RESUMEN
An adult male patient was admitted for a pericardial effusion occurring during a longstanding mesalazine treatment for Crohn's disease. The relation between the drug's administration, symptoms and ECG changes suggests that the pericardial injury was caused by mesalazine. Also, the rapid resolution of clinical signs and ECG changes following the drug withdrawal were in agreement with this hypothesis. Eight months later, the patient remains well and symptom-free, and ECG and echocardiographic control were normal.
Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Mesalamina/efectos adversos , Pericarditis/inducido químicamente , Enfermedad de Crohn/tratamiento farmacológico , Ecocardiografía , Electrocardiografía , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pericarditis/diagnóstico por imagenRESUMEN
We report a case of pseudotumoral nodular lymphoid hyperplasia of the ileum in an immunocompetent 62-year-old woman. Ileoscopy showed multiple voluminous, soft, pliable, polypoid ileal lesions. Perendoscopic biopsies revealed a florid inflammation of the mucosa, characterised by numerous enlarged follicles with well-developed reactive germinal centres separated by a mixed infiltrate of lymphocytes, plasma cells and eosinophils. Immunohistochemistry showed a polytypic staining for kappa and lambda light-chains in the follicles and between and confirmed the reactive nature of the infiltrate. CT scan of the abdomen disclosed large periileal lymph nodes and a right ileocolectomy was performed. Twelve cases of pseudotumoral nodular lymphoid hyperplasia of the ileum have been reported in the literature in patients older than 25. In all cases, the diagnosis was performed after laparotomy. As shown in our case report, the diagnosis is possible on multiple perendoscopic biopsies.