[Blood macroamylase and celiac disease].
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Biomedical subjects
Publications and source records attributed to P Kessler Saiz.
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We introduce a young patient, without history of inflammatory bowel disease (I.B.D.) who started with an acute gastroenteritis, which in the following days progressed to a toxic megacolon. The patient had come to hospital with nausea, vomiting, fever and liquid, explosive diarrhoea without pathologic products. There was no clinical remission with astringent diet, hydroelectrolitic reposition and antidiarrheic opiates. The patient was admitted in hospital when he had blood in the diarrhoea. This progressed to a toxic megacolon in three days and the patient had to be operated on urgently. The surgeons found perforations in the colon and the pathologists diagnosed Crohn disease. Even without previous E.B.D. history we reached the diagnosis from the clinical and analytical data and the plain abdominal radiology. It was impossible to confirm the diagnosis with a colonoscopy because of the high risk of perforation. In cases like this, early surgery may save the life of the patient.
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Evan's Syndrome (ES) may develop in isolation or associated to other autoimmune diseases, solid tumors and lymphoproliferative syndromes. This type of processes can be refractory to the usual medication, that is, to corticoids and splenectomy. High doses of Immunoglobulins (polyvalent IgG) and immunosuppressive drugs are therapeutical alternatives that have been used with different results. We present a case of idiopathic ES refractory to high doses of corticoids and IgG, showing complete remission after the administration of two infusions of vinblastin. We believe that vinblastin is a very useful therapeutical alternative in the cases of ES refractory to the usual treatment.
We studied all the cases with suspicion of Mononucleosis Syndrome admitted at the Emergency Service of the Hospital 12 de Octubre from october to december of 1992. The selection was conducted on the basis of clinical criteria, being the more frequent observations fever, faringitis and adenopathies. Signs and symptoms were compared with other series without observing any significant differences. The diagnosis was confirmed through the quick detection of Heterophil antibodies (50% +), conducting afterwards specific serologic test for the most frequent germs. We conclude that the Mononucleosis Syndrome is an infection whose diagnosis, treatment and out-patient follow-up can be made by a Primary Health Care Team.
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