RESUMEN
BACKGROUND/AIMS: To determine the value of systemic cytokines as predictors of relapse in inflammatory bowel disease (IBD). METHODOLOGY: A prospective study with 135 patients in clinical remission for at least 3 months. At enrollment, a venous blood was drawn in order to measure, by an ELISA test, the following cytokines: TNFalpha, TNFalpha-R1 and R2, IL-16, IL-1beta, IL 2, IL-R2, IL-6, IL-10, and IFNgamma. All patients were followed-up for one year. RESULT: Sixty-six patients had Crohn's disease (CD) and 69 had ulcerative colitis (UC). Thirty-nine (30%) had a relapse. Forty-four percent were receiving immunomodulatory therapy. No differences were found regarding detection and baseline concentration of the various cytokines between patients with CD and UC, or between patients with or without ongoing use of immunomodulators. The detection and concentration levels of cytokines were not associated with the risk of relapse of IBD. CONCLUSIONS: Systemic cytokines are of little value to predict IBD relapse.
Asunto(s)
Citocinas/sangre , Enfermedades Inflamatorias del Intestino/inmunología , Adulto , Femenino , Humanos , Inmunosupresores/uso terapéutico , Enfermedades Inflamatorias del Intestino/diagnóstico , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Estudios Prospectivos , RecurrenciaRESUMEN
BACKGROUND: There is scant information on the use of endoscopic retrograde cholangiopancreatography (ERCP) in patients under 18. OBJECTIVE: To analyze our experience in all patients under 18 who underwent ERCP. PATIENTS AND METHODS: We performed a retrospective study of all ERCP conducted in patients under 18 between 1993 and 2006. We analyzed indications, endoscopic and radiologic findings, diagnostic and therapeutic success, and complications. RESULTS: We included 31 patients who underwent 36 ERCP in total. The mean age was 9.89 +/- 5 years old. We used general anesthesia in 58.3% (21 patients), with a mean age of 8 +/- 5 years. The most frequent indications were complications after liver transplantation in 33.3% (12 patients), suspicion of biliary obstruction in 27.7% (10 patients), and pancreatitis in 22.2% (8 patients). We achieved cannulation and repletion in the selected duct in 94.4%. The most frequent pathologic findings were changes in the biliary tract after liver transplantation in 25% (9 patients). The results of ERCP were normal in 10 patients (27.7%). Therapeutic maneuvers were indicated in 17 out of the 34 (50%) examinations considered, achieving therapeutic success in 76.47% (13/17). Complications consisted of hemorrhage after simple sphincterotomy in one patient (2.8%) and mild pancreatitis in two patients (5.6%). CONCLUSIONS: We found ERCP to be a safe procedure with a high diagnostic and therapeutic success rate, and a low rate of early complications.
Asunto(s)
Enfermedades de los Conductos Biliares/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Enfermedades Pancreáticas/diagnóstico , Adolescente , Factores de Edad , Enfermedades de los Conductos Biliares/terapia , Niño , Preescolar , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Femenino , Humanos , Lactante , Masculino , Enfermedades Pancreáticas/terapia , Estudios RetrospectivosRESUMEN
ANTECEDENTES: Hay una escasa información sobre el empleode la colangiopancreatografía retrógrada endoscópica(CPRE) en pacientes menores de 18 años.OBJETIVO: Analizar nuestra experiencia en todos los pacientesmenores de 18 años sometidos a CPRE.PACIENTES Y MÉTODOS: Estudio retrospectivo de todas lasCPRE realizadas a pacientes menores de 18 años entre 1993y 2006. Se analizaron las indicaciones, hallazgos endoscópicosy radiológicos, el éxito diagnóstico y terapéutico, y lascomplicaciones.RESULTADOS: Se incluyeron 31 pacientes a los que se realizaron36 exploraciones en total. La edad media fue de 9,89 ± 5años. Se utilizó la anestesia general en un 58,3% de los pacientes(n = 21), con una edad de 8 ± 5 años. Las indicacionesmás frecuentes fueron, por este orden, las complicacionespostrasplante hepático (12 casos; 33,3%), la sospecha de obstrucciónbiliar (10 casos; 27,77%) y la evaluación de pancreatitis(8 casos; 22,2%). Se logró la canulación y la replecióndel conducto deseado en un 94,4% de los casos. Los hallazgospatológicos más frecuentes fueron las alteraciones en la víabiliar postrasplante hepático (9 casos; 25%). La exploraciónfue compatible con la normalidad en 10 casos (27,7%). Se indicaronmaniobras terapéuticas en 17 de las 34 exploracionesconsideradas como éxito diagnóstico (50%), lográndose eléxito terapéutico en 13 de ellas (76,4%). Las complicacionesregistradas fueron un caso de hemorragia leve postesfinterotomía(2,8%) y 2 pancreatitis leves (5,6%).CONCLUSIONES: La realización de CPRE en nuestra serie hasido segura, con un alto índice de éxito diagnóstico y terapéutico,y pocas complicaciones precoces
BACKGROUND: There is scant information on the use of endoscopicretrograde cholangiopancreatography (ERCP) inpatients under 18.OBJECTIVE: To analyze our experience in all patients under18 who underwent ERCP.PATIENTS AND METHODS: We performed a retrospective studyof all ERCP conducted in patients under 18 between 1993and 2006. We analyzed indications, endoscopic and radiologicfindings, diagnostic and therapeutic success, and complications.RESULTS: We included 31 patients who underwent 36 ERCPin total. The mean age was 9.89 ± 5 years old. We used generalanesthesia in 58.3% (21 patients), with a mean age of 8 ±5 years. The most frequent indications were complicationsafter liver transplantation in 33.3% (12 patients), suspicionof biliary obstruction in 27.7% (10 patients), and pancreatitisin 22.2% (8 patients). We achieved cannulation and repletionin the selected duct in 94.4%. The most frequent pathologicfindings were changes in the biliary tract after livertransplantation in 25% (9 patients). The results of ERCPwere normal in 10 patients (27.7%). Therapeutic maneuverswere indicated in 17 out of the 34 (50%) examinations considered,achieving therapeutic success in 76.47% (13/17).Complications consisted of hemorrhage after simple sphincterotomyin one patient (2.8%) and mild pancreatitis in twopatients (5.6%).CONCLUSIONS: We found ERCP to be a safe procedure witha high diagnostic and therapeutic success rate, and a lowrate of early complications