RESUMEN
A 71-year-old female with primary biliary cirrhosis, multiple myeloma and hypothyroidism is reported. The liver biopsy showed stage II-III histologic damage according to Scheuer's classification and the multiple myeloma was IgG-lambda type, stage II-A at the time of diagnosis. Another three cases of primary biliary cirrhosis associated with multiple myeloma were found in the literature. As a group, the four cases had mild or moderate liver damage, extensive bone lesions and three of four cases had multiple myeloma IgG-lambda type. Although this association could be incidental, there is evidence that implies a pathogenic relationship. This information is summarized in this report.
Asunto(s)
Hipotiroidismo/complicaciones , Cirrosis Hepática Biliar/complicaciones , Mieloma Múltiple/complicaciones , Anciano , Transformación Celular Neoplásica , Femenino , Humanos , Hipergammaglobulinemia/etiología , Inmunoglobulina M/sangre , Cadenas lambda de Inmunoglobulina/análisis , Cirrosis Hepática Biliar/inmunología , Activación de Linfocitos , Subgrupos Linfocitarios/inmunología , Subgrupos Linfocitarios/patología , Proteínas de Mieloma/análisis , Vitíligo/complicacionesRESUMEN
Acute suppurative cholangitis is a life-threatening condition and prompt biliary decompression (BD) is essential for survival. The evolution of thirty-one patients (21 women and 10 men, mean age 64 years) with acute suppurative cholangitis attended from February 1989 to February 1994 treated by endoscopic cannulation and sphincterotomy for biliary drainage were retrospectively reviewed. The mean hospital stay was 18 +/- 12 days and during hospitalization there were 5 deaths, none related to biliary drainage. Sixteen patients had previous cholecystectomy, 12 patients had previous cholangitis in the last year, 23 patients had choledocholithiasis and an additional three patients pancreatobiliary neoplasias and common duct stones. Only 67.7% showed the classic Charcot's triad (fever, abdominal pain and jaundice). Total bilirubin, aspartate aminotransferase, alanine aminotransferase and total leukocytes decreased significantly (p < 0.05) after BD. Retroperitoneal perforation was the only complication is a safe and effective procedure for emergency biliary decompression in the treatment of acute suppurative cholangitis.
Asunto(s)
Bilis , Colangitis/cirugía , Drenaje , Endoscopía , Enfermedad Aguda , Adolescente , Adulto , Anciano , Colangitis/mortalidad , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Esfínter de la Ampolla Hepatopancreática/cirugía , SupuraciónRESUMEN
Diet may be modified and can alter the hepatic function or contributes to maintain it on excellent state. The objective of this paper was to review the recently advances on the clinical aspects of nutrition in chronic liver diseases and the underlying rationale for specific nutritional therapies focusing in the works in Mexico. Original papers in english and spanish informed on Medline until 1994 were included. We also review the national literature about nutrition aspects on liver diseases.
Asunto(s)
Hepatopatías/dietoterapia , Fenómenos Fisiológicos de la Nutrición , Enfermedad Crónica , Metabolismo Energético , Humanos , Hepatopatías/metabolismo , Minerales/administración & dosificación , Trastornos Nutricionales/etiología , Necesidades Nutricionales , Oligoelementos/administración & dosificación , Vitaminas/administración & dosificaciónRESUMEN
Solitary rectal ulcer syndrome (SRUS) is an unusual disorder which is seldom seen in our hospital. Considerable uncertainly remains concerning the cause, natural history, and management of this condition. During 1980-1992 period, 7 patients were seen at the Instituto Nacional de la Nutrición and the diagnosis was established on histological, sigmoidoscopic and clinical grounds. Most of the patients suffered rectal bleeding, abdominal pain, straining at defecation, tenemus and rectal mucus discharge. Laboratory results were non specific. Eighty-five percent has macroscopic ulcerations and these were found within 5.2 cm of the anal margin and usually situated anteriorly. Neither medical nor local surgical treatment consistently achieved relief of symptoms or healing of the lesion.