The case histories of 1200 patients admitted to our hospital over a 20 month period were reviewed to determine the degree, frequency and cause of dissociated cholestasis as a biological syndrome. Patients were divided into two groups: group I with 80 cases, included all patients whose gamma-GT levels were more than 30 mU/ml and serum-bilirubin less than 1.2 mg/ml, with alkaline phosphatase levels between 90-180 mU/ml. Group II included those with alkaline phosphatase levels higher than 180 mU/ml (57 cases). All over incidence of dissociated cholestasis was 13.82%. Main causes in group I were infectious diseases, mainly pneumonias and urinary infections and congestive cardiac failure. In group II, neoplasias such as Hodgkin's disease and epithelial metastases and obstructions of the biliary tract such as vesicular or choledocal litiasis were the main causes. Transaminase levels underwent variable increases according to the different entities, without there being any difference between the two groups. The physiopathology as well as the anatomopathological aspects which could originate the syndrome are discussed.

Alkaline Phosphatase↗

PubMed1981

Ascites from polyserositis in periarteritis nodosa.

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Adult↗

PubMed1980

[Cerebral tuberculoma: an atypical case (author's transl)].

A case is reported of a 72 year-old female patient with multiple cerebral tuberculomas and a clinical course of 11 months that was characterized by personality changes, disorientation and progressive mental obtundation. The patient had a fatal outcome in spite of ventricular drainage and antituberculous therapy. Postmortem examination disclosed small tuberculomas in the cerebellum and brain stem, as well as residual tuberculous lesions in the upper lobe of the right lung. The clinical interest of this case lies in the old age of the patient, the rarity of the disease in western countries, and the location of tuberculomas in the brain stem with associated tuberculous meningitis. The higher incidence of cerebral tuberculomas in eastern and african countries is commented upon, and its anatomical, clinical, diagnostic and therapeutic features are reviewed. Finally, the two existing pathological forms and their respective clinical and therapeutic peculiarities are analyzed.

Aged↗

PubMed1975