Interleucina-18 (IL-18) y otros parámetros inmunológicos como marcadores de gravedad en la pancreatitis aguda / No disponible

Objetivo: se trata de comparar prospectivamente el comportamientodurante la primera semana del ingreso de los niveles de interleucina-18 (IL-18), y otros parámetros inmunológicos entre pacientescon pancreatitis aguda con y sin criterios de gravedad, así comoentre pacientes con y sin desarrollo ulterior de seudoquiste.Pacientes y métodos: se compararon en 36 pacientes conpancreatitis aguda los resultados de sTNF-RI, IL-1Ra, IL-6 e IL-18los días 1, 2, 3 y 7 desde el ingreso entre pancretitis leve, grave y ungrupo control (13 pacientes) con cólico biliar simple, así como entrepacientes con o sin seudoquiste.Resultados: al comparar pancreatitis leve con grave, IL-18 fuesignificativamente superior sólo el primer día en las pancreatitis gravesy los otros parámetros a partir del segundo día de forma mantenida.También en pacientes que desarrollaron seudoquiste, IL-18 estuvosignificativamente elevada el primer día.Conclusiones: IL-18 resultó el marcador más precoz de complicacionesy gravedad de la pancreatitis aguda a nivel sistémico y local(seudoquiste)

Objective: our aim was to prospectively compare the behaviorof interleukin 18 (IL-18) levels and other immunological parametersduring the first week of hospitalization between acute pancreatitispatients with and without severity criteria, as well asbetween patients with and without late pseudocyst development.Patients and methods: in 36 patients with acute pancreatitiswe compared sTNF-RI, IL-1Ra, IL-6, and IL-18 levels at days1, 2, 3 and 7 after hospitalization between mild pancreatitis, severepancreatitis, and a “control” group (13 patients) with uncomplicatedbiliary colic, as well as between patients with and withoutpseudocyst.Results: on comparing mild to severe pancreatitis, IL-18 wassignificantly higher only the first day in severe pancreatitis, whilethe other parameters were steadily higher after the second day. Inpatients developing pseudocyst, IL-18 was also noticeably higherthe first day.Conclusions: IL-18 appears to be the earliest marker of complicationsand severity in acute pancreatitis at both the systemicand local level (pseudocyst)

Esofagitis necrotizante aguda. Una patología poco conocida / No disponible

La esofagitis necrotizante aguda (ENA) es una rara entidadcuya etiología es desconocida, siendo el mecanismo patogénicomultifactorial, participando fundamentalmente el compromiso isquémico,la malnutrición y la obstrucción del tracto digestivo alto.Los hallazgos endoscópicos muestran una coloración negruzca dela mucosa esofágica con transición brusca a nivel de la unión esofagogástrica.El pronóstico depende de las enfermedades de base.Se revisan los casos de ENA, excluyendo los secundarios a caústicos,recogidos de forma retrospectiva durante los últimos 2 años.Se analizan los factores de riesgo, la presentación clínica, los hallazgosendoscópicos, la histología, el tratamiento y la evolución.En nuestro departamento, se han diagnosticado 7 casos de ENAen 6.003 gastroscopias realizadas en el periodo de estudio, representandoasí la ENA el 0,11% de la exploraciones

Acute esophageal necrosis is a rare disorder, and its etiology isunknown, the mechanism of damage being usually multifactorialand secondary to ischemic compromise, acute gastric outlet obstruction,and malnutrition. Endoscopic findings show circumferentialblack discoloration of the distal esophagus with proximal extensionending sharply at the gastroesophageal junction, which isthe most common presentation. Prognosis depends on comorbidillnesses. In this study we analyze all cases reported in a retrospectiveanalysis over a 2-year period to define risk factors, clinicalpresentation, endoscopic features, histological appearance, treatmentand outcome. Our department has recorded 7 cases from6,003 endoscopies performed in the last 2 years. The finding of a"black esophagus" represented 0.11% of cases

[Interleukin 18 (IL-18) and other immunological parameters as markers of severity in acute pancreatitis]. / Interleucina-18 (IL-18) y otros parámetros inmunológicos como marcadores de gravedad en la pancreatitis aguda.

OBJECTIVE: Our aim was to prospectively compare the behavior of interleukin 18 (IL-18) levels and other immunological parameters during the first week of hospitalization between acute pancreatitis patients with and without severity criteria, as well as between patients with and without late pseudocyst development. PATIENTS AND METHODS: In 36 patients with acute pancreatis we compared sTNF-RI, IL-1Ra, IL-6, and IL-18 levels at days 1, 2, 3 and 7 after hospitalization between mild pancreatitis, severe pancreatitis, and a "control" group (13 patients) with uncomplicated biliary colic, as well as between patients with and without pseudocyst. RESULTS: On comparing mild to severe pancreatitis, IL-18 was significantly higher only the first day in severe pancreatitis, while the other parameters were steadily higher after the second day. In patients developing pseudocyst, IL-18 was also noticeably higher the first day. CONCLUSIONS: IL-18 appears to be the earliest marker of complications and severity in acute pancreatitis at both the systemic and local level (pseudocyst).

[Acute esophageal necrosis. An underdiagnosed disease]. / Esofagitis necrotizante aguda. Una patología poco conocida.

Acute esophageal necrosis is a rare disorder, and its etiology is unknown, the mechanism of damage being usually multifactorial and secondary to ischemic compromise, acute gastric outlet obstruction, and malnutrition. Endoscopic findings show circumferential black discoloration of the distal esophagus with proximal extension ending sharply at the gastroesophageal junction, which is the most common presentation. Prognosis depends on comorbid illnesses. In this study we analyze all cases reported in a retrospective analysis over a 2-year period to define risk factors, clinical presentation, endoscopic features, histological appearance, treatment and outcome. Our department has recorded 7 cases from 6,003 endoscopies performed in the last 2 years. The finding of a "black esophagus" represented 0.11% of cases.