[Peripheral arterial thromboembolism in Crohn's disease]. / Tromboembolia arterial periférica en enfermedad de Crohn.

INTRODUCTION: Inflammatory Bowel Disease (IBD) usually affects the gastrointestinal tract, although some patients can also develop extraintestinal manifestations, such as vascular symptoms both venous and arterial ones. The former being more frequent than the latter. CLINICAL REPORT: We report the case of a 62-year-old male, diagnosed of Crohns disease (CD) (A3,L1+L4,B3), admitted to hospital for treatment of a retroperitoneal abscess. He presented a peripheral arterial thromboembolism during his stay, which required urgent embolectomy. After anticoagulation with low-molecular-weight heparin (LMWH), vascular magnetic resonance imaging revealed a large thrombus involving the descent aorta, which was solved with surgery and long-term anticoagulation. CONCLUSION: Peripheral arterial thrombosis is a rare extraintestinal manifestation of IBD. Nevertheless it is always important to consider it in patients with IBD. Prophylactic treatment should be made with low-molecular-weight heparin (LMWH) and definitive treatment with a combination of LMWH and surgery.

[Mesalazine renal lithiasis.] / Nefrolitiasis por Mesalazina.

Mesalazine (5-aminosalicylic acid, 5-ASA),is an anti-inflammatory drug well-established as first-line treatment in the management of inflammatory bowel disease. Nephritic colic has been described as an uncommonside effect, but very few mesalazine nephrolithiasis have been published in the literature, probably due to its underdiagnosis for not using appropriate methodology for calculi analysis. We present two cases of lithiasis in patients treated with mesalazine at high dosage, an adverse effect to betaken into account as a drug lithiasis and which is not even mentioned in the patient information leaflet.

La mesalazina (ácido 5-aminosalicilico,5-ASA) es un fármaco antiinflamatorio utilizado en primera línea del tratamiento de la enfermedad inflamatoria intestinal. Aunque se ha descrito la presentación de cólicos nefríticos como efecto adverso con su uso, apenas se encuentran publicados casos de nefrolitiasis medicamentosa por mesalazina, probablemente infradiagnósticado por no utilizar la metodología adecuada para el análisis de los cálculos. Presentamos dos casos de litiasis en dos pacientes tratados a altas dosis de mesalazina, efecto adversoa tener en cuenta y que ni siquiera es citado en la ficha técnica del medicamento.

Nefrolitiasis por Mesalazina / Mesalazine renal lithiasis

La mesalazina (ácido 5-aminosalicilico,5-ASA) es un fármaco antiinflamatorio utilizado en primera línea del tratamiento de la enfermedad inflamatoria intestinal. Aunque se ha descrito la presentación de cólicos nefríticos como efecto adverso con su uso, apenas se encuentran publicados casos de nefrolitiasis medicamentosa por mesalazina, probablemente infradiagnósticado por no utilizar la metodología adecuada para el análisis de los cálculos. Presentamos dos casos de litiasis en dos pacientes tratados a altas dosis de mesalazina, efecto adverso a tener en cuenta y que ni siquiera es citado en la ficha técnica del medicamento

Mesalazine (5-aminosalicylic acid, 5-ASA), is an anti-inflammatory drug well-established as first-line treatment in the management of inflammatory bowel disease. Nephritic colic has been described as an uncommon side effect, but very few mesalazine nephrolithiasis have been published in the literature, probably due to its underdiagnosis for not using appropriate methodology for calculi analysis. We present two cases of lithiasis in patients treated with mesalazine at high dosage, an adverse effect to be taken into account as a drug lithiasis and which is not even mentioned in the patient information leaflet

Tromboembolia arterial periférica en enfermedad de Crohn / Peripheral arterial thromboembolism in Crohn's disease

Introducción Los fenómenos tromboembólicos venosos y arteriales son una complicación extraintestinal infrecuente de la enfermedad inflamatoria intestinal (EII) potencialmente prevenible. Caso clínico Varón de 62 años, con diagnóstico de enfermedad de Crohn (EC) (A3, L1+L4, B3) que durante su ingreso para drenaje percutáneo de absceso retroperitoneal presenta episodio de tromboembolia arterial periférica de miembro superior derecho, que requirió embolectomía urgente. Tras anticoagulación con heparina de bajo peso molecular (HBPM), se realiza estudio etiológico con hallazgo en la resonancia magnética vascular de un trombo arterial de gran tamaño en la aorta descendente, por lo que se realizó cirugía aórtica y se pautó anticoagulación indefinida con acenocumarol. Conclusión La trombosis arterial periférica es una complicación poco común de la EII que debe ser considerada en pacientes con enfermedad activa y prevenida adecuadamente con HBPM. El tratamiento habitual es la cirugía combinada con anticoagulación y optimización de la terapia farmacológica(AU)

Introduction Inflammatory Bowel Disease (IBD) usually affects the gastrointestinal tract, although some patients can also develop extraintestinal manifestations, such as vascular symptoms both venous and arterial ones. The former being more frequent than the latter. Clinical report We report the case of a 62-year-old male, diagnosed of Crohns disease (CD) (A3,L1+L4,B3), admitted to hospital for treatment of a retroperitoneal abscess. He presented a peripheral arterial thromboembolism during his stay, which required urgent embolectomy. After anticoagulation with low-molecular-weight heparin (LMWH), vascular magnetic resonance imaging revealed a large thrombus involving the descent aorta, which was solved with surgery and long-term anticoagulation. Conclusion Peripheral arterial thrombosis is a rare extraintestinal manifestation of IBD. Nevertheless it is always important to consider it in patients with IBD. Prophylactic treatment should be made with low-molecular-weight heparin (LMWH) and definitive treatment with a combination of LMWH and surgery (AU)