RESUMEN
INTRODUCTION: The incidence of inflammatory bowel disease (IBD) is increasing worldwide. OBJECTIVES: To evaluate the incidence of IBD in Castilla y León describing clinical characteristics of the patients at diagnosis, the type of treatment received and their clinical course during the first year. MATERIALS AND METHODS: Prospective, multicenter and population-based incidence cohort study. Patients aged >18 years diagnosed during 2017 with IBD (Crohn's disease [CD], ulcerative colitis [UC] and indeterminate colitis [IC]) were included from 8 hospitals in Castilla y León. Epidemiological, clinical, and therapeutic variables were registered. The global incidence and disease incidence were calculated. RESULTS: 290 patients were diagnosed with IBD (54.5% UC, 45.2% CD, and 0.3% IC), with a median follow-up of 9 months (range 8-11). The incidence rate of IBD in Castilla y Leon in 2017 was 16.6 cases per 10,000 inhabitants-year (9/105 UC cases and 7.5/105 CD cases), with a UC/CD ratio of 1.2:1. Use of systemic corticosteroids (47% vs 30%; P=.002), immunomodulatory therapy (81% vs 19%; P=.000), biological therapy (29% vs 8%; P=.000), and surgery (11% vs 2%; p=.000) were significatively higher among patients with CD comparing with those with UC. CONCLUSIONS: The incidence of patients with UC in our population increases while the incidence of patients with CD remains stable. Patients with CD present a worse natural history of the disease (use of corticosteroids, immunomodulatory therapy, biological therapy and surgery) compared to patients with UC in the first year of follow-up.
Asunto(s)
Colitis Ulcerosa , Colitis , Enfermedad de Crohn , Enfermedades Inflamatorias del Intestino , Humanos , Incidencia , Estudios Prospectivos , Estudios de Cohortes , Enfermedades Inflamatorias del Intestino/epidemiología , Colitis Ulcerosa/epidemiología , Colitis Ulcerosa/terapia , Colitis Ulcerosa/diagnóstico , Enfermedad de Crohn/diagnóstico , Corticoesteroides/uso terapéuticoRESUMEN
We report a case of chronic infection by Strongyloides stercoralis in a 29-year-old Colombian woman who had been living in Spain for 2 years. The patient had recurrent abdominal pain and malabsorption syndrome. The diagnosis was made through intestinal biopsy in upper gastrointestinal endoscopy. Transport of the parasite through the lung parenchyma (Loeffler syndrome) was visible on simple chest X-ray. Bronchoalveolar lavage, bronchoalveolar aspirate and repeated stool examination were negative.
Asunto(s)
Síndromes de Malabsorción/complicaciones , Eosinofilia Pulmonar/complicaciones , Strongyloides stercoralis/aislamiento & purificación , Estrongiloidiasis/complicaciones , Adulto , Animales , Femenino , Humanos , Estrongiloidiasis/diagnósticoRESUMEN
Presentamos un caso de infección crónica por Strongyloides stercoralis en una mujer de 29 años de edad, natural de Colombia, con 2 años de residencia en España. Presentaba dolor abdominal recurrente y síndrome de malabsorción. El diagnóstico fue obtenido a través de biopsia duodenal con endoscopia digestiva alta. En nuestra paciente se pudo observar el paso del parásito a través del parénquima pulmonar mediante radiografías simple de tórax, fenómeno conocido como síndrome de Loeffler. Tanto el lavado como el aspirado broncoalveolar fueron negativos, así como los parásitos en heces
We report a case of chronic infection by Strongyloides stercoralis in a 29-year-old Colombian woman who had been living in Spain for 2 years. The patient had recurrent abdominal pain and malabsorption syndrome. The diagnosis was made through intestinal biopsy in upper gastrointestinal endoscopy. Transport of the parasite through the lung parenchyma (Loeffler syndrome) was visible on simple chest X-ray. Bronchoalveolar lavage, bronchoalveolar aspirate and repeated stool examination were negative