[Severe hepatitis from therapeutic doses of paracetamol in an alcoholic patient]. / Hepatitis grave por dosis terapéuticas de paracetamol en un paciente alcohólico.

The case of a 36-year-old chronic alcoholic patient who came to the hospital for presenting general bad shape, arthromyalgia and jaundice and who developed severe hepatitis with an extreme elevation in the transaminase levels following the consumption of therapeutic doses of paracetamol (3 g/day for 4 days). The possibility of other causes of hepatitis were duly discarded. Liver biopsy showed confluent centrolobular necrosis compatible with the diagnosis of toxic hepatitis. The patient was discharged from hospital in stable condition and with a slight alteration in the transaminase levels. Recognizing hepatotoxicity by paracetamol in alcoholics is simple if the clinical history, the marked transaminase elevation and the history of paracetamol intake are adequately evaluated. Lower doses of paracetamol or even avoidance of this drug is recommended in circumstances in which the toxicity of the drug may be potentiated by chronic alcohol consumption or by the lack of appetite associated with deficient alimentation.

[Tracheobronchomegaly associated with light chain deposition disease]. / Traqueobroncomegalia asociada a enfermedad por depósito de cadenas ligeras.

Tracheobronchomegaly, also known as Mounier-Kühn's Syndrome, is characterized by market dilation of the trachea and main bronchi and has been reported in association with several conditions, particularly connective tissue disease. The pathogenesis and clinical signs of light chain deposition disease are similar to those of light chain amyloidosis, in which these chains are deposited as amorphous material lacking the tinctorial features of the amyloid. We present a case involving both entities, an association that has not been previously reported, and we review the main characteristics of both diseases.