ABSTRACT
Collagenous sprue is a rare disease of the small bowel characterized by mucosal atrophy and excessive subepithelial collagen deposition. The etiology remains unclear and the diagnosis is based upon patient´s clinical picture and anatomopathological findings. Clinically, collagenous sprue is characterized by persistent diarrhoea, severe malabsorption, multiple nutrient deficiencies and progressive weight loss. Differential diagnosis includes celiac disease, which is mandatory to rule out because of their frequent association. Glutenfree diet is the first therapeutic step, but it usually is not effective. However, recent studies show high success rates with immunomodulators, mainly corticosteroids. We report the case of a patient presenting with chronic diarrhea and severe malabsorption who was diagnosed with collagenous sprue, with no response to gluten free diet, but with excellent response to budesonida.
Subject(s)
Collagenous Sprue/diagnosis , Aged, 80 and over , Chronic Disease , Collagenous Sprue/complications , Connective Tissue , Diarrhea/etiology , Humans , MaleABSTRACT
El esprúe colágeno es una patología infrecuente del intestino delgado caracterizada por atrofia de la mucosa y depósito excesivo de colágeno a nivel subepitelial. Su etiología es desconocida y su diagnóstico se realiza en base a la presencia tanto de un cuadro clínico compatible como de hallazgos anatomopatógicos sugestivos. Los pacientes suelen presentar diarrea crónica, malabsorción, deficiencias nutricionales graves y una marcada pérdida ponderal. Dentro del diagnóstico diferencial es mandatorio descartar enfermedad celiaca por su frecuente asociación a la misma. La dieta sin gluten es el primer escalón terapéutico, pero generalmente no es efectiva. Sin embargo, estudios recientes señalan altas tasas de éxito mediante el uso de inmunomoduladores. Presentamos el caso de un paciente con diarrea crónica y malabsorción grave diagnosticado de esprúe colágeno, sin respuesta a la dieta sin gluten, en el que el tratamiento con budesonida ha conseguido una excelente respuesta(AU)
Collagenous sprue is a rare disease of the small bowel characterized by mucosal atrophy and excessive subepithelial collagen deposition. The etiology remains unclear and the diagnosis is based upon patients clinical picture and anatomopathological findings. Clinically, collagenous sprue is characterized by persistent diarrhoea, severe malabsorption, multiple nutrient deficiencies and progressive weight loss. Differential diagnosis includes celiac disease, which is mandatory to rule out because of their frequent association. Gluten-free diet is the first therapeutic step, but it usually is not effective. However, recent studies show high success rates with immunomodulators, mainly corticosteroids. We report the case of a patient presenting with chronic diarrhea and severe malabsorption who was diagnosed with collagenous sprue, with no response to gluten free diet, but with excellent response to budesonida(AU)
Subject(s)
Humans , Male , Aged, 80 and over , Malabsorption Syndromes/complications , Malabsorption Syndromes/diagnosis , Connective Tissue/physiology , Diarrhea/complications , Diarrhea/diagnosis , Diagnosis, Differential , Celiac Disease/complications , Celiac Disease/diagnosis , Celiac Disease/physiopathology , Fibrosis/complications , Fibrosis/diagnosis , Endoscopy/methods , Endoscopy , Immune Tolerance/physiology , Monitoring, ImmunologicABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Pancreatitis/chemically induced , Anti-Bacterial Agents/adverse effects , Doxycycline/adverse effects , Knee Prosthesis/microbiology , Mycobacterium fortuitum/pathogenicity , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/drug therapyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Hyperkalemia/chemically induced , Zingiber officinale/adverse effects , Liver Cirrhosis/complications , Herb-Drug InteractionsABSTRACT
The application of recombinant human granulocyte colony-stimulating factor (filgrastim) seems to be a safe, well tolerated and potentially effective therapy for active Crohn's disease. We report the case of an adolescent boy with Crohn's disease and intra-abdominal abscess associated who had a significant response to treatment with recombinant human granulocyte colony-stimulating factor after all standard treatments had failed.
Subject(s)
Abdominal Abscess/etiology , Crohn Disease/drug therapy , Granulocyte Colony-Stimulating Factor/therapeutic use , Adult , Anti-Bacterial Agents/therapeutic use , Antibodies, Monoclonal/therapeutic use , Azathioprine/therapeutic use , Cell Differentiation , Combined Modality Therapy , Crohn Disease/immunology , Crohn Disease/pathology , Crohn Disease/surgery , Cytokines/biosynthesis , Drug Resistance , Filgrastim , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Infliximab , Macrophages/pathology , Male , Methotrexate/adverse effects , Methotrexate/therapeutic use , Neutrophils/drug effects , Prednisone/adverse effects , Prednisone/therapeutic use , Recombinant Proteins , Tumor Necrosis Factor-alpha/biosynthesisABSTRACT
El tratamiento con factor recombinante estimulante de progenitores granulocíticos (filgrastim) parece ser una alternativa terapéutica segura, bien tolerada y potencialmente efectiva en pacientes con una enfermedad de Crohn activa. Presentamos el caso de un varón adolescente con enfermedad de Crohn y absceso intraabdominal asociado, en el que los tratamientos convencionales habían fracasado, que experimentó una importante respuesta al tratamiento con factor recombinante estimulante de progenitores granulocíticos
The aplication of recombinant human granulocyte colony-stimulating factor (filgrastim) seems to be a safe, well tolerated and potentially effective therapy for active Crohn's disease. We report the case of an adolescent boy with Crohn's disease and intra-abdominal abscess associated who had a significant response to treatment with recombinant human granulocyte colony-stimulating factor after all standard treat-ments had failed
