[Acute adrenal insufficiency caused by bilateral adrenal hemorrhage as first manifestation of antiphospholipid syndrome. Report of a case and review]. / Insuficiencia suprarrenal aguda por hemorragia suprarrenal bilateral como primera manifestación de un síndrome antifosfolípido. A propósito de un caso y revisión.

Although adrenal hemorrhage is an unusual feature of antiphospholipid syndrome (APS), it can be its first clinical manifestation. The pathogenetic substratum is the thrombosis of the adrenal veins leading to hemorrhagic infarction. Recurrences are frequent in patients with APS-related thrombosis, thus long-term anticoagulation is advocated by most authors.

Insuficiencia suprarrenal aguda por hemorragia suprarrenal bilateral como primera manifestación de un síndrome antifosfolípido. A propósito de un caso y revisión / Acute adrenal insuficiency caused by adrenal hemorrhage as a first manifestation of the antiphospholipid syndrome. A case report and review

La hemorragia suprarrenal (HS) asociada a síndrome antifosfolípido (SAF) en relación con lupus eritematoso sistémico (LES), es poco frecuente. Puede ser la manifestación inicial de la enfermedad. Se invoca como patogenia la trombosis en las venas de drenaje suprarrenales e infarto hemorrágico secundario. El riesgo de trombosis recurrente en estos pacientes es alto. Se aconseja por ello la anticoagulación indefinida (AU)

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Indicaciones y limitaciones de la biopsia de la arteria temporal en la arteritis de Horton / Indications and limitations of the biopsy of temporal artery in Horton's arteritis

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Clinical resolution of Scedosporium prolificans pneumonia associated with treatment with liposomal amphotericin B in a patient with acute leukemia.

Scedosporium prolificans is a filamentous fungus which has been recently identified as the aetiologic agent of severe infections in patients with haematological malignancies. Due to the resistance of S. prolificans to all known antifungals there are very few patients recovering from invasive infections. We describe the case of a patient with acute leukaemia who developed a S. prolificans pneumonia successfully treated with liposomal amphotericin B and who underwent autologous peripheral blood stem cells transplantation. The patient is in good health and has shown no evidence of reactivation of S. prolificans infection over one year after the transplant. Liposomal amphotericin B may be an effective treatment of pneumonia caused by S. prolificans in haematological patients.

[Recurrent polychondritis associated with ulcerative colitis]. / Asociación de policondritis recidivante y colitis ulcerosa.

Relapsing polychondritis and Ulcerative Colitis is an uncommon association that has been described only ten times in medical literature. We report a new case of this association in which it was necessary to treat with azathriopine to stop disease progression. Relapsing Polichondritis is a disorder to be considered in patients with Ulcerative Colitis and inflammation of the cartilagenous structures.

[Severe heart failure and skin lesions caused by Salmonella virchow. Report of a case]. / Insuficiencia cardiaca grave y lesiones cutáneas por Salmonella virchow. A propósito de un caso.

We describe a case of congestive heart failure caused by a Salmonella virchow sepsis. Concurrent with this there were considerable skin lesions. The diagnosis was made as result of stool and skin biopsy culture. There was a good response to treatment.

Severe valvular heart disease in a patient with primary antiphospholipid syndrome.

Valvular replacement was performed in a patient with primary antiphospholipid syndrome and severe mitral insufficiency. The valvular tissue presented thrombotic phenomena and fibrosis with minimum inflammatory component.

[Invasive bronchopulmonary aspergillosis treated with itraconazole in a patient with acute leukemia]. / Aspergilosis broncopulmonar invasiva tratada con itraconazol en una paciente con leucemia aguda.

A case of invasive broncopulmonar aspergillosis caused by Aspergillus terreus successfully treated with itraconazole is reported in a patient undergoing autologous bone marrow transplantation for acute lymphoblastic leukaemia. Although the patient was on prophylaxis with fluconazole and she did not respond to amphotericin B, there was an excellent response to itraconazole which allowed the transplant without any Aspergillus infection during both the transplant and the post-transplant periods. Due to its oral administration, good tolerance and low toxicity, itraconazole is a promising drug for the treatment of invasive broncopulmonar aspergillosis.

[Tricuspid and pulmonary percutaneous valvulopathy in the cardiopathy of the carcinoid syndrome. A case report]. / Valvuloplastia percutánea tricúspide y pulmonar en la cardiopatía del síndrome carcinoide. Presentación de un caso.

We present a 36-year-old woman with a malignant carcinoid syndrome, liver metastases and right heart involvement with severe tricuspid and pulmonic valve stenosis. She was admitted with severe heart failure and poor general status. A combined tricuspid and pulmonic valvuloplasty was performed and she exhibited great clinical improvement that was maintained during the follow-up. We point out the importance of two-dimensional echocardiography in the diagnosis of this pathology and the role of Doppler measurements for the evaluation of the valvuloplasty's results.