external pouch. Although it ensures the evacuation of stools, it can also lead to significant fluid losses for the body. Symptoms Frequent diarrhoeaWeight loss due to inadequate absorption of nutrients (malnutrition)(link to the malnutrition health condition)DehydrationAbnormalities in the blood: a deficiency of certain essential minerals such as sodium or potassium, as well as vitamins and trace elementsFatigue How is Short Bowel Syndrome diagnosed? You will first be seen by a specialist gastroenterologist, who will take the time to review your symptoms as well as your medical and surgical history. Further examinations will then be carried out:A complete blood test to assess your general health, kidney and liver function, as well as your vitamin and mineral levels.A urine test.A CT scan and intestinal transit study to measure the length of the remaining intestine .A liver ultrasound and FibroScan to ensure that your liver is healthy.A bone densitometry scan to assess the strength of your bones. Treatment and care Your care is provided by a team of several specialists, coordinated by your gastroenterologist:A dietitian will support you in adapting your diet to your situation.Medication and vitamin supplements will be prescribed to slow intestinal transit and correct any deficiencies.If your intestine is no longer able to absorb enough nutrients, nutrition may be provided directly intravenously—this is called parenteral nutrition—. A specialist nurse and a pharmacist will explain how it works, as well as the type of catheter (a small tube inserted into a vein) that will be used.In some cases, a specific medication may be offered to stimulate your intestine’s absorptive capacity (GLP-2 agonists).Is there a surgical solution?Depending on your situation, a new surgical procedure may be considered in order to reconnect the different parts of the intestine. If you have a stoma, its closure may also be discussed.How is follow-up carried out?Regular follow-up is essential to ensure your well-being and the effectiveness of your treatment:At least 3 consultations per year with your gastroenterologist.Blood tests and urine tests at each visit.A liver ultrasound and a FibroScan every year.A bone density scan every 2 years, or more frequently if necessary.For young patients: the transition to adulthoodIf you have been followed in paediatrics until now, the transition to an adult service is prepared progressively, from the age of 16:Your paediatrician will contact the adult team and provide it with all the information concerning your health and treatment.A first joint consultation—in the presence of your paediatrician and your new referring doctor—will be organised, so that you do not feel alone) at this stage.If necessary, follow-up in both services (paediatric and adult) may be continued for a maximum of 6 months in order to facilitate this transition in complete peace of mind. Our specialists Prof. Marianna Arvanitakis Head of the Pancreatology and Nutritional Support ClinicGastroenterologist, specialising in pancreatic diseases, interventional endoscopy and clinical nutrition.Professor Marianna Arvanitakis specialised in pancreatology and interventional endoscopy within Professor Jacques Devière’s team at Erasme Hospital. After obtaining a University Diploma in Clinical Nutrition in 2005, she took over the medical coordination of the nutritional support service in 2018. Research conducted within the clinic focuses in particular on optimising the management of patients with severe acute pancreatitis and chronic pancreatitis, as well as on the management of patients suffering from short bowel syndrome. A member of several scientific societies, she is Secretary-General of the European Society of Gastrointestinal Endoscopy (ESGE) for the 2025–2027 term and a gastroenterology clinical supervisor for the Université Libre de Bruxelles (ULB). Languages spoken: French, English, Greek. Professor Alia Hadefi Professor Hadefi is a gastroenterologist with expertise in clinical nutrition and metabolic liver diseases. She defended her doctoral thesis on the interaction between the gut and liver diseases in 2024 and completed further training in 2025 within the Department of Gastroenterology, Chronic Inflammatory Bowel Diseases (IBD) and Nutritional Support at Beaujon Hospital (Paris).Languages spoken: French, English, Arabic. Dr Michael Fernandez Y Viesca Dr Fernandez is a gastroenterologist with expertise in pancreatology, acquired after obtaining a university diploma in Pancreatology in 2017 (Sorbonne). He is the coordinating physician for Benign Pancreatic Diseases within the multidisciplinary pancreatology consultation team and is currently preparing a doctoral thesis on severe acute pancreatitis.Languages spoken: French, English, Spanish. Associated department Contact You can make an appointment for a consultation (by email at ConsGastroMed [dot] erasme [at] hubruxelles [dot] be or by telephone on +32 (0)2 555.35.04, or contact the Gastroenterology department of H.U.B directly at SecMed [dot] GastroMed [dot] erasme [at] hubruxelles [dot] be (SecMed[dot]GastroMed[dot]erasme[at]hubruxelles[dot]be)You can also contact the clinical nutrition nurse, Ms Ballarin, at asuncion [dot] ballarin [at] hubruxelles [dot] be (asuncion[dot]ballarin[at]hubruxelles[dot]be)  Discover the Pancreatology Clinic

What are the causes of bleeding from the small intestine? The small intestine: What is it? The small intestine is the part of the intestine located between the duodenum and the colon (large intestine). It is responsible for absorbing nutrients and can reach several metres in length. It can be the source of gastrointestinal bleeding, a problem frequently encountered in gastroenterology.Bleeding from the small intestine can have various causes. The small intestine is the part of the digestive tract located between the stomach and the colon. Some causes are more common in older people, while others occur more frequently in young adults or children.Abnormalities of the blood vesselsThis is the most common cause.Angiodysplasias: small malformations of the blood vessels in the intestinal wall. These vessels are more fragile and may bleed spontaneously, particularly in older people.Arteriovenous malformations: abnormalities of blood circulation in which arteries and veins are directly connected, which may promote bleeding.Inflammatory bowel diseasesInflammation weakens the intestinal wall and may cause bleeding.Crohn’s disease: a chronic disease in which the immune system causes inflammation in certain parts of the digestive tract. This inflammation may lead to ulceration and bleeding.Enteritis: inflammation of the small intestine caused by an infection, certain medicines or the side effects of radiotherapy.Ulcers of the small intestineAn ulcer is a sore that forms in the intestinal wall.These ulcers may be caused by:prolonged use of anti-inflammatory medicines (such as ibuprofen or diclofenac);a reduction in the blood supply to the intestine (ischaemia);certain infections.TumoursBleeding may sometimes be linked to a tumour.Benign tumours: growths that are not cancerous, such as certain polyps.Malignant tumours (cancers): these may weaken the intestinal wall and cause bleeding.Meckel’s diverticulumMeckel’s diverticulum is a small pouch present on the intestine from birth. Most of the time, it causes no symptoms, but it may sometimes lead to bleeding, especially in children and young adults.MedicinesSome treatments do not directly cause bleeding but increase the risk when a lesion is already present.This is particularly the case with:anticoagulants, which thin the blood to prevent clots;antiplatelet medicines, which prevent platelets (cells involved in blood clotting) from clumping together.Rarer causesMore rarely, bleeding may be linked to:trauma to the intestine;ingestion of a foreign body;a clotting disorder, that is, difficulty forming a blood clot;certain rare diseases affecting the blood vessels. Symptoms Depending on their origin, gastrointestinal bleeding can manifest in different ways:Vomiting fresh blood (haematemesis)Black stools (melaena)Fresh blood in the stools (haematochezia)Sometimes, the bleeding is invisible to the naked eye (occult) and is detected only through anaemia identified in a blood test, related to iron deficiencyIn the event of bleeding originating in the small intestine, the most common manifestations are melaena and anaemia. In all cases, you should consult a gastroenterologist for an assessment. How is bleeding from the small intestine diagnosed? In the event of visible or occult gastrointestinal bleeding and/or iron-deficiency anaemia, your gastroenterologist may prescribe several examinations, carried out progressively and adapted to your situation:Gastroscopy : allows the upper digestive tract (oesophagus, stomach and duodenum) to be visualisedColonoscopy : allows the lower digestive tract (large intestine) to be visualisedAn abdominal CT scan with contrast injection (CT angiography), allows any sources of bleeding in the abdomen or intestine to be identified medical imaging link)Video capsule examination of the small intestine allows the entire small intestine (located between the duodenum and the large intestine) to be visualised by swallowing a capsule the size of a tablet, equipped with cameras that take photographs throughout its passage through your digestive tract. These photographs are transmitted to a device that you wear over your shoulder for an entire day and are subsequently analysed by your gastroenterologist.Double-balloon enteroscopy is an endoscopic examination used to investigate or treat gastrointestinal bleeding in the small intestine, visualised, for example, during a small-intestine video capsule examination or an imaging examination such as a CT scan. This examination is performed under general anaesthesia. It can be carried out through the mouth or the anus, depending on the location of the bleeding in the small intestine. Treatments and care management How can you be treated if the bleeding comes from the small intestine?In the majority of cases, we can treat the source using double-balloon enteroscopy. More rarely, angiography may be required through the interventional radiology department, or digestive surgery. Our department is a reference centre for the diagnosis and treatment of gastrointestinal bleeding and anaemia, particularly bleeding from the small intestine (video capsule endoscopy and double-balloon enteroscopy).  Our experience and multidisciplinary approach, which sometimes also combines the expertise of several disciplines such as radiology, endoscopy and surgery, ensure optimal diagnosis and treatment tailored to each patient.What does follow-up involve?Regular follow-up is essential for the proper management of your care:Blood tests to assess anaemia and iron deficiencySometimes intravenous iron injections or a transfusion are necessary; these can be administered at the Day Hospital without hospitalisation. Our specialists Prof. Marianna Arvanitakis Director of the Pancreatology and Nutritional Support ClinicGastroenterologist, specialising in pancreatic diseases, interventional endoscopy and clinical nutrition.Professor Marianna Arvanitakis specialised in pancreatology and interventional endoscopy as part of Professor Jacques Devière’s team at Erasme Hospital. After obtaining a University Diploma in Clinical Nutrition in 2005, she took over the medical coordination of the nutritional support service in 2018. Research conducted within the clinic focuses in particular on optimising the management of patients with severe acute pancreatitis and chronic pancreatitis, as well as on the management of patients suffering from short bowel syndrome. A member of several scientific societies, she is Secretary-General of the European Society of Gastrointestinal Endoscopy (ESGE) for the 2025–2027 term, and a gastroenterology clinical supervisor for the Université Libre de Bruxelles (ULB). Languages spoken: French, English, Greek. Professor Alia Hadefi Professor Hadefi is a gastroenterologist with expertise in clinical nutrition and metabolic liver diseases. She defended her doctoral thesis on the interaction between the intestine and liver diseases in 2024 and completed additional training in 2025 within the Department of Gastroenterology, Chronic Inflammatory Bowel Diseases (IBD) and Nutritional Support at Beaujon Hospital (Paris).Languages spoken: French, English, Arabic. Dr Michael Fernandez Y Viesca Dr Fernandez is a gastroenterologist with expertise in pancreatology, acquired after obtaining a university diploma in pancreatology in 2017 (Sorbonne). He is the coordinating physician for benign pancreatic diseases within the multidisciplinary pancreatology consultation and is currently preparing a doctoral thesis on severe acute pancreatitis.Languages spoken: French, English, Spanish. Contact If you experience signs of significant gastrointestinal bleeding (haematemesis, melaena, haematochezia), please go to our Emergency Department as soon as possible; they will contact our team.If the bleeding is a more chronic phenomenon, please do not hesitate to make an appointment for a consultation (by email at ConsGastroMed [dot] erasme [at] hubruxelles [dot] be (ConsGastroMed[dot]erasme[at]hubruxelles[dot]be) or by telephone on +32 (0)2 555.35.04, or contact the H.U.B’s Gastroenterology Department directly at SecMed [dot] GastroMed [dot] erasme [at] hubruxelles [dot] be (SecMed[dot]GastroMed[dot]erasme[at]hubruxelles[dot]be)  Discover the Pancreatology Clinic

Rare diseases Patients with a rare disease should receive appropriate and specific care: a diagnosis as quickly as possible and follow-up in care units trained in these rare conditions. The Rare Diseases Function (8 in Belgium) is responsible for coordinating, with the teams possessing the relevant expertise, care pathways and scientific research and training projects involving all stakeholders, to ensure appropriate care that is constantly evolving.

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What is a respiratory allergy? A blocked or running nose, itching eyes, sneezing, night cough, breathing problems... Whether chronic, persistent or seasonal, these symptoms can be the sign of a respiratory allergy (such as hay fever) and/or an asthma of allergic origin. Not all cases of asthma or rhinitis are attributable to an allergy. However, it is important to know whether or not this is the case as this will determine the choice of treatment, its effectiveness and even certain reimbursements!  Care The H.U.B’s Asthma and Allergic Diseases Clinic offers diagnosis and treatment for persons with these diseases or who present respiratory or skin symptoms of the allergic type.    Diagnosis and follow up   First consultation: The person is seen by a pneumologist who notes the symptoms, their frequency and the moments and circumstances in which they appear. The doctor will also carry out a spirometry test which is a simple test that measures the respiratory function. A prick test is also carried out to identify the allergen(s) responsible for the symptoms. This skin test involves placing a drop of the allergen on the arm and then pushing it beneath the epidermis using a fine needle.  The patient should also have a blood test the same day at the Testing Centre. There is no need to fast. In all cases the doctor will already be able to diagnose treatment to relieve the symptoms.    Tests for asthma: if asthma is suspected,  If the respiratory test shows a bronchial obstruction, a bronchodilatation test is carried out immediately;    If the respiratory function is normal, the person is asked to return for a bronchial provocation test using histamine. Carried out under medical supervision, this test makes it possible to either rule out or confirm asthma with quasi certainty.    Second consultation : 6 to 8 weeks later, the patient returns for a consultation.  Aims: to assess the response  to the symptomatic treatment and to discuss the blood test results and other treatment that could be considered.    Follow-up consultations : Once the asthma or respiratory allergy is under control, follow up is proposed at a frequency that depends on the severity of the condition.    Good to know: Depending on the case and needs, the H.U.B.’s Asthma and Allergic Diseases Clinic proposes joint consultations. This enables patients to see  a pneumologist and ENT specialist at the same time or, in the case of a skin allergy, a pneumologist and dermatologist.    Persons with asthma can also benefit from treatment education programmes at the  School of Asthma. Treatment Treatment for a respiratory allergy depends both on the allergens in question and the symptoms.    Symptomatic treatment includes antihistamines taken orally, corticoid-based nasal sprays and eye drops.     Immunotherapy consists of modifying the immune response of the patient, causing it to evolve from an allergic status to a tolerance status in regard to the allergen.   Immunotherapy often involves taking tablets that melt on the tongue or otherwise drops. This treatment is effective but it is relatively long and costly. It is only reimbursed if the asthma is caused by an allergy to dust mites and associated with a dust mite allergic rhinitis.      Asthma treatment (bronchodilatators, anti-IgE, anti-interleukins, biological treatment, etc.) is varied and  depends on the type of asthma. As the illness varies over time, the treatment must be adapted accordingly.    Advice Treatment by avoidance is always recommended in the case of allergies. This involves avoiding as much as possible exposing oneself to allergens or applying certain measures to reduce to the maximum exposure to the allergens. For example: washing sheets at 90°C; airing rooms in winter when it is cold; in the case of allergy to dust mites, closing the windows when pollen is at a peak (allergies to grains and other pollens), etc.    Image Research The main line of translational research pursued by the H.U.B’s Asthma and Allergic Diseases Clinic concerns inflammation of the lower respiratory tract (bronchi). Doctor  researchers work on the use of exhaled NO to guide immunotherapies and biological therapies as well as on induced expectorated sputum as a means of identifying the phenotype of an asthma and to guide treatment.    Related service Related doctors

What are allergies? Image Does your child have a blocked nose, bouts of sneezing or itchy eyes? If so, they may be allergic to pollen or dust mites. Does your child have difficulty breathing, a persistent cough, or are they regularly diagnosed with bronchitis or bronchiolitis? If so, they may have asthma. Does your child consistently develop a skin reaction, bloating, abdominal pain or even more severe reactions after eating a particular food? If so, your child may have a food allergy or intolerance.Please do not hesitate to make an appointment with our Pneumology-Allergology (Pediatric) department if you think that one of these situations applies to you. Care management During the consultation, the doctor will first take a detailed medical history of your child’s health condition. Additional examinations may then be proposed, such as allergy tests (skin tests or measurement of antibodies in the blood), respiratory function tests (for children aged 6 and over) and oral challenge tests (more specifically for food or medication allergies). These tests help confirm the diagnosis or monitor the progression of your child’s condition. Finally, treatment and advice will be prescribed. Sometimes, opinions from other specialists (dietitians, dermatologists, ophthalmologists, ENT specialists, etc.) are requested to optimise your child’s care. Advice If you suspect a severe Food allergy or Severe asthma attack, go to the Emergency Department or see your general practitioner or paediatrician to receive initial treatment and advice. Unfortunately, waiting times for our consultations can sometimes be long; primary care doctors are there to support you while you wait for your first appointment in pneumology-allergology. Search At H.U.B, and more specifically at Erasme Hospital, we have developed expertise in the management of Food allergy. Your child will be seen in a joint Food Allergy consultation by the paediatric allergist and the dietitian specialising in allergology. We offer accurate and safe diagnoses of Food allergy so as not to impose an elimination diet if this is not necessary. To do this, we perform an oral food challenge in your child, offering them the food suspected of causing the allergy in increasing doses, in hospital, in order to identify allergic reactions and treat them appropriately. Indeed, skin tests and blood antibody measurements do not always make it possible to establish the diagnosis with certainty. This oral food challenge provides certainty.Once your child’s Food allergy diagnosis has been established, we can offer you reintroduction of the allergen at home, following a well-established protocol personalised to your child, in order to desensitise them to the allergy; the aim is therefore to make them no longer allergic to this food. Our specialists Associated services

Eating disorders in children and adolescents What are eating disorders?An eating disorder is an “abnormal” eating pattern associated with severe psychological distress, which becomes long-lasting and whose consequences for the individual’s health can be serious. In this type of mental illness, attitudes towards one’s body, weight and food are disturbed. Psychosocial functioning and quality of life are also significantly impaired.Eating disorders generally emerge during adolescence and primarily affect girls. However, they can also occur in boys and may develop during childhood or adulthood.H.U.B Reference Centre for Eating Disorders Advice for Parents Early identification of warning signs is crucial for effective intervention. Parents should pay attention to the following changes in their children:Changes in eating habitsPreoccupation with weight and appearanceWeight lossSigns of social and/or family withdrawalMood changes: sadness, irritability, anxiety, perfectionismLow self-esteem  Time is a decisive factor in the treatment of eating disorders. Rapid diagnosis can help prevent serious health problems such as:Arrested pubertal growth and developmentHeart problemsBone fragilityHair lossDental damageIndicationsIf you suspect that your child or adolescent has an eating disorder, prompt medical consultation is essential. General practitioners, paediatricians or other primary care providers can refer you to specialised facilities, such as the Children’s Hospital (HUDERF) or Erasme Hospital. To make an appointment:Children’s Hospital (HUDERF) +32 2 477 31 80Appointment request form Erasme: EMC Child and Adolescent ConsultationSecretariat: +32 2 555 32 96Appointment request form 

What is irritable bowel syndrome? Irritable bowel syndrome is a chronic digestive disorder that affects the small and large intestine. Common symptoms are stomach pain and bloating associated with changes in the intestinal transit (constipation or diarrhoea). An estimated 10% of Belgians suffer from this disease. The causes are multiple and examinations (blood tests, imaging, endoscopy) do not show any anomaly.  Clinic The Functional Digestive Disorders Clinic at the Erasmus Hospital proposes a digestive comfort consultation in order to evaluate the situation, relieve symptoms and improve the quality of life of patients. Treatment includes changes to diet, dietary consultation, medication and sometimes physiotherapy as part of a multidisciplinary approach.    Research Innovative tratment is regularly proposed in the framework of clinical trials.    Our specialists Associated service

What is Parkinson’s disease? Parkinson’s disease is a common neurodegenerative disease, the second most common after Alzheimer’s. It is caused by a lack of the neurotransmitter dopamine that is present deep in the brain. Parkinson’s is estimated to affect some 30,000 people in Belgium, which is about 2.5 people for every 1,000 inhabitants. Parkinson’s disease is slightly more prevalent among men than women. The causes remain unclear and complex genetic and environmental factors are no doubt involved. Typical signs of Parkinson’s are resting tremors, stiffness and slowness of movement. There can also be non-motor symptoms that may affect sleep, behaviour or memory for example. Treatment Neurologists can prescribe medication. This does not treat the disease itself but is effective in alleviating symptoms. Physiotherapy can also play an important role in maintaining a good physical condition. A complete physiotherapy assessment can be carried out in cooperation with the Centre for Adult Neurological Functional Rehabilitation. At an advanced stage of the disease, deep brain stimulation  may be proposed in cooperation with the Department of Neurosurgery, especially for persons  aged under 70. Other persons can benefit from pump treatment that introduces medication into the digestive tract. This is carried out in cooperation with the Department of Gastroenterology.    Other diseases Certain rare diseases can resemble the early stages of Parkinson’s disease. Neurologists will draw on their expertise to detect specific signs of these diseases that are known as  Parkinson-plus syndromes and they will make the differentiation, often in cooperation with the Departments of Diagnostic Neuroradiology, Nuclear Medicine and in association with neuropsychologists.   Not all tremors indicate Parkinson’s. Essential tremor is a disease that can be distinguished by the fact that the trembling is the only symptom and is distinctive in that it occurs when making certain movements, such as eating, drinking or brushing your teeth. It is often overlooked despite the fact that it is probably more common than Parkinson’s disease. It can be treated very effectively with medication and more rarely with neurosurgery.   Dystonia is a neurological disease resulting in an abnormal muscle tone caused by a bad signal sent by the brain. Persons with dystonia suffer from involuntary muscle contractions. This causes abnormal posture or movements, such as torticolis, writer’s cramp and blepharospasm (involuntary contraction of the eyelid muscles). It can also be generalised, confining patients  to a wheelchair or distorting  the skeleton. It can affect people of any age, including children. Treatment is by medication, especially botulinum toxin injections, and sometimes by neurosurgery with deep brain stimulation.   Huntington’s disease is a neurodegenerative disease characterised by involuntary movements that are called chorea, cognitive disorders and behavioural disorders. It is transmitted by parents to the children with a 50% risk of transmission. A simple genetic test gives a diagnosis with 100% certainty. There is worldwide registration of Huntingdon’s disease, on the  Enroll-HD research platform to which we contribute, and that operates as a gateway to possible clinical trials. Treatment is for the symptoms only and of limited effectiveness although progress in recent years is encouraging.  Other pathologies are also treated:   restless leg syndrome, Gilles de la Tourette syndrome, paroxymal dyskinesia, orthostatic tremors, etc.   Our specialists Related service

What is systemic mastocytosis Systemic mastocytosis is a rare disease. Mastocytosis is a group of diseases that cause an excessive build up of mast cells in the body. A mast cell is a type of white blood cell that helps our immune system to function correctly.  When you suffer from systemic mastocytosis an excess of mast cells builds up in the skin, bone marrow, digestive tract or other body organs. When activated these mast cells release substances that can trigger signs and symptoms similar to those of an allergic reaction. Serious inflammation can sometimes cause organic lesions. Common triggers include alcohol, spicy food, insect bites and some medicines. Mast cell activation syndrome and systemic mastocytosis present the same signs and symptoms. In the case of mast cell activation syndrome there is no build up of mast cells in the bone marrow. Systemic mastocytosis is also characterised by the presence of a mutation of the c-KIT gene. This mutation is not generally hereditary.  Care The signs and symptoms of systemic mastocytosis depend on the part of the body affected by an excess of mast cells. An excess of mast cells can build up in the skin, liver, spleen, bone marrow or intestines. More rarely, other organs such as the brain, heart or lungs can also be affected The signs and symptoms of systemic mastocytosis can include Flushing, itching.Abdominal pain, diarrhoea, nausea or vomiting.Palpitations, feeling faint.Allergic reactions ranging from urticaria to Quincke’s oedema and anaphylaxis Coughing, shortness of breath, rhinorrhea, lachrymation.Frequent urination, urinary burning.Bone and muscle pain.Depression, mood changes or problems concentrating.Anaemia or bleeding disorders.Enlarged liver, spleen or lymph nodes.The various triggers for mastocytosis symptoms include: Insect bites.Food rich in histamine or histamine liberators.Physical factors (change in temperature, fever) Surgery, traumas.Certain medicines.To diagnose systemic mastocytosis a biopsy of the organ or organs affected is necessary to establish the link between the symptoms and the illness. The biopsy is to detect the presence of an accumulation of mast cells as well as the c-KIT mutation. The tryptase level is a blood marker that is very often useful for the diagnosis. Once the diagnosis has been established a number of additional examinations must be carried out (abdominal ultrasound, bone density test, osteo-medular biopsy) to determine the severity.   There are two aspects to mastocytosis treatment. The symptomatic treatment aims to control the symptoms whereas the antiproliferative treatment aims to control the excessive production and accumulation of mast cells in the organs. Antiproliferative treatment is not always required and will depend on the specialist’s assessment. Symptomatic treatment is based on identifying and eliminating factors that trigger the symptoms as well as the use of antihistamines, antacids and other anti-allergy medication. An adrenaline pen is proposed to patients who have had a severe anaphylactic reaction.The antiproliferative treatment is based on chemotherapy and certain targeted therapies. In rare cases an allogeneic stem cell transplant can be envisaged  Advice If you are being monitored for a stystemic mastocytosis and you have respiratory distress or feel faint (Quincke’s oedema or anaphylaxis) you should go immediately to the emergency department or dial 112. If you have an auto-injector EPIPEN (adrenaline) you should use it to make an intramuscular injection while awaiting the arrival of the ambulance.  Focus Patients with symptoms that are suspected to indicate a mastocytosis will be directed to a consultation with a specialist. You may be directed initially to haematology or internal medicine and then redirected to another specialist depending on the results.  Our specialists Related services

What is Histiocytosis? Histiocytosis refers to a group of rare tumour pathologies characterised by the accumulation of histiocytes (a subgroup of immune system cells) in various tissues. This group of diseases includes, most notably,  Langerhans cell histiocytosis, Erdheim-Chester disease, Rosai-Dorfman disease and malignant histiocytoses and cutaneous histiocytoses.  Frequently affected organs are the skin, bones, lungs, pituitary gland, the central nervous system, the heart, the large blood vessels and the retroperitonium.The diagnosis is based on microscopic and genetic analyses carried out on biopsies of the affected organs.  Due to the rarity of these diseases and the sometimes difficult anatomopathological analysis, consultation is required between the reference centres for the purposes of diagnosis and treatment.    Treatment A multidisciplinary approach is adopted for the treatment of histiocytosis. The treatment will depend on the type of histiocytosis and the seriousness of the affected organs  Close monitoring without treatment can sometimes be proposed. In some situations, the use of analgesic medicines and bone consolidation succeeds in managing symptoms.  For certain localised bone or cutaneous forms of histiocytosis, surgery and radiotherapy enable the disease to be managed or even cured. In other more serious situations it can be necessary to have recourse to the use of corticoids or chemotherapy.  In 2010, the discovery of genetic anomalies in cases of histiocytosis made it possible to improve significantly the treatment of severe forms thanks to the use of targeted therapies.  The often chronic nature of these diseases justifies regular monitoring by a specialist in the field of histiocytoses.     Useful linksAssociation Histiocytose France et Groupe d’Etude des Histiocytoses : Histiocytose.org - Histiocytose Langheransienne - histiocytose.orgFilière de santé Maladies Rares Immuno-Hématologiques (MARIH) : Accueil - MaRIH - Filière de santé Maladies Rares Immuno-Hématologiques Our specialists Prof. Virgnie de WildeAssociate Director of Hematology (Erasme) Make an appointment Dr. Tom AbrassartHematologistSpecialist in Histiocytosis Make an appointment Advice Patients with histiocytosis sometimes have a long waiting period before obtaining a firm diagnosis. Please feel free to contact our team regarding a diagnosis and benefit from a medical assessment. Focus Our department is actively involved in  number of protocols for translational and clinical research (expression of BCL2 in histiocytoses, in cooperation with the French reference centre for histiocytoses, under the supervision of Professor Julien Haroche.Do not hesitate to talk to your haematologist.  Discover our Hematology Department

What is porphyria? Porphyrias are rare disorders caused by a deficient production of haem, an essential molecule for the transport of oxygen (via the haemoglobin) and the elimination of medicines (via the cytochromes). Depending on the type of porphyria these diseases result in abdominal pain,  neurological disorders and/or skin problems. Some crises can be triggered by certain medicines, fasting, alcohol or an infection. In most cases porphyrias are hereditary diseases that develop during adulthood. Some of the skin problems can become apparent during childhood while others can be secondary to other health problems. The diagnosis is established by blood, urine and genetic tests. Treatment of porphyria Treatment of porphyria depends on the type of porphyria. Acute porphyrias require a multidisciplinary approach based on prevention and the treatment of acute attacks. Haem is administered via a central venous catheter in acute situations.  Pain management sometimes requires the administration of powerful analgesics. Neurological disorders can require specific care.  Prevention consists principally of  eliminating trigger factors such as certain medicines (especially the contraceptive pill) and alcohol.  Certain severe forms may require a liver transplant.  Recently, a new treatment with Givosiran has made it possible, under certain specific conditions, to improve the quality of life of patients who suffer recurring acute attacks of porphyria. This can only be prescribed following an initial assessment at one of the 2 reference centres in Belgium, one of which is at the Brussels University Hospital (H.U.B) and the other at UZ Leuven university hospital. When the porphyria takes the form of a skin complaint, treatment can be by bleedletting, medicines and/or protection against the sun.  In the long term, porphyrias  can be accompanied by complications such as high blood pressure, chronic kidney disease or liver problems.Regular follow-up with a specialist is therefore essential to prevent acute attacks and to identify complications related to the disease. Our specialists Need some medical advice?Dr. Tom AbrassartHématologistSpecialized in porphyria Make an appointment Focus The Hematology Department of the Brussels University Hospital (H.U.B) and the Medical Chemistry Department of LHUB-ULB together form the Belgian Porphyria Centre, which is one of the 16 expert clinical centers for porphyrias (PECC). In Belgium, it is one of the two centers authorized to initiate treatment with Givosiran.The Medical Chemistry Department is one of the specialized centers in the international network dedicated to porphyria, IPNET. It also holds recognition as a National Reference Center for Rare Diseases for certain analyses related to porphyrias. Discover our Hematology Department Associate doctors Prof. Frédéric Cotton - Head of Medical Chemistry Department - Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB).Prof. Fleur Wolff - Head of Hormonology Clinic -  Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB).Ph.Biol. David Fage - Medical Director - Special Biochemistry -  Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB).