[The autoimmune hepatitis-primary biliary cirrhosis overlap syndrome: a case report]. / Síndrome overlap hepatitis autoinmune-cirrosis biliar primaria: a propósito de un caso.

The autoimmune hepatitis-primary biliary cirrhosis overlap syndrome is an entity characterized by clinical, analytical, immunological and histological manifestations of both entities. We present the case of a 26-year-old woman with a serious acute hepatitis that fulfills the diagnostic criteria of the overlap syndrome and that showed a satisfactory response to oral corticoid therapy.

[Tuberculous peritonitis: a Third World's disease?]. / Peritonitis tuberculosa: ¿una enfermedad del tercer mundo?

Tuberculous peritonitis has a high morbidity and mortality. The clinical outcome of tuberculous peritonitis depends on an early diagnosis and treatment. We review five cases of tuberculous peritonitis diagnosed in a short stay medical unit over a one-year period. All patients were successfully treated with antituberculous drugs. The clinical management of this disease is described and current views regarding the value of computed tomography and other diagnostic techniques are discussed.

Isoniazid-induced hyperacute liver failure in a young patient receiving carbamazepine.

A 16-year-old female under long-term carbamazepine and clobazam therapy developed fulminant liver failure after initiating therapy with isoniazid, rifampin, and pirazinamide for intestinal tuberculosis. Liver failure was hyperacute (with a minimal interval between jaundice and encephalopathy) and occurred very shortly (5 days) after the start of antituberculous therapy. The patient recovered completely with conservative measures. Later, she tolerated carbamazepine, clobazam, rifampin, and pirazinamide without problems, thus confirming that liver failure was isoniazid-induced. Drug interaction between isoniazid and carbamazepine could explain the atypical presentation of this case.

[Complications and yield of percutaneous liver biopsy with ultrasonographic marking]. / Complicaciones y rendimiento de la biopsia hepática percutánea con marcado ecográfico.

OBJECTIVES: To describe the complications and the diagnostic yield of percutaneous liver biopsies performed under ultrasonographic control in an Internal Medicine department. PATIENTS AND METHODS: A total of 750 percutaneous liver biopsies were performed at the Internal Medicine department of our institution during the 1995-2001 time period. The Menghini technique was employed previous ultrasonographic marking of the puncture site was performed by the same physicians who performed the biopsy. Major and minor complications as well as the diagnostic yield (obtention of diagnostic hepatic tissue) of the technique were recorded. RESULTS: No deaths occurred in our series. Two patients (0.3%) had major complications presenting as liver subcapsular hematoma with hemoperitoneum which resolved with conservative measures. One of them was a male patient with acute leukemia and the other was a woman on antiaggregant therapy. Eight patients (1.1%) had minor complications (vasovagal syncope), all of them young males. In three cases no adequate material for diagnosis was obtained (technique yield 99.6%). CONCLUSIONS: In our series, percutaneous liver biopsy with ultrasonographic marking is a diagnostic technique associated with a low rate of severe complications and with a high diagnostic yield. The use of ultrasonographic marking by the same physicians performed the biopsy does not involve a longer time or increased cost of the technique, provides more safety in the procedure and has a low morbidity rate. This procedure could be used on a routine basis for all percutaneous liver biopsies.

Síndrome overlap hepatitis autoinmune-cirrosis biliar primaria: a propósito de un caso / The autoinmune hepatitis-primary biliary cirrhosis overlap syndrome: a case report

El síndrome overlap hepatitis autoinmune- cirrosis biliar primaria es una entidad caracterizada por manifestaciones clínicas, analíticas, inmunológicas e histológicas de ambas entidades. Presentamos el caso de una mujer de 26 años con una hepatitis aguda grave que cumple los criterios diagnósticos del síndrome de superposición y que respondió de forma satisfactoria al tratamiento con corticoides orales

The autoinmune hepatitis-primary biliary cirrhosis overlap syndrome is an entity characterized by clinical, analytical, immunological and histological manifestations of both entities. We present the case of a 26-year-old woman with a serious acute hepatitis that fulfills the diagnostic criteria of the overlap syndrome and that showed a satisfactory response to oral corticoid therapy

Piomiositis del esternocleidomastoideo / Esternocleidomastoid pyomyositis

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Pileflebitis idiopática en paciente con mutación del factor V Leiden / Idiopathic pylephlebitis in patient with factor V Leiden mutation

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Hipotiroidismo y miositis por lovastina / Hypothyroidism and lovastatin-induced myositis

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Orquiepididimitis brucelosica / Brucella epididymo-orchitis

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Lesiones osteolíticas como forma de presentación de linfoma no Hodgkin / Osteolitic lesions as non-Hodgkin lymphoma presentation form

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Disección espontánea de la arteria carótida interna / Spontaneous dissection of the internal carotid artery

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Peritonitis tuberculosa: ¿una enfermedad del Tercer Mundo? / Tuberculous peritonitis: a Third World's disease?

La tuberculosis peritoneal todavía causa una importante morbi-mortalidad. La evolución clínica de la enfermedad depende de la rapidez en el diagnóstico y en el inicio del tratamiento. Hemos revisado cinco casos de tuberculosis peritoneal diagnosticados en una unidad médica de corta estancia durante el período de un año. Todos los pacientes respondieron favorablemente al tratamiento. Se discute el manejo clínico de la tuberculosis peritoneal y se revisa el papel actual de la tomografía computerizada y otras técnicas en el diagnóstico de esta enfermedad (AU)