ABSTRACT
Introducción: la carboximaltosa férrica (CF) es una preparación intravenosa que ayuda a la corrección rápida de anemia con menor riesgo de reacciones adversas. Sin embargo, se ha encontrado asociación entre la administración de la CF y el desarrollo de hipofosfatemia. Caso clínico: presentamos el caso clínico de una paciente de 57 años con anemia ferropénica que tras recibir tratamiento con CF (Ferinjet®) de forma crónica, desarrolla un cuadro clínico de debilidad muscular severa. En la analítica se aprecia hipofosfatemia, normocalcemia, nivel de vitamina D normal (tras corrección) y aumento de excreción renal de fósforo. Tras estudio se llega al diagnóstico de hipofosfatemia crónica secundaria al uso de la CF. Discusión: la CF puede provocar un aumento de FGF-23 el cual actúa a nivel renal induciendo fosfaturia, pudiendo generar hipofosfatemia grave. Este caso demuestra la importancia de reconocer y tratar esta entidad clínica a tiempo. (AU)
Introduction: ferric carboxymaltose (CF) is an intravenous preparation that helps the rapid correction of anemia with a lower risk of adverse reactions. However, an association has been found between the administration of CF and the development of hypophosphatemia. Case report: we present the clinical case of a 57-year-old patient with a history of iron de-ficiency anemia who, after receiving treatment with CF (Ferinjet®) chronically, develops a clinical of severe muscle weakness. Laboratory tests showed hypophosphatemia, normocalcemia, normal vitamin D level (after correction) and increased renal excretion of phosphorus. After study, the diagnosis of chronic hypophosphatemia secondary to the use of CF is reached. Discussion: CF can cause an increase in FGF-23 which acts at the renal level inducing phosphaturia, which can generate severe hypophosphatemia. This case demonstrates the importance of recognizing and treating this clinical entity in time. (AU)
Subject(s)
Humans , Female , Middle Aged , Ferric Compounds/adverse effects , Hypophosphatemia/diagnosis , Anemia, Iron-Deficiency/drug therapy , Ferric Compounds/administration & dosage , Maltose/analogs & derivativesABSTRACT
Introduction: Introduction: ferric carboxymaltose (CF) is an intravenous preparation that helps the rapid correction of anemia with a lower risk of adverse reactions. However, an association has been found between the administration of CF and the development of hypophosphatemia. Case report: we present the clinical case of a 57-year-old patient with a history of iron de-ficiency anemia who, after receiving treatment with CF (Ferinjet®) chronically, develops a clinical of severe muscle weakness. Laboratory tests showed hypophosphatemia, normocalcemia, normal vitamin D level (after correction) and increased renal excretion of phosphorus. After study, the diagnosis of chronic hypophosphatemia secondary to the use of CF is reached. Discussion: CF can cause an increase in FGF-23 which acts at the renal level inducing phosphaturia, which can generate severe hypophosphatemia. This case demonstrates the importance of recognizing and treating this clinical entity in time.
Introducción: Introducción: la carboximaltosa férrica (CF) es una preparación intravenosa que ayuda a la corrección rápida de anemia con menor riesgo de reacciones adversas. Sin embargo, se ha encontrado asociación entre la administración de la CF y el desarrollo de hipofosfatemia. Caso clínico: presentamos el caso clínico de una paciente de 57 años con anemia ferropénica que tras recibir tratamiento con CF (Ferinjet®) de forma crónica, desarrolla un cuadro clínico de debilidad muscular severa. En la analítica se aprecia hipofosfatemia, normocalcemia, nivel de vitamina D normal (tras corrección) y aumento de excreción renal de fósforo. Tras estudio se llega al diagnóstico de hipofosfatemia crónica secundaria al uso de la CF. Discusión: la CF puede provocar un aumento de FGF-23 el cual actúa a nivel renal induciendo fosfaturia, pudiendo generar hipofosfatemia grave. Este caso demuestra la importancia de reconocer y tratar esta entidad clínica a tiempo.
Subject(s)
Anemia, Iron-Deficiency , Hypophosphatemia , Humans , Middle Aged , Anemia, Iron-Deficiency/drug therapy , Ferric Compounds/adverse effects , Maltose/adverse effects , Hypophosphatemia/chemically inducedABSTRACT
Introducción: La ascitis quilosa es la acumulación de líquido linfático en la cavidad peritoneal. Se trata de una patología poco frecuente cuya causa puede ser traumática oatraumática, siendo la obstrucción por neoplasias abdominales la etiología más frecuente en adultos. No existe evidenciacientífica acerca de una terapia que resulte totalmente eficazen el tratamiento de esta patología. Objetivos: El objetivo fundamental de esta revisión esprofundizar, integrar, resumir y actualizar la información publicada sobre este tema, así como proporcionar informaciónútil y contrastada a otros compañeros para su aplicación en lapráctica clínica. Material y Métodos: Se realiza una revisión de la bibliografía empleando la base de datos PubMed, Medline y Sciencedirect con los descriptores chylous ascitis AND diet. Los filtros empleados fueron: humanos, últimos 5 años y lenguasespañola e inglesa. Se revisaron los artículos y se seleccionaron 12 trabajos. Resultados: Se describen las diferentes alternativas terapéuticas tanto dietéticas como el tratamiento intervencionista.Discusión: La ascitis quilosa supone un problema médicocomplejo por el potencial deterioro nutricional e inmunológico que genera. Revisada la literatura, existe poca evidenciacientífica sobre el tratamiento de elección en los pacientescon ascitis quilosa, aunque parece existir consenso de que ladieta es el tratamiento más simple y, habitualmente, el primero en implementarse. Debido a esta complejidad, es imprescindible la valoración del paciente por un equipo multidisciplinar y la actitud terapéutica elegida dependerá de lacausa de la ascitis, la situación clínica y la experiencia de losprofesionales sanitarios. Conclusiones: La terapia nutricional de la ascitis quilosase basa en una dieta baja en grasas suplementada con triglicéridos de cadena media y es el tratamiento de elección porsu alto porcentaje de eficacia.(AU)
Introduction: Chylous ascites is the accumulation oflymphatic fluid in the peritoneal cavity. It is a rare pathologyand it can be traumatic or no traumatic. The most commoncause of chylous ascites in adults is obstruction by abdominalneoplasms. There is insufficient evidence about an effectivetreatment. Objectives: The main objective of this review is to deepen, integrate, summarize and update the information published about this topic. Also, we want to provide to other healthprofessionals, a useful and verified information to applicate inclinical practice. Material and Methods: A literature review was made: PubMed, Medline and Science direct search using as descriptors chylous ascites AND diet. The following filters areused: human, last 5 years and Spanish/English languages.Articles were reviewed and 12 papers were selected. Results: We describe the dietary alternatives and the interventional treatment. Discussion: Chylous ascites is an important medical problem, because of the deterioration of immune system and nutritional parameters. Literature review was made and there isno scientific evidence about the treatment of choice in patients with chylous ascites. Diet is the simplest treatment andthe first to be implemented. A multidisciplinary team is important in the treatment of these patients. To choose the besttherapeutic attitude, we must know the cause, the clinical situation and the experience of health care workers. Conclusions: A lowfat diet supplemented with mediumchain triglycerides is the most efficacy treatment for chylousascites. There is no evidence about an effective treatment forthis pathology and most publications are clinical cases.Prospective, randomized studies are needed to get more evidence on the management of chylous ascites.(AU)
Subject(s)
Humans , Male , Female , Chylous Ascites , Rare Diseases , Abdominal Neoplasms , Diet, Food, and Nutrition , Diet, High-Protein , Nutrition Therapy , Food Service, Hospital , 52503ABSTRACT
OBJECTIVE: PELD (Progressive Encephalopathy with or without Lipodystrophy or Celia's Encephalopathy) is a fatal and rare neurodegenerative syndrome associated with the BSCL2 mutation c.985C>T, that results in an aberrant transcript without the exon 7 (Celia seipin). The aim of this study was to evaluate both the process of cellular senescence and the effect of unsaturated fatty acids on preadipocytes from a homozygous c.985C>T patient. Also, the role of aberrant seipin isoform on adipogenesis was studied in adipose-derived human mesenchymal stem cells. MATERIAL AND METHODS: Cellular senescence was evaluated using ß-galactosidase staining of preadipocytes obtained from a homozygous c.985C>T patient. Moreover, these cells were cultured during 24 hours with Intralipid, a soybean oil-based commercial lipid emulsion. The expression of the different BSCL2 transcripts was measured by qPCR. Adipose-derived human mesenchymal stem cells were differentiated to a fat lineage using StemPRO adipogenesis kit, and the expression of BSCL2 transcripts and several adipogenesis-related genes was measured by qPCR. RESULTS: the treatment of preadipocytes with unsaturated fatty acids significantly reduced the expression of the BSCL2 transcript without exon 7 by 34 to 63%. On the other hand, at least in preadipocytes, this mutation does not disturb cellular senescence rate. Finally, during adipocyte differentiation of adipose-derived human mesenchymal stem cells, the expression of adipogenic genes (PPARG, LPIN1, and LPL) increased significantly over 14 days, and noteworthy is that the BSCL2 transcript without exon 7 was differentially expressed by 332 to 723% when compared to day 0, suggesting an underlying role in adipogenesis. CONCLUSIONS: our results suggest that Celia seipin is probably playing an underestimated role in adipocyte maturation, but not in senescence, and its expression can be modified by exogenous factors as fatty acids.
