RESUMEN
Patients with immune-mediated inflammatory diseases are prone to steatotic liver disease (SLD), which has been observed in patients with psoriasis and hidradenitis suppurativa. We aimed to assess whether systemic lupus erythematosus (SLE) was associated with SLD and to define factors associated with SLD in SLE. This was a cross-sectional study, we included 106 consecutive patients with SLE who were seen in the rheumatology clinic between June 2021 and March 2022 and we chose two sex-paired controls for each SLE. All the participants underwent FibroScan and anthropometric assessments. SLD was defined as a controlled attenuation parameter ≥ 275dB/m. Prevalence of SLD was lower in patients with SLE (21.7% vs 41.5%, p < 0.001). Patients with SLE and SLD had a lower frequency of hydroxychloroquine use (65% vs 84%, p = 0.04), and higher C3 levels [123mg/dl (IQR 102-136) vs 99mg/dl (IQR 78-121), p = 0.004]. Factors associated with SLD in SLE were body mass index (BMI), waist circumference, glucose, and C3; hydroxychloroquine use was a protective factor. On univariate analysis, SLE was associated with a reduced risk of SLD (OR 0.39, 95%CI 0.23-0.67); however, after adjusting for age, BMI, waist, glucose, triglycerides, high-density cholesterol, low-density cholesterol, leukocytes, and hydroxychloroquine, it was no longer associated (OR 0.43, 95%CI 0.10-1.91). In conclusion, the prevalence of SLD in patients with SLE was not higher than that in the general population, and SLE was not associated with SLD. The factors associated with SLD were anthropometric data, glucose, hydroxychloroquine, and C3 levels.
Asunto(s)
Hidroxicloroquina , Lupus Eritematoso Sistémico , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/tratamiento farmacológico , Femenino , Masculino , Estudios Transversales , Adulto , Persona de Mediana Edad , Hidroxicloroquina/uso terapéutico , Hígado Graso/epidemiología , Hígado Graso/complicaciones , Índice de Masa Corporal , Prevalencia , Factores de Riesgo , Circunferencia de la Cintura , Complemento C3/metabolismo , Complemento C3/análisisRESUMEN
A 38-year-old male with established diagnosis of stage IV squamous cell carcinoma of the esophagus treated with chemoradiotherapy (25 sessions of 50 Gy), presented with acute aphagia, thoracic pain, productive cough, and mild hemoptysis. Upon physical examination the right hemithorax presented with crepitations. An initial CT scan showed an esophageal perforation. An upper endoscopy was performed, visualizing the esophageal perforation in the mid third of the esophagus at 26 cm of the dental arcade. It was possible to bypass and intubate the stomach, enabling the placement of a guide wire under endoscopic visualization. Afterwards, a partially covered, self-expandable, metal stent (Wallflex esophageal stent 10 cm/18/23; Boston Scientific) was placed in the esophagus restoring continuity, visualized by fluoroscopy.
Asunto(s)
Neoplasias Esofágicas , Perforación del Esófago , Masculino , Humanos , Adulto , Perforación del Esófago/diagnóstico por imagen , Perforación del Esófago/etiología , Perforación del Esófago/terapia , Neoplasias Esofágicas/terapia , Endoscopía , Stents/efectos adversos , Quimioradioterapia/efectos adversosRESUMEN
Epitheloid hemangioendothelioma is a very rare tumor, with a variable presentation and unpredictable clinical behavior. The etiology and the triggering risk factors have not been specified. Unlike other primary liver tumors, it does not arise in the background of chronic liver disease. The approach is challenging due to the spectrum of possibilities and the need for immunohistochemistry to establish the definitive diagnosis. The information available so far is limited due to the few published cases, this favors that the therapeutic options are few or that there is insufficient evidence to standardize them when the lesion is not resectable.
El hemangioendotelioma epiteloide es un tumor muy infrecuente, con una presentación variable y un comportamiento clínico impredecible. No se han precisado la etiología ni los factores de riesgo desencadenantes. A diferencia de otros tumores hepáticos primarios, no surge en el contexto de una enfermedad crónica del hígado. El abordaje es un reto debido al espectro de posibilidades y la necesidad de inmunohistoquímica para establecer el diagnóstico definitivo. La información disponible hasta el momento es limitada por los escasos casos publicados, lo que favorece que las opciones terapéuticas sean pocas o no exista la evidencia suficiente para estandarizarlas cuando la lesión no sea resecable.
Asunto(s)
Hemangioendotelioma Epitelioide , Neoplasias Hepáticas , Neoplasias Vasculares , Hemangioendotelioma Epitelioide/diagnóstico , Hemangioendotelioma Epitelioide/cirugía , Humanos , Inmunohistoquímica , Neoplasias Hepáticas/diagnósticoAsunto(s)
Pancreatitis , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pancreatitis/diagnóstico , Pancreatitis/mortalidad , Pancreatitis/terapia , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
No disponible.
Asunto(s)
COVID-19 , Trasplante de Hígado , Vacunas Virales , Anticuerpos Antivirales , Vacunas contra la COVID-19 , Humanos , SARS-CoV-2RESUMEN
La fibromatosis tipo desmoide es un tumor benigno de suma rareza con características localmente agresivas. Se desarrolla en especial en tejidos blandos por su origen en los músculos y las aponeurosis. El diagnóstico se establece por inmunohistoquímica con positividad para vimentina, B-catenina y en ocasiones para actina de músculo liso. El espectro clínico de presentación es amplio, y según este y la resecabilidad se ofrece el tratamiento. Presentamos el caso de una paciente con síntomas de obstrucción al vaciamiento gástrico secundaria a una lesión subepitelial en cuerpo con inmunohistoquímica concluyente para fibromatosis gástrica.Desmoid-type fibromatosis is an extremely rare benign tumor with locally aggressive features. It is predominantly developing in soft tissues due to its origin in muscles and aponeurosis. The diagnosis is established by immunohistochemistry with positivity for vimentin, B-catenin and sometimes for smooth muscle actin. The clinical spectrum of presentation is wide, based on this and resectability the treatment is offered. We present the case of a patient with symptoms of gastric outlet obstruction secondary to a subepithelial lesion in the gastric body with conclusive immunohistochemistry for gastric fibromatosis.
