Penfigoide ampolloso en lactante tras vacunación / Bullous pemphigoid in an infant after vaccination

El penfigoide ampolloso es una enfermedad que característicamente afecta a personas de edad avanzada aunque se han descrito casos en niños. Presentamos un caso de penfigoide ampolloso en una lactante de 2 meses de vida con lesiones ampollosas en palmas y plantas, que aparecieron una semana después de recibir la primera dosis de la vacuna contra la hepatitis B, poliomielitis, difteria-tétanos-pertussis (DTP) y Haemophilus. Recibió tratamiento con agua sulfatada, dexametasona y ácido fusídico, con lo que desaparecieron las lesiones. Un mes después presentó un nuevo brote, más generalizado, a los 3 días de la segunda dosis de la misma vacuna. La erupción cutánea cedió por completo a los 3 meses de instaurar tratamiento con deflazacort (1 mg/kg/día). Tras 5 años de seguimiento, no ha vuelto a presentar lesiones a pesar de haber recibido el resto de vacunas del calendario oficial

Bullous pemphigoid (BP) is a disease that characteristically affects the elderly, although cases have been described in children. We present a case of BP in a twomonth- old infant with bullous lesions on the palms and soles, which appeared one week after receiving the first dose of the hepatitis B, polio, DTP and HiB vaccine. She was treated with sulphated water, dexamethasone and fusidic acid, and the lesions disappeared. One month later, she presented with a new, more generalized outbreak, three days after the second dose of the same vaccine. The skin eruption completely subsided 3 months after treatment with deflazacort was initiated (1 mg/kg/day). After five years of follow up, the patient has not presented with lesions again, despite having received the rest of the vaccines on the official schedule

Estudio prospectivo de los niveles de citocinas séricas en pacientes con melanoma: valor pronóstico / Prospective study of the levels of serum cytokines in patients with melanoma: prognostic value

Introducción. La producción de citocinas tiene un papel primordial en la lucha antitumoral por parte del sistema inmunitario. Por ello, en este trabajo nos propusimos investigar si las concentraciones séricas de distintos tipos de citocinas en pacientes con melanoma se asociaban con la evolución de su enfermedad. Material y métodos. Se analiza la variación en los niveles séricos de citocinas representativas de los fenotipos Th1 (interferón gamma [IFN-gama] e interleucina 15 [IL-15]) y Th2 (IL-6 e IL-10) en 33 pacientes con melanoma cutáneo primario. Se obtuvieron semestralmente muestras de sangre periférica hasta conseguir un total de cuatro muestras por paciente. Resultados. A los 30 meses, 29 pacientes (87,9 %) sobrevivieron sin signos de recidiva. La IL-10 basal era más alta en el grupo de enfermos que fallecieron que en los supervivientes. En los pacientes que fallecieron se observó un aumento de la IL-6 sérica en la última muestra. No se pudo demostrar ninguna relación entre los niveles de IFN-gama e IL-15 y la progresión del melanoma. Conclusión. La determinación de citocinas de tipo Th2 (IL-6 e IL-10) en suero de pacientes con melanoma podría ser útil en el seguimiento clínico de estos enfermos y servir como factor predictivo de la mejor o peor evolución de la enfermedad, en el sentido de un peor pronóstico para los enfermos con niveles elevados de IL-10 e IL-6. Por el contrario, la determinación de los niveles séricos de las citocinas de tipo Th1 (IL-15 e IFN-gama) no parece de tanta utilidad a la hora de orientar sobre el pronóstico

Introduction. The production of cytokines plays a primordial role in the immune system’s fight against tumors. Therefore, we proposed to investigate whether the serum levels of different types of cytokines in melanoma patients were associated with the evolution of their disease. Material and methods. We analyzed the variation in the serum levels of cytokines representative of the Th1 (INF-gamma and IL-15) and Th2 (IL-6 and IL-10) phenotypes in 33 patients with primary cutaneous melanoma. Peripheral blood samples were obtained every six months until we had a total of 4 samples per patient. Results. After 30 months, 29 patients (87.9 %) had survived with no signs of recurrence. Basal IL-10 serum levels were higher in the group of patients who expired than in the survivors. Among the patients who expired, an increase in IL-6 serum levels was observed in the last sample. No relationship could be proven between INF-gamma and IL-15 levels and melanoma progression. Conclusion. Determining the levels of type Th2 cytokines (IL-6 and IL-10) in the serum of melanoma patients could be useful in the clinical follow-up of these patients and serve as a predictive factor for the progression of the disease, with the prognosis being worse for patients with high IL-10 and IL-6 levels. On the other hand, determining the serum levels of type Th1 cytokines (IL-15 and INF-gamma) does not seem to be as useful in predicting the prognosis

[Prospective study of the levels of serum cytokines in patients with melanoma: prognostic value]. / Estudio prospectivo de los niveles de citocinas séricas en pacientes con melanoma: valor pronóstico.

INTRODUCTION: The production of cytokines plays a primordial role in the immune systems fight against tumors. Therefore, we proposed to investigate whether the serum levels of different types of cytokines in melanoma patients were associated with the evolution of their disease. MATERIAL AND METHODS: We analyzed the variation in the serum levels of cytokines representative of the Th1 (INFg and IL-15) and Th2 (IL-6 and IL-10) phenotypes in 33 patients with primary cutaneous melanoma. Peripheral blood samples were obtained every six months until we had a total of 4 samples per patient. RESULTS: After 30 months, 29 patients (87.9 %) had survived with no signs of recurrence. Basal IL-10 serum levels were higher in the group of patients who expired than in the survivors. Among the patients who expired, an increase in IL-6 serum levels was observed in the last sample. No relationship could be proven between INFg and IL-15 levels and melanoma progression. CONCLUSION: Determining the levels of type Th2 cytokines (IL-6 and IL-10) in the serum of melanoma patients could be useful in the clinical follow-up of these patients and serve as a predictive factor for the progression of the disease, with the prognosis being worse for patients with high IL-10 and IL-6 levels. On the other hand, determining the serum levels of type Th1 cytokines (IL-15 and INFg) does not seem to be as useful in predicting the prognosis.

[Bullous pemphigoid in an infant after vaccination]. / Penfigoide ampolloso en lactante tras vacunación.

Bullous pemphigoid (BP) is a disease that characteristically affects the elderly, although cases have been described in children. We present a case of BP in a two-month-old infant with bullous lesions on the palms and soles, which appeared one week after receiving the first dose of the hepatitis B, polio, DTP and HiB vaccine. She was treated with sulphated water, dexamethasone and fusidic acid, and the lesions disappeared. One month later, she presented with a new, more generalized outbreak, three days after the second dose of the same vaccine. The skin eruption completely subsided 3 months after treatment with deflazacort was initiated (1 mg/kg/day). After five years of follow up, the patient has not presented with lesions again, despite having received the rest of the vaccines on the official schedule.

Cambios en los factores de riesgo metabólicos en pacientes obesos en tratamiento / The effect of treatment on metabolic risk factors in obese patients

Background: Obesity is a threaten to health due to its association with cardiovascular risk factors. Aim: To assess the change in metabolic risk factors after weight reduction in obese patients. Patients and methods: A retrospective analysis of 277 obese patients (198 female) aged 39.5ñ12 years old, that completed a six month treatment period, consisting in a calori restricted diet (800-1200 Kcal/day), physical activity, education and group psychological counseling. At the beginning and at the end of the program, weight, waist circumference, resting energy expenditure (REE), serum lipid profile, plasma glucose and plasma insulin levels were measured. Results: During the treatment period, body mass index decreased from 38ñ7 to 33.2ñ6.4 kg/m2 with a weight loss of 11.7 kg, waist circumference decreased from 106.6ñ14.6 to 93.9ñ13.5 cm, REE decreased from 1774ñ383 to 1585ñ267 Kcal/day, blood glucose fell by 5.8 percent, plasma insulin fell by 40.4 percent, total cholesterol fell by 7.5 percent, LDL cholesterol fell by 8.7 percent, triglycerides fell by 26.6 percent, and total cholesterol/HDL ratio fell by 12.2 percent. Conclusions: Weight loss was associated with improvement in metabolic cardiovascular risk factors in obese patients