Hepatotoxicidad grave inducida por sertralina / Sertraline-induced severe hepatotoxicity

We report the case of a 19-year-old patient, with a history of traumatic liver damage, but with a normal liver profile at her first discharge; 1 month after the event, with post-traumatic stress disorder, treatment with 25 mg of sertraline was started every day; one month later, she develops severe hepatotoxicity without a specific etiology. According to the Naranjo algorithm, it is attributed as a probable case of sertraline hepatotoxicity. Management is carried out with support measures and suspension of the medication, and the patient recovers until she is asymptomatic, currently has normal liver tests

Reportamos el caso de una paciente de 19 años, con antecedentes de daño hepático traumático, pero con un perfil hepático normal en su primer alta; después de 1 mes del evento, con trastorno de estrés postraumático se inició tratamiento con 25 mg diarios de sertralina; un mes después, desarrolla una hepatotoxicidad severa sin etiología determinada. De acuerdo con el algoritmo de Naranjo, se atribuye como caso probable de hepatotoxicidad por sertralina. El manejo se realiza con medidas de apoyo y suspensión del medicamento, y la paciente se recupera hasta que se encuentra asintomática, actualmente tiene pruebas hepáticas normales

Ecotomografía transcraneana para el diagnóstico de enfermedad de Parkinson y otros trastornos del movimiento: estudio piloto de 39 casos y su correlato clínico - radiológico / Transcranial sonography for diagnosis of the Parkinson disease and other movement disorders: clinical study of 39 cases and clinical - radiological correlate

Introduction: Parkinson disease diagnosis is based on physical neurologic exam, however sometimes ancillary tests could be needed. Transcranial sonography is a useful tool to perform Parkinson disease and others movement disorders diagnosis, showing pathologic hyperecogenicities of nigra substance and basal ganglia. Objective and methods: The objective of this study is to report the first 39 patients in whom transcranial sonography was performed. We recruit patients consulting to movement disorders unit at University of Chile hospital. Two independent investigators (PVF and GMG) blinded to clinical diagnosis performed transcranial sonography by temporal window. Considering clinical diagnosis as gold standard we calculated specificity and sensibility. Concordance between investigators was estimated too. Results: Concordance between investigators was 100 percent. Sensibility was 85.71 percent and specificity was 100 percent. Conclusion: According our report, transcranial sonography performed at University of Chile Hospital, is a high sensibility and specificity tool to support Parkinson disease and others movement disorders.