Novel life cycle stages of Colpodella sp. (Apicomplexa) identified using Sam-Yellowe’s trichrome stains and confocal and electron microscopy / Nuevas etapas del ciclo de vida de Colpodella sp. (Apicomplexa) identificado mediante tinciones tricrómicas de Sam-Yellowe y microscopía confocal y electrónica

Colpodella spp. are free-living flagellates closely related to the apicomplexans. Human infections by Colpodella sp. have been reported. A biflagellated trophozoite and cyst stage comprise the known life cycle stages of Colpodella sp. However, the process of encystation and excystation within the life cycle is unclear. Life cycle stages initiating human infections are unknown. We performed a detailed investigation of the life cycle of Colpodella sp. (ATCC 50594) in culture using Sam-Yellowe’s trichrome stains and differential interference contrast (DIC) for light microscopy and fluorescence microscopy of Congo red-stained cells and investigated ultrastructure using transmission electron microscopy (TEM). We report previously undocumented stages of Colpodella sp. Asymmetric and asynchronous division was detected inside cysts by trichrome staining and by TEM. Odd-numbered juveniles and cysts containing more than four juvenile trophozoites were identified. Live imaging of active cultures captured the excystation and egress of juvenile trophozoites and confirmed the presence of multinucleate cysts. The ultrastructure of the multinucleate cyst is reminiscent of apicomplexan schizonts. Insights gained from the life cycle stages observed in culture allowed the construction of the life cycle of Colpodella sp. Knowledge of the life cycle will aid biochemical and molecular characterization of Colpodella sp. and help identify stages in human infections.(AU)

Amiloidosis tarsal unilateral / Unilateral tarsal amyloidosis

CASO CLÍNICO: Varón de 23 años con ptosis unilateral izquierda de 2 años de evolución. Tras meses de tratamiento ineficaz para conjuntivitis vernal, la biopsia demostró una amiloidosis tarsal. La resolución quirúrgica del cuadro fue satisfactoria, tanto anatómica como funcionalmente. Discusión: La amiloidosis ocular es una enfermedad rara que se debe sospechar en casos de masas infiltrativas. El método diagnóstico es la biopsia. El tratamiento debe ser individualizado

CASE REPORT: A 23-year-old man presented with a unilateral left ptosis of two years onset. After ineffective treatment for vernal conjunctivitis for several months, the biopsy demonstrated tarsal amyloidosis. Surgical resolution of the case was anatomically and functionally satisfactory. DISCUSSION: Ocular amyloidosis is a rare disease that must be suspected with infiltrative mass lesions. Biopsy is the diagnostic method. Treatment should be individualised

Tumor amiloide de mama / Amyloid tumour of the breast

La amiloidosis primaria de afectación mamaria es una dolencia infrecuente, por lo que, ante su aparición, debemos descartar la existencia de otras enfermedades o la amiloidosis visceral difusa. Presentamos el caso de una paciente en cuya mamografía de control se identifican 2 nódulos con microcalcificaciones en la mama derecha. Las biopsias muestran alteraciones compatibles con depósito de amiloide. Se procede a la resección de las mismas, cuyo análisis de anatomía patológica confirma que se trata de un tumor amiloide. En los controles posteriores no ha presentado ninguna alteración local ni sistémica, lo que nos lleva a pensar que se trata de una amiloidosis primaria. Es de gran relevancia mantener revisiones periódicas para permitirnos diagnosticar precozmente la aparición de otras lesiones (AU)

Primary amyloid tumour of the breast is an unusual disease and consequently, when suspected, the presence of other illnesses or systemic amyloidosis must be excluded. We report the case of a woman in whom mammography revealed 2 nodes with microcalcifications in the right breast. Biopsies showed amyloid deposits. The lesions were resected and the diagnosis of amyloid tumour was confirmed by pathological analysis. Subsequently, the patient has shown no local or systemic alterations, leading us to believe that the lesions were primary amyloid tumours. It is essential to conduct frequent follow-up visits to rapidly diagnose the appearance of other lesions (AU)

Colchicine use in isolated renal AA amyloidosis / Uso de colchicina en amiloidosis AA renal aislada

We present the case of a 45-year-old woman, with two-year history of chronic renal insufficiency and proteinuria. A kidney biopsy showed the presence of AA amyloidosis (positive Congo red staining and immunohistochemistry). There was no evidence of amyloid deposits in other organs and there was no underlying disease. AA amyloidosis normally is secondary to chronic inflammatory or infectious diseases. High levels of IL-1, IL-6 and TNF-α play a role in the pathogenesis of amyloidosis and induce the synthesis of serum amyloid A protein (SAA), a precursor of tissue amyloid deposits. We empirically treated the patient with a low dose colchicine. The patient responded well. Colchicine has been used for the treatment of Familiar Mediterranean Fever and related auto-inflammatory diseases. To monitor treatment responses, we measured SAA finding low titers. Soon after treatment onset there were signs of improvement pertaining to proteinuria and stabilization of renal function (AU)

Se presenta el caso de una paciente de 45 años de edad con insuficiencia renal crónica y proteinuria. La biopsia renal demostró una amiloidosis tipo AA con un estudio de extensión negativo para depósitos en otros órganos. No se detectó enfermedad asociada. La amiloidosis tipo AA se asocia habitualmente a una enfermedad crónica inflamatoria o infecciosa. Las interleucinas IL1, IL-6 y TNF son responsables de la síntesis hepática de la proteína sérica amiloide A (SAA), precursor del amiloide que se deposita en los tejidos. Ante la imposibilidad de tratar una amiloidosis sin evidencia de enfermedad subyacente, instauramos empíricamente tratamiento con colchicina con buenos resultados. La colchicina es eficaz para el tratamiento de la fiebre mediterránea familiar y otros procesos inflamatorios. Se midieron niveles de la SAA en sangre que inicialmente fueron muy elevados alcanzándose niveles normales al poco tiempo de tratamiento con mejoría de la proteinuria, manteniéndose estable la función renal (AU

Detection of AA-type amyloid protein in labial salivary glands

Objectives: Among the diverse forms of amyloidosis, secondary type is the most frequent one. Diagnosis of amyloiddeposition is based on the identification of the fibrillary protein amyloid by means of Congo Red (CR) or crystalviolet (CV) stains, but these techniques do not differentiate between the different types of amyloid fibrils. Theaim of this study was to identify by immunofluorescence (IF) AA amyloid a pathological fibrillar low-molecularweightprotein formed by cleavage of serum amyloid A (SAA) protein in labial salivary gland (LSG) biopsies frompatients with secondary amyloidosis.Study design: 98 LSG were studied, 65 were from patients with secondary amyloidosis and 33 from subjects withchronic inflammatory diseases without evidence of this anomaly. All sections were stained with hematoxylin andeosin (H&E), CV, CR and IF using anti-AA antibodies. Positive and negative controls were used for all techniques.Results: CV and CR demonstrated that the amyloid substance was found mainly distributed periductally (93.8%),followed by periacinar and perivascular locations (p<0.001); however, the IF demonstrated that amyloid AA substancepredominates in the periacinar area (73.8%), followed by periductal and perivascular locations (p<0.001).IF has a sensitivity of 83%, 100% of specificity, 100% of predictive positive value and 75% of predictive negativevalue.Conclusions: The results of this study confirm the efficacy of the LSG biopsy as a highly reliable method fordiagnosis of secondary amyloidosis (AU)

Revisión de la aplicación clínica de los colorantes en cromoendoscopia digestiva y su formulación magistral / review of the clinical application of dyes in gastrointestinal chromoendoscopy, and their magistral formulation

Objetivo: El objetivo del presente trabajo es revisar la formulación magistral de los colorantes empleados y su efectividad clínica. Método: Se realizó una búsqueda bibliográfica en Medline, Cochrane Library y Micromedex, utilizando el término cromoendoscopia y repitiendo la búsqueda con los colorantes localizados asociados al término endoscopia. Se revisaron también diversas monografías, revistas científicas y las citas de los trabajos seleccionados. Los trabajos recuperados se clasificaron en función de su metodología. Resultados: Se localizaron 96 referencias, recuperándose el artículo original sólo en 57 de ellas correspondientes a 13 ensayos clínicos, 21 series de casos y 11 revisiones. Se encontraron referencias para 7 colorantes. Se describen las principales indicaciones, las evidencias de efectividad, la forma de administración y la fórmula magistral para cada uno de los colorantes. Conclusiones: El número de trabajos es elevado aunque la accesibilidad a los mismos es limitada. La evidencia es escasa en conjunto aunque en determinados casos como el azul de metileno en esófago de Barrett, el lugol en la detección de carcinomas esofágicos y el índigo carmín en la diferenciación de pólipos hiperplásicosa nivel colónico es alta. La formulación magistral es bastante simple aunque está poco desarrollada

Objective: To review the drug compounding of dyesemployed in chromoendoscopy, and their clinical effectiveness. Method: A literature search in Medline, Cochrane Library, and Micromedex was carried out with the term chromoendoscopy as a keyword, and the search was then repeated for each dye found in association with the term endoscopy. A number of monographs, scientific journals, and references quoted in selected papers were also reviewed. Papers collected were then classifiedaccording to their methodology. Results: Ninety-six references were found, their original article being recovered for only 57 of these – 13 clinical trials, 21case series, and 11 reviews. References were found for 7 dyes. Main indications, evidence of effectiveness, administration route, and drug formulation are described for each dye. Conclusions: The number of papers involved is high, but their accessibility is limited. Evidence is overall scarce, but high in cases such as methylene blue for Barrett's esophagus, lugol in the detection of esophageal carcinoma, and indigo carmine for colonic hyperplastic polyp differentiation. Drug compounding is rather simple, but scarcely developed

Artropatía degenerativa en un paciente en hemodiálisis / Degenerative arthropathy in a patient under hemodialysis

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Amiloidosis localizada en vesículas seminales: revisión clínico patológica de 8 casos diagnosticados en material quirúrgico / Amyloidosis of the seminal vesicles: clinical and pathological review of 8 cases diagnosed from surgical specimens

No disponible