RESUMO
Thirty patients, 18 males and 12 females, with PSC have been studied between 1972 and 1986. In nine PSC was associated with ulcerative colitis (30%), in 4 with Crohn's disease (13%) and 17 were free of any chronic bowel disease. Four of these 17 were siblings. Alkaline Phosphatase, Gamma GT, total bile acids and 7-alpha-hydroxilated bile acids were elevated in all patients. In 14 patients plasma and urinary copper as well as ceruloplasmin were studied, showing the copper in all cases and ceruloplasmin in 10 cases elevated, 4 were normal. By means of cholangiography alterations of the extrahepatic ducts, the intrahepatic ducts, and both the intra- and extrahepatic ducts were seen in 13%, 27% and 40% of the cases, respectively. Alterations of the pancreatic duct were observed by pancreatography in 21% of cases. 40% of the PSC-patients had also a Sjögren's syndrome, while 3% were associated with diabetes mellitus Type I and II, psoriasis and red lichen planus, iridocyclitis and hepatic hemangioma.
Assuntos
Colangite/patologia , Adulto , Idoso , Ductos Biliares/patologia , Biópsia , Colangiopancreatografia Retrógrada Endoscópica , Colite Ulcerativa/patologia , Doença de Crohn/patologia , Feminino , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos/patologia , Pancreatite/patologia , EscleroseRESUMO
Two patients has been presented to whom general anaesthesia consecutive with halogenated anesthetics has been administrated. In one of the observations the first anaesthesia was administrated with enfluorane and halothane was for the others. The two patients inured with jaundice and in one of them accompanied with hepatic insufficiency; both of them had favourable evolution. The histology of one of them show us a lesion compatible with injury caused by halogenated anaesthesia. In one of the patients appears evidences of hypersensitivity. It is request the possibility that the enfluorane could be acting as a sensibilisant drug of the hepatic injury produced by the halothane. This experience suggest us the danger already described of the consecutive use at short intervals of halogenated anesthetics. So long as fat patients are more sensible to the toxic action of these anesthetics it is suggested prevent in their cases.
Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Enflurano/efeitos adversos , Halotano/efeitos adversos , Humanos , Fígado/patologia , Masculino , Pessoa de Meia-Idade , NecroseRESUMO
Two patients has been presented to whom general anaesthesia consecutive with halogenated anesthetics has been administrated. In one of the observations the first anaesthesia was administrated with enfluorane and halothane was for the others. The two patients inured with jaundice and in one of them accompanied with hepatic insufficiency; both of them had favourable evolution. The histology of one of them show us a lesion compatible with injury caused by halogenated anaesthesia. In one of the patients appears evidences of hypersensitivity. It is request the possibility that the enfluorane could be acting as a sensibilisant drug of the hepatic injury produced by the halothane. This experience suggest us the danger already described of the consecutive use at short intervals of halogenated anesthetics. So long as fat patients are more sensible to the toxic action of these anesthetics it is suggested prevent in their cases.
RESUMO
Se presentan dos pacientes a los que se les efectuan anestesias generales sucesivas con anestesicos halogenados. En una de las observaciones la primera anestesia se efectuo con enfluorano empleandose para todas las demas halotano. Los dos pacientes cursaron con ictericia acompanada, en uno de ellos de signos de insuficiencia hepatica grave; ambos evolucionaron favorablemente. La histologia de una de ellos muestra lesion compatible con injuria por anestesico halogenado. En ninguno de los pacientes hubo evidencias de hipersensibilidad. Se postula la posibilidad de que el enfluorano pudiera haber actuado como droga sensibilizante de la lesion hepatica desencadenada por el halotano. Esta experiencia sugiere el peligro ya descripto de la utilizacion consecutiva a intervalos cortos de anestesicos halogenados.Dado que los pacientes obesos son mas sensibles a la accion toxica de estos anestesicos se aconseja evitarlos en ellos
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Enflurano , Fígado , Halotano , NecroseRESUMO
Se presentan dos pacientes a los que se les efectuan anestesias generales sucesivas con anestesicos halogenados. En una de las observaciones la primera anestesia se efectuo con enfluorano empleandose para todas las demas halotano. Los dos pacientes cursaron con ictericia acompanada, en uno de ellos de signos de insuficiencia hepatica grave; ambos evolucionaron favorablemente. La histologia de una de ellos muestra lesion compatible con injuria por anestesico halogenado. En ninguno de los pacientes hubo evidencias de hipersensibilidad. Se postula la posibilidad de que el enfluorano pudiera haber actuado como droga sensibilizante de la lesion hepatica desencadenada por el halotano. Esta experiencia sugiere el peligro ya descripto de la utilizacion consecutiva a intervalos cortos de anestesicos halogenados.Dado que los pacientes obesos son mas sensibles a la accion toxica de estos anestesicos se aconseja evitarlos en ellos