RESUMEN
Two patients with secretory diarrhea and signs and symptoms consistent with the Verner-Morrison syndrome and islet cell hyperplasia are described. Both patients responded well to subtotal pancreatectomies. The morphologic changes in the pancreata were characterized by proliferation of islets associated with periductal and interstitial fibrosis. Immunohistochemical stains demonstrated increased staining for serotonin in islet cells. A few islet cells also stained for vasoactive intestinal polypeptide. The significance of these results is discussed.
Asunto(s)
Adenoma de Células de los Islotes Pancreáticos/patología , Islotes Pancreáticos/patología , Neoplasias Pancreáticas/patología , Serotonina/metabolismo , Vipoma/patología , Adulto , Femenino , Histocitoquímica , Humanos , Hiperplasia , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/metabolismo , Péptido Intestinal Vasoactivo/análisis , Vipoma/metabolismoRESUMEN
This report describes a 59-year-old woman, who, after an initial reaction to hydralazine, inadvertently took the drug again. She promptly developed symptoms of acute cholangitis--fever, right upper quadrant tenderness, obtundation, and hypotension. Cholecystectomy was performed and no obstruction or infection of the biliary tract was present. Perioperative studies support a diagnosis of hydralazine-induced acute cholangitis, a side effect of the drug which has not been previously described.
Asunto(s)
Colangitis/inducido químicamente , Hidralazina/efectos adversos , Enfermedad Aguda , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Colangitis/patología , Colecistitis/inducido químicamente , Colecistitis/patología , Femenino , Humanos , Persona de Mediana EdadRESUMEN
The classification, clinical course, etiology and treatment of chronic hepatitis are discussed. The clinical manifestations of chronic hepatitis are of limited diagnostic use. Diagnosis must be made by liver biopsy. The disease is classified as chronic persistent or chronic active hepatitis. The prognosis for chronic persistent hepatitis is excellent, and no treatment is required. Chronic active hepatitis may progress to cirrhosis and is associated with a poor prognosis if untreated. Recognized causes of chronic active hepatitis are hepatitis-B virus infection, post-transfusion hepatitis not associated with hepatitis-B virus, and certain drugs. For drug-induced hepatitis, discontinuation of the medication is indicated. For other types of chronic active hepatitis the recommended treatment is prednisone 10 mg and azathioprine 50 mg daily.