Search PubMed⌕ Search

Biomedical subjects

M Ingelmo

Publications and source records attributed to M Ingelmo.

At least 217 records · Page 12Linked to original sources

[Clinical significance of dissociated cholestasis as a biological syndrome (author's transl)].

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↗

[Hypersensitivity vasculitis and granulomatous hepatitis induced by glybenclamide: a case report (author's transl)].

The second case in the medical literature of hypersensitivity vasculitis induced by glybenclamide is reported, and for the first time vasculitic lesions are demonstrated in the histopathological study of liver tissue. The case was a male patient admitted because of a febrile illness and generalized malaise of long duration. He had diabetes mellitus that was being treated with glybenclamide. Physical examination disclosed fever, poor general condition, hepatomegaly, and red nodes in the finger-tips of both hands. Abnormal laboratory parameters included normochromic normocytic anemia, leukocytosis with a high eosinophil count, and markedly elevated erythrocyte sedimentation rate. There was as well slight cytolysis and marked elevation of cholestatic serum enzymes without hyperbilirubinemia. Biopsy of the skin lesions demonstrated anular granulomata, a common lesion in diabetics. The histopathological study of the liver revealed a vasculitic hypersensitivity reaction with conspicuous granulomata located in the vicinity of blood vessels and in the wall of portal arterioles, the endothelium of the latter being disrupted at different levels. Glybenclamide withdrawal resulted in a clinical, biological and histopathological cure of the disease. Unlike the previously reported case, the patient remains alive, and this may partly have been due to early institution of corticosteroid therapy.

Diabetes Mellitus↗

[Macrocytosis in chronic alcoholism (author's transl)].

The present study reported a group of 168 chronically alcoholic patients with a daily ingestion superior to 80 grams. Twenty of these patients (10 percent) did not have liver disease, and 148 (68.5 percent) had different forms of liver disease classified by histopathologic examination. Considering a 97 fi MCV as macrocytosis, we have found in the group of alcoholics without hepatopathy a 50 percent rate of macrocythemia with a mean value of 97.9 fl. In the group of chronic alcoholics with liver disease there was a 64.2 percent macrocytosis with a mean value of 100 fl. We have also studied 43 (21.5 percent) patients with cryptogenetic cirrhosis with a 32.6 percent macrocytosis and a mean value of 93.9 fl. With respect to the alcoholic hepatopathy subgroups, macrocytosis is more frequent in portal fibrosis and acute alcoholic hepatitis, the mean value being higher in the latter. We consider macrocytosis to be frequent among alcoholics, and a good persistence indicator of alcoholic ingestion, pathogenically linked to the now proven dyserythropoietic factor of the alcohol upon the bone marrow. There is no statistically significant correlation between anemia and reticulocytes. We consider macrocytosis to be a more precocious data, and believe that the positive correlation with certain intraerythrocitary enzymes in the juvenile population of red cells corroborates this fact. With respect to the rest of parameters studied there was a correlation with gammaglutamiltranspeptidase, glutamic-oxalacetic transaminase, and the value of prothrombin. The values of mean macrocytosis and elevations of gammaglutamiltranspeptidase and glutamic-oxalacetic transaminase are good persistence indicators of alcoholic ingestion.

Alcoholism↗