RESUMEN
Deep venous thrombosis of the upper limbs is a rare entity which is usually associated to a high number of risk factors, with an incidence of 12.4% approximately, although the development of associated fatal complications is rare. We present the case of a patient without known risk factors who, in the course of a thrombosis at the right subclavian vein, developed very severe pulmonary hypertension secondary to multiple pulmonary embolism.
Asunto(s)
Hipertensión Pulmonar/etiología , Embolia Pulmonar/complicaciones , Vena Subclavia , Trombosis/complicaciones , Adulto , Femenino , Humanos , Hipertensión Pulmonar/diagnóstico , Flebografía , Arteria Pulmonar/diagnóstico por imagen , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiología , Vena Subclavia/diagnóstico por imagen , Trombosis/diagnósticoRESUMEN
Interleukin-1 (IL-1) is a cytokine produced by the macrophage-monocyte system that has important effects on immunological responses and inflammatory reactions. Several clinical studies have shown that severe protein energy malnutrition adversely effects cell-mediated immune responses and the functional state of macrophages. The objective of this study was to analyse IL-1 production by adherent cells stimulated in vitro with lipopolysaccharide B (LPS) from patients with alcoholic cirrhosis of the liver and its possible relationship with nutritional states. Forty-five patients with alcoholic cirrhosis and 28 healthy donors were investigated. A combined index of nine anthropometric and biochemical parameters was used to evaluate nutritional status of cirrhotic patients, allowing a distinction to be made between those patients with acceptable nutrition (group I: 40%), those with slight malnutrition (group II: 37.7%), and those with severe malnutrition (group III: 22.3%). IL-1 activity was significantly lower in the cirrhosis patients than in the controls (P less than 0.001). This activity also was significantly lower in samples obtained from cirrhotics with severe malnutrition than in those with acceptable nutrition (P less than 0.05); the combined index and the sole anthropometric index gave the same results, suggesting that malnutrition may play a role in the immunoregulatory disturbances in the pathogenesis of alcoholic liver disease.
Asunto(s)
Interleucina-1/biosíntesis , Cirrosis Hepática Alcohólica/metabolismo , Estado Nutricional , Adulto , Anciano , Antropometría , Proteínas Sanguíneas/química , Células Cultivadas , Interpretación Estadística de Datos , Femenino , Humanos , Lipopolisacáridos/metabolismo , Cirrosis Hepática Alcohólica/complicaciones , Masculino , Persona de Mediana Edad , Monocitos/metabolismo , Trastornos Nutricionales/etiología , Trastornos Nutricionales/metabolismoRESUMEN
An analysis was made of spontaneous Natural Killer (NK) activity, the proportion of NK cells and Interleukin 2 (IL-2) production in response to a phytohemagglutinin (PHA) using isolated mononuclear peripheral blood cells from 27 patients with Crohn's disease (CD) and 27 healthy controls. The results obtained showed a decrease in NK activity in comparison with the control group (p less than 0.05), occurring mainly in patients in whom the disease was in an active phase (p less than 0.005), with no apparent relationship to the proportion of NK cells. IL-2 production was, however, similar to that of the healthy controls. A positive correlation between spontaneous NK activity and IL-2 production was evident. The origin of these findings is controversial, suggesting that other factors with a negative modulating effect may inhibit NK function.