RESUMO
BACKGROUND: Neutropenic enterocolitis (NEC) is characterized by inflammatory damage and necrosis of the intestinal mucosa, mainly of the terminal ileum and the cecum. It is more frequent in patients with leukemia and/or undergoing antineoplastic chemotherapy, and the main risk factor is neutropenia <1000/mm3. OBJECTIVE: To know the prevalence of NEC and the mortality associated with it in adults with hematologic conditions and neutropenia <1000/mm3. MATERIAL AND METHODS: All adult patients who were hospitalized for malignant hematologic conditions with neutropenia <1000/mm3 were enrolled in the study; those with neutropenia >1000/mm3 were excluded. The diagnosis of NEC was based on the clinical data and imaging tests (abdominal plain X-rays and CT scan). Demographics of all patients were collected, as well as the data related with the course and treatment of the underlying hematologic condition and the NEC. RESULTS: 117 patients were enrolled in the study; 75.2% of them with some type of acute leukemia. The diagnosis of NEC was made in 8 patients (6.8%). NEC occurred in 10.5% of the patients with acute myeloid leukemia and in 8.0% of those with acute lymphocytic leukemia. Three patients died, which resulted in a 37.5% mortality rate. No association was found between the severity of neutropenia and the onset of NEC or NEC-related mortality. CONCLUSIONS: The prevalence of NEC in patients with hematologic conditions admitted for severe neutropenia is 6.8% and the mortality rate associated with this complication is 37.5%.
Assuntos
Enterocolite Neutropênica/epidemiologia , Neutropenia/etiologia , Adolescente , Adulto , Enterocolite Neutropênica/complicações , Enterocolite Neutropênica/mortalidade , Feminino , Humanos , Contagem de Leucócitos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Neutropenia/complicações , Neutropenia/mortalidade , Prevalência , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Azarcon, a lead tetroxide salt, is used among Mexican and Mexican-American populations for the treatment of digestive illness. Chemical analysis of the azarcon sample used in this study showed it to be 96% lead, 1% calcium, 1% other minor metals, and 2% unidentified material. Taking into account the fact that Pb absorption was estimated at 2% following a single oral administration of 100 mg/kg (Aungst et al., 1981), it is possible to propose a chemical interaction between the components of azarcon, and as a result, the toxicity of Pb tetroxide would be different when given as azarcon than when given as a pure compound. The present work studied this possibility, with the following results. When the treatments of equal doses of pure Pb tetroxide and azarcon were compared (158 mg/kg/day p.o. for 96 h), five of nine tissues studied had similar Pb concentrations. However, with the pure compound the Pb levels were higher in bone and intestines; while with azarcon the Pb levels were higher in heart and brain. The pure Pb tetroxide treatment affects lipid peroxidation only in liver, but a low induction of peroxidation was found also in kidney and heart in rats which received the azarcon treatment. Liver and kidney damage were evident in rats treated with a high dose of azarcon (1.1 g/kg/day p.o. for 96 h), while the effects with the pure compound were similar in type but lower in magnitude. Pb tetroxide as a pure compound inhibits ALA-D by 26% while an inhibition of 42% was found with azarcon.(ABSTRACT TRUNCATED AT 250 WORDS)