RESUMEN
Ulcerative proctitis (UP) is often involved in the diagnosis of inflammatory bowel disease (IBD). The increase of leukocytes and pro-inflammatory factors in peripheral blood and in the active forms, as well as the infiltration of neutrophils and monocytes/macrophages in the intestinal mucosa is known to occur in this entity. This infiltration of cells damages the mucosa due to the liberation of proteases, oxidation radicals and cytokines, among others. Apheresis techniques such as leukocyte apheresis may be used among the different therapeutic options such as steroids, sulfasalazine, 5-aminosalicylic, tacrolimus, azathioprine, cyclosporine, mycophenolate and biological agents.
Asunto(s)
Procedimientos de Reducción del Leucocitos , Proctitis/terapia , Úlcera/terapia , Anciano , Humanos , Procedimientos de Reducción del Leucocitos/métodos , Masculino , Enfermedades del Recto/terapia , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Intubación Gastrointestinal , Silicatos , Humanos , Silicatos/administración & dosificación , Masculino , FemeninoAsunto(s)
Instituciones de Atención Ambulatoria , Bacteriemia/epidemiología , Brotes de Enfermedades , Infecciones por Enterobacteriaceae/epidemiología , Pantoea , Diálisis Renal , Microbiología del Agua , Abastecimiento de Agua , Anciano , Anciano de 80 o más Años , Bacteriemia/microbiología , Infecciones por Enterobacteriaceae/microbiología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AA (secondary) amyloidosis is one of the most severe and uncommon complications of several rheumatic disorders and chronic infections such as tuberculosis (TB). Successful treatment depends on the control of the underlying inflammatory process, what can lead to an improvement or a regression in organ dysfunction. If the disorder persists, it has been reported in some cases of AA amyloidosis secondary to rheumatic diseases, that the use of biologic therapy is so far the only opportunity to reduce the development of AA amyloidosis and to reverse established deposits. We report herein a case of a latent TB infection complicated by a life-threatening AA amyloidosis presented as nephrotic syndrome. After an adequate antituberculostatic treatment, AA amyloidosis remained active and Tocilizumab (TCZ) was started with a dramatic resolution of the proteinuria, stabilization of the amyloid deposits and improvement in general condition.