Masquerade syndrome: An eye problem as a manifestation of a more sinister disease. / Síndrome de mascarada: un problema ocular como manifestación de un mal mayor.

A middle-aged man with cardiovascular risk factors, who suffered from a slight loss of unilateral vision for 6 months. After obtaining a diagnosis of diffuse choroiditis+papillitis within a probable masquerade syndrome, the patient was referred to outpatient Internal Medicine where this diagnosis was confirmed as an extended neoplastic disease.

[Veno-occlusive liver disease due to intake of Senecio vulgaris tea]. / Enfermedad venooclusiva hepática por ingestión de infusiones de Senecio vulgaris.

Veno-occlusive liver disease (VOLD) is a cause of portal hypertension by non thrombotic obstruction of hepatic venous drainage attributed to multiple etiologies (toxic, irradiation, antineoplastic, conditioning for bone marrow transplantation). One case of VOLD in a senile patient due to continuous two year consumption of Senecio vulgaris tea is reported. This compound, which has a high pyrrolizidine alkaloid content induced a subacute course of portal hypertension and death. The clinicopathologic features of VOLD and the etiopathogenesis in relation to the pyrrolizidine alkaloids present in Senecio vulgaris are discussed. The need for considering the history of medicinal plant ingestion in patients under portal hypertension studies are strongly recommended as is the advice regarding the possible dangers involved in the inappropriate use of remedies provided by herbalists.

[Male with sudden-onset dementia associated with long lasting diarrhea as manifestations of Whipple's disease]. / Varón con demencia de aparición brusca, asociada a diarrea de larga evolución como manifestaciones de la enfermedad de Whipple.

A case of a 55-year old male with Whipple's disease who consulted for dementia (aggressivity, memory loss of recent events, sleep rhythm disturbances) is presented. Furthermore, the patient had referred changes in intestinal movement four years beforehand in addition to erratic arthralgias. Response to treatment (trimethoprim-sulfamethoxazole for one year) was favorable with resolution of both the neurologic and gastrointestinal pictures. The radiologic alterations of this entity are reviewed and suggest that this disease should be considered as a cause of dementia.