RESUMEN
To evaluate KL-6 levels in medium-term post-COVID and to compare them in three groups categorised by the severity of COVID-19, we conducted a real-world, retrospective, cohort study. Data from the COVID-19 episode and follow-up during the post-COVID phase were extracted from the COVID@HULP and POSTCOVID@HULP databases, respectively. For the post-COVID period we included demographics, medical history, symptoms, quality of life, physical activity, anxiety and depression status and laboratory results. Patients were categorised into three groups based on the severity of COVID-19: Group 1 (inpatient critical), Group 2 (inpatient non-critical) and Group 3 (hospitalised at home). KL-6 was measured during the follow-up of the three groups. In all, 802 patients were included (Group 1 = 59; Group 2 = 296; Group 3 = 447 patients). The median age was 59 years (48-70), and 362 (45.2%) were males. At admission, fibrinogen and ferritin levels were lower in Group 3 than in the other groups (p < 0.001). Follow-up data were obtained 124 days (97-149) after the diagnosis of COVID-19. The median levels of fibrinogen, ferritin and KL-6 at follow-up were 336 mg/dL (276-413), 80.5 ng/mL (36-174.3) and 326 U/mL (240.3-440.3), respectively. KL-6 levels were lower in Group 3 than in the other groups (298 U/mL (231.5-398) vs. 381.5 U/mL (304-511.8) (Group 1) and 372 U/mL (249-483) (Group 2) (p < 0.001)). KL-6 was associated with ferritin (p < 0.001), fibrinogen (p < 0.001), D-dimer (p < 0.001) and gamma-glutamyl transferase (p < 0.001). KL-6 levels are less elevated at medium-term post-COVID follow-up in patients with mild COVID-19 than in those with moderate or severe disease. KL-6 is associated with systemic inflammatory, hepatic enzyme and thrombosis biomarkers.
Asunto(s)
Pruebas de Coagulación Sanguínea , Colonoscopía , Hemorragia Gastrointestinal/prevención & control , Trastornos Hemorrágicos/diagnóstico , Cuidados Preoperatorios/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Pruebas de Coagulación Sanguínea/estadística & datos numéricos , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/prevención & control , Neoplasias del Colon/cirugía , Pólipos del Colon/diagnóstico , Pólipos del Colon/cirugía , Colonoscopía/efectos adversos , Comorbilidad , Femenino , Hemorragia Gastrointestinal/etiología , Trastornos Hemorrágicos/complicaciones , Humanos , Enfermedades Intestinales/diagnóstico , Masculino , Persona de Mediana Edad , Factores de Riesgo , Procedimientos Innecesarios , Adulto JovenRESUMEN
El síndrome de Cronkhite-Canada es una poliposis no adenomatosa, adquirida e infrecuente que asocia alteraciones ectodérmicas, de la cual desconocemos la etiopatogenia y el manejo terapéutico óptimo. Presentamos un caso de síndrome de Cronkhite-Canada en un varón de 58 años de edad que, tras el tratamiento combinado con corticoides, cromoglicato disódico, loratadina, ciprofloxacino y cinc, obtuvo la remisión clínica y endoscópica parcial. Las lesiones polipoides del síndrome de Cronkhite-Canada pueden revertir con tratamiento médico, por lo que es posible modificar la historia natural de la enfermedad y mejorar su pronóstico
Cronkhite-Canada syndrome is an infrequent, nonadenomatous, acquired polyposis that is associated with ectodermic alterations. The etiopathogenesis and optimal therapeutic management are unknown. We present a case of Cronkhite-Canada syndrome in a 58-year-old man who, after combined treatment with corticosteroids, disodium cromoglycate, loratadine, ciprofloxacin, and zinc, showed complete clinical and partial endoscopic remission. The polypoid lesions of Cronkhite-Canada syndrome can be reversed with medical treatment. Consequently, the natural history of the disease can be modified and its prognosis improved
Asunto(s)
Masculino , Persona de Mediana Edad , Humanos , Poliposis Intestinal/diagnóstico , Poliposis Intestinal/tratamiento farmacológico , Resultado del Tratamiento , Quimioterapia CombinadaRESUMEN
Cronkhite-Canada syndrome is an infrequent, nonadenomatous, acquired polyposis that is associated with ectodermic alterations. The etiopathogenesis and optimal therapeutic management are unknown. We present a case of Cronkhite-Canada syndrome in a 58-year-old man who, after combined treatment with corticosteroids, disodium cromoglycate, loratadine, ciprofloxacin, and zinc, showed complete clinical and partial endoscopic remission. The polypoid lesions of Cronkhite-Canada syndrome can be reversed with medical treatment. Consequently, the natural history of the disease can be modified and its prognosis improved.
Asunto(s)
Poliposis Intestinal/tratamiento farmacológico , Humanos , Poliposis Intestinal/diagnóstico , Masculino , Persona de Mediana Edad , Inducción de RemisiónRESUMEN
FUNDAMENTO: Relacionar los cambios hemodinámicos renales, valorados por ecografía Doppler, con el desarrollo de ascitis, función renal y sistemas vasoactivos endógenos en pacientes con cirrosis hepática. PACIENTES Y MÉTODO: Se estudiaron de formas prospectiva 60 pacientes cirróticos, 31 compensados y 29 con ascitis. Se determinaron el índice de resistencia renal, la función renal y los valores plasmáticos de actividad de renina, aldosterona, noradrenalina y hormona antidiurética. RESULTADOS: El índice de resistencia renal fue significativamente superior en los pacientes cirróticos con ascitis (0,68) que en los cirróticos compensados (0,63) y se correlacionó significativamente con las concentraciones séricas de creatinina, excreción urinaria de sodio, actividad de renina plasmática y concentración plasmática de aldosterona. CONCLUSIONES: El índice de resistencia renal, determinado por ecografía Doppler, se eleva progresivamente con la evolución de la cirrosis hepática, con el empeoramiento de la función renal y con la activación de los sistemas vasoactivos endógenos (AU)
