Colangitis biliar primaria: experiencia de cinco años en el Hospital Clínico de la Universidad de Chile / Primary biliary cholangitis. Experience in 179 patients

BACKGROUND: Primary biliary cholangitis (PBC) is a chronic autoimmune cholestatic disease, which can progress to cirrhosis. It mainly affects middle-aged women. Its most frequent form of presentation is asymptomatic with biochemical cholestasis and the presence of antimitochondrial antibodies (AMA). AIM: To describe the epidemiological characteristics, clinical presentation and treatment for patients with PBC at a clinical hospital. MATERIAL AND METHODS: Descriptive, observational, retrospective study, carried out between January 2015 and December 2020. Results: 179 patients (158 women) were cared in the study period. At the time of diagnosis, the median age was 54 years (range 24-76), 55% of them were asymptomatic, 45% had fatigue and 28% had pruritus. Positive AMA were present in 65% of patients, antinuclear antibodies (ANA) in 51%, and anti-smooth muscle antibodies (ASMA) in 9%. Immunoglobulin M (IgM) was elevated in 30% of the patients and 50% of patients were biopsied. Splenomegaly and esophageal varices were present in 24 and 22% of patients, respectively. PBC was associated with Sjogren's syndrome in 15%, hypothyroidism in 14%, osteoporosis in 13%, and scleroderma in 8%. CONCLUSIONS: The epidemiological characteristics of our patients agree with those published abroad. Laboratory cholestasis associated with the presence of AMA, currently allows diagnosis without the need for histological study. Ursodeoxycholic acid (UDCA) is the first-line treatment for patients with PBC. The use of biochemical response criteria is essential to identify patients who require other UDCA alternatives for isolated or combined treatment.

Seroprevalencia de Toxoplasma gondii en un hospital universitario en Chile / Toxoplasma gondii seroprevalence in a university hospital in Chile

Resumen La toxoplasmosis es una enfermedad zoonótica causada por Toxoplasma gondii. Se estima que afecta a un tercio de la población mundial. En Chile, en 1996, se reportó que la seroprevalencia de anticuerpos del tipo IgG contra T. gondii fue 36,9%, la cual aumentaba progresivamente de norte a sur del país. Hasta el momento, no existe información actualizada sobre la seroprevalencia de T. gondii en la Región Metropolitana. En el presente estudio, se determinó la seroprevalencia de IgG anti T. gondii en el periodo 2013-2018 en un centro universitario de Santiago. De un total de 1.666 resultados, 386 (23,2%) fueron positivos. No se encontraron diferencias según sexo y hubo un incremento significativo según el rango etario. No se observó una disminución de la seroprevalencia en los últimos seis años; sin embargo, los resultados señalan una reducción significativa con respecto a investigaciones previas realizadas en la Región Metropolitana.

Abstract Toxoplasmosis is a zoonotic disease caused by Toxoplasma gondii. It is estimated to affect a third of the world's population. In Chile, in 1996, a seroprevalence of IgG antibodies against T. gondii of 36.9% was reported, which progressively increased from north to south of the country. There are no updated reports of the seroprevalence of T. gondii in the Metropolitan Region. In the present study, we determined the seroprevalence of anti T. gondii IgG in the 2013-2018 period at the Clinical Hospital University of Chile. Of a total of 1,666 results, 386 (23.2%) were positive, without gender differences, but with a significant increase with age. A decrease in seroprevalence was not observed in the last six years, however the results obtained show a significant reduction compared to previous research carried out in the Metropolitan Region.