ABSTRACT
No disponible
Subject(s)
Female , Humans , Young Adult , Glutens/adverse effects , Diet, Gluten-Free , Ataxia/diet therapy , Celiac Disease/diet therapy , Feeding and Eating Disorders/diet therapy , Conduct Disorder/etiology , Celiac Disease/complicationsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Atrophy/complications , Diarrhea/complications , Diarrhea/diagnosis , Diet, Gluten-Free , Celiac Disease/diagnosis , Celiac Disease/etiology , Collagenous Sprue/complications , Collagenous Sprue/diagnosis , Collagenous Sprue/drug therapy , Adrenal Cortex Hormones/therapeutic use , Immunohistochemistry , Flow Cytometry , Diagnosis, Differential , Celiac Disease/chemically induced , Celiac Disease/physiopathology , Malabsorption Syndromes/complications , Duodenal Diseases/complications , Duodenal Diseases/diagnosis , Duodenum , Duodenum/pathologyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Celiac Disease/chemically induced , Celiac Disease/complications , Celiac Disease/diagnosis , Angiotensin I/adverse effects , Angiotensin I/therapeutic use , Angiotensin II/adverse effects , Angiotensin II/therapeutic use , Diarrhea/complications , Diarrhea/diagnosis , Diarrhea/drug therapy , Hypertension/complications , Hypertension/diagnosis , Clostridioides difficile/isolation & purification , Microscopy, Fluorescence/methods , Fluorescent Antibody Technique, Direct , Diagnosis, DifferentialSubject(s)
Ataxia/etiology , Celiac Disease/complications , Diet, Gluten-Free , Leukoencephalopathies/etiology , Mental Disorders/etiology , Biopsy , Celiac Disease/diagnosis , Celiac Disease/diet therapy , Celiac Disease/psychology , Cross Reactions , Duodenum/pathology , Female , Folic Acid Deficiency/complications , Folic Acid Deficiency/drug therapy , Frontal Lobe/physiopathology , Humans , IgA Deficiency/complications , Iron/therapeutic use , Iron Deficiencies , Leukoencephalopathies/diagnostic imaging , Leukoencephalopathies/physiopathology , Leukoencephalopathies/psychology , Magnetic Resonance Imaging , Mental Disorders/physiopathology , Purkinje Cells/immunology , Tremor/etiology , Young AdultSubject(s)
Antihypertensive Agents/adverse effects , Imidazoles/adverse effects , Malabsorption Syndromes/chemically induced , Tetrazoles/adverse effects , Aged , Antihypertensive Agents/therapeutic use , Atrophy , Celiac Disease/diagnosis , Chronic Disease , Diagnosis, Differential , Diarrhea/chemically induced , Diarrhea/pathology , Duodenum/immunology , Duodenum/pathology , Humans , Hypertension/complications , Hypertension/drug therapy , Imidazoles/therapeutic use , Immunophenotyping , Intestinal Mucosa/ultrastructure , Lymphocyte Subsets/immunology , Malabsorption Syndromes/diagnosis , Malabsorption Syndromes/pathology , Male , Microvilli/pathology , Tetrazoles/therapeutic useSubject(s)
Intestinal Mucosa/ultrastructure , Malabsorption Syndromes/classification , Microvilli/pathology , Atrophy , Autoantibodies/blood , Celiac Disease/diagnosis , Chronic Disease , Collagenous Sprue/diagnosis , Collagenous Sprue/pathology , Common Variable Immunodeficiency/diagnosis , Common Variable Immunodeficiency/pathology , Diagnosis, Differential , Diarrhea/etiology , Duodenum/pathology , Enteritis/diagnosis , Enteritis/pathology , Enterocytes/immunology , Eosinophilia/diagnosis , Eosinophilia/pathology , Gastritis/diagnosis , Gastritis/pathology , Humans , Imidazoles/adverse effects , Malabsorption Syndromes/chemically induced , Malabsorption Syndromes/diagnosis , Malabsorption Syndromes/pathology , Polyendocrinopathies, Autoimmune/diagnosis , Polyendocrinopathies, Autoimmune/pathology , Polyendocrinopathies, Autoimmune/physiopathology , Tetrazoles/adverse effectsABSTRACT
No disponible
Subject(s)
Humans , Glutens/adverse effects , Food Hypersensitivity/diagnosis , Diet, Gluten-FreeABSTRACT
Collagenous sprue is a rare disease of the small bowel characterized by mucosal atrophy and excessive subepithelial collagen deposition. The etiology remains unclear and the diagnosis is based upon patient´s clinical picture and anatomopathological findings. Clinically, collagenous sprue is characterized by persistent diarrhoea, severe malabsorption, multiple nutrient deficiencies and progressive weight loss. Differential diagnosis includes celiac disease, which is mandatory to rule out because of their frequent association. Glutenfree diet is the first therapeutic step, but it usually is not effective. However, recent studies show high success rates with immunomodulators, mainly corticosteroids. We report the case of a patient presenting with chronic diarrhea and severe malabsorption who was diagnosed with collagenous sprue, with no response to gluten free diet, but with excellent response to budesonida.
Subject(s)
Collagenous Sprue/diagnosis , Aged, 80 and over , Chronic Disease , Collagenous Sprue/complications , Connective Tissue , Diarrhea/etiology , Humans , MaleABSTRACT
No disponible
Subject(s)
Humans , Diarrhea/diagnosis , Malabsorption Syndromes/diagnosis , Collagen/adverse effects , Connective Tissue/physiopathology , Risk Factors , Immunologic Factors/therapeutic useABSTRACT
El esprúe colágeno es una patología infrecuente del intestino delgado caracterizada por atrofia de la mucosa y depósito excesivo de colágeno a nivel subepitelial. Su etiología es desconocida y su diagnóstico se realiza en base a la presencia tanto de un cuadro clínico compatible como de hallazgos anatomopatógicos sugestivos. Los pacientes suelen presentar diarrea crónica, malabsorción, deficiencias nutricionales graves y una marcada pérdida ponderal. Dentro del diagnóstico diferencial es mandatorio descartar enfermedad celiaca por su frecuente asociación a la misma. La dieta sin gluten es el primer escalón terapéutico, pero generalmente no es efectiva. Sin embargo, estudios recientes señalan altas tasas de éxito mediante el uso de inmunomoduladores. Presentamos el caso de un paciente con diarrea crónica y malabsorción grave diagnosticado de esprúe colágeno, sin respuesta a la dieta sin gluten, en el que el tratamiento con budesonida ha conseguido una excelente respuesta(AU)
Collagenous sprue is a rare disease of the small bowel characterized by mucosal atrophy and excessive subepithelial collagen deposition. The etiology remains unclear and the diagnosis is based upon patients clinical picture and anatomopathological findings. Clinically, collagenous sprue is characterized by persistent diarrhoea, severe malabsorption, multiple nutrient deficiencies and progressive weight loss. Differential diagnosis includes celiac disease, which is mandatory to rule out because of their frequent association. Gluten-free diet is the first therapeutic step, but it usually is not effective. However, recent studies show high success rates with immunomodulators, mainly corticosteroids. We report the case of a patient presenting with chronic diarrhea and severe malabsorption who was diagnosed with collagenous sprue, with no response to gluten free diet, but with excellent response to budesonida(AU)
Subject(s)
Humans , Male , Aged, 80 and over , Malabsorption Syndromes/complications , Malabsorption Syndromes/diagnosis , Connective Tissue/physiology , Diarrhea/complications , Diarrhea/diagnosis , Diagnosis, Differential , Celiac Disease/complications , Celiac Disease/diagnosis , Celiac Disease/physiopathology , Fibrosis/complications , Fibrosis/diagnosis , Endoscopy/methods , Endoscopy , Immune Tolerance/physiology , Monitoring, ImmunologicSubject(s)
Collagen Diseases/complications , Diarrhea/etiology , Malabsorption Syndromes/etiology , Adrenal Cortex Hormones/therapeutic use , Atrophy , Celiac Disease/diagnosis , Chronic Disease , Collagen/analysis , Collagen Diseases/diagnosis , Collagen Diseases/immunology , Collagen Diseases/pathology , Colorectal Neoplasms/complications , Combined Modality Therapy , Diagnosis, Differential , Diet, Gluten-Free , Female , Fibrosis , Humans , Intestinal Mucosa/chemistry , Intestinal Mucosa/pathology , Intestine, Small/chemistry , Intestine, Small/pathology , Malabsorption Syndromes/diagnosis , Malabsorption Syndromes/epidemiology , Malabsorption Syndromes/immunology , Malabsorption Syndromes/pathology , Malabsorption Syndromes/therapy , Male , Paraneoplastic Syndromes/etiology , PrevalenceABSTRACT
Coeliac disease is a permanent immunological intolerance to gluten proteins in genetically predisposed individuals. The only management is life-long strict adherence to a gluten-free diet. Unfortunately, compliance with gluten-free diet is very difficult in practice due to the widespread presence of gluten in Western diets. For this reason, about 50% of coeliacs following a gluten-free diet continue to suffer from symptoms and present with autoantibodies and/or villous atrophy while on a gluten-free diet. It is therefore important to explore new therapies to improve the management of coeliac disease. To date, five experimental therapies have been tested in randomized and controlled clinical trials. Larazotide acetate reduces the para-cellular passage of gluten to the lamina propria by preventing the opening of intercellular tight junctions. The endopeptidases ALV003 and AN-PEP break down gluten to produce less or non-toxic peptide fragments. A therapeutic vaccine is being tested with the aim of developing gluten tolerance. Finally, infection with the nematode Necator americanus and treatment with the CCR9 antagonist Traficet-EN have also been reported. While substantial progress has been made in the last few years, it is important to remember that all these investigational therapies are in research stage and are generally being considered as "adjunctive" therapies to the gluten-free diet and not as substitutes of the gluten-free diet at this point in time.
Subject(s)
Celiac Disease/therapy , Clinical Trials as Topic , Diet, Gluten-Free , HumansABSTRACT
El diagnóstico de la enfermedad celíaca resistente (ECR) se establece, tras la exclusión de otras entidades, ante la persistencia de datos clínicos de malabsorción y atrofia vellositaria durante 6-12meses a pesar de una estricta dieta sin gluten (DSG). La detección de alteraciones en la población linfocitaria intraepitelial es importante para su diagnóstico. Un subgrupo de pacientes con ECR pueden desarrollar complicaciones severas, como linfoma T asociado a enteropatía (LTAE). Presentamos el caso de un paciente con EC silente de larga evolución que finalmente derivó en LTAE y que evidencia el reto que supone para el clínico tanto el diagnóstico como el tratamiento de esta entidad (AU)
Diagnosis of refractory celiac disease (CD) is based on exclusion of other disorders, persistence of malabsorptive symptoms and villous atrophy, despite a strict gluten-free diet for at least 6-12months. Detection of alterations in the intraepithelial lymphocyte population is crucial for diagnosis. A subgroup of patients with refractory CD may develop severe complications such as enteropathy-associated T cell lymphoma (EATL). We present the case of a patient with longstanding silent CD who developed EALT, highlighting the challenge posed by the diagnosis and treatment of this entity (AU)
Subject(s)
Humans , Male , Middle Aged , Lymphoma, T-Cell/complications , Celiac Disease/complications , Enteropathy-Associated T-Cell Lymphoma/diagnosis , Immunophenotyping , Antineoplastic Agents/therapeutic useABSTRACT
Diagnosis of refractory celiac disease (CD) is based on exclusion of other disorders, persistence of malabsorptive symptoms and villous atrophy, despite a strict gluten-free diet for at least 6-12 months. Detection of alterations in the intraepithelial lymphocyte population is crucial for diagnosis. A subgroup of patients with refractory CD may develop severe complications such as enteropathy-associated T cell lymphoma (EATL). We present the case of a patient with longstanding silent CD who developed EALT, highlighting the challenge posed by the diagnosis and treatment of this entity.
Subject(s)
Enteropathy-Associated T-Cell Lymphoma/diagnosis , Humans , Male , Middle AgedABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Lasers, Gas/therapeutic use , Plummer-Vinson Syndrome/surgery , Argon/therapeutic use , Anemia, Iron-Deficiency/complications , Deglutition Disorders/complications , Esophagus/abnormalitiesABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Adult , /etiology , Stomach Neoplasms/etiology , Acquired Immunodeficiency Syndrome/complications , /drug therapy , Hepatitis B virus , Anti-Retroviral Agents/therapeutic useSubject(s)
Laser Coagulation , Plummer-Vinson Syndrome/surgery , Aged, 80 and over , Argon , Female , HumansSubject(s)
HIV Infections/complications , Sarcoma, Kaposi/complications , Stomach Neoplasms/complications , Adult , Humans , MaleABSTRACT
El síndrome de hipersensibilidad a anticomiciales es una reacción adversa grave e impredecible, inicialmente descrita con antiepilépticos aromáticos, como la carbamacepina, la fenitoína y el fenobarbital. Suele caracterizarse por presencia de fiebre, eosinofilia, erupción cutánea y afectación de uno o más órganos internos. No existen criterios diagnósticos ni normas de tratamiento claramente establecidos. Es necesario un alto índice de sospecha para identificar esta entidad como un verdadero síndrome, suspender precozmente el fármaco implicado y evitar nuevas exposiciones. A continuación comunicamos un ilustrativo caso clínico y revisamos la literatura médica publicada (AU)
Anticonvulsant hypersensitivity syndrome is an unpredictable, potentially fatal drug reaction to aromatic anticonvulsants such as carbamazepine, phenytoin and phenobarbital. The hallmark features include fever, eosinophilia, rash and involvement of one or more internal organs. Clearly established diagnostic criteria and treatment guidelines are lacking. A high index of suspicion is required to identify this syndrome, allowing early withdrawal of the drug and avoiding re-exposure. We report an illustrative case of anticonvulsant hypersensitivity syndrome and review the published literature (AU)