RESUMEN
La intoxicación aguda por litio es una entidad poco común en nuestro medio, aunque potencialmente fatal. Alrededor del 75 a 90 % de los pacientes tratados crónicamente con carbonato de litio pueden tener niveles tóxicos durante su tratamiento. Este medicamento es ampliamente usado en Colombia para el tratamiento del trastorno afectivo bipolar. Se caracteriza por tener rangos terapéuticos estrechos lo que favorece que se presente con frecuencia toxicidad. Muchos sistemas pueden estar comprometidos, entre ellos el neurológico, el gastrointestinal y el cardiovascular.Presentamos el caso de un paciente que ingresa al Hospital con intoxicación por litio.
Acute lithium intoxication is a rare entity in our environment but serious and potentially fatal. According to world literature about 75-90 % of patients with chronic lithium carbonate therapy can have toxic levels during treatment. This drug is widely use in Colombia as a stabilizer of affection, is effective for the treatment of bipolar disorder among other treatments. It has very narrow therapeutic ranges which favors present acute and chronic toxicity. Most systems are compromised: neurological, gastrointestinal and cardiovascular. It is important for all doctors who work in the emergency room, whether General Practitioner or Emergency Medicine thinking in this situation. In a patient with risk factors and therapy with this drug is essential to guide appropriate therapy, discard differential diagnosis and thus avoid consequences that may become long-term irreversible. We report a case of toxicity with Lithium in a patient arriving at a hospital of high complexity.
RESUMEN
OBJECTIVE: The aim was to examine the relationship between clinicopathological features and immunoexpression of hMLH1 and hMSH2 proteins in pleomorphic adenoma (PA) of minor salivary glands. STUDY DESIGN: Paraffin-embedded samples of typically benign PA lesions (n = 35) were prepared for histologic and immunohistochemical assessment. Based on the clinicopathologic features, the samples were categorized into low- and high-risk subtypes for their estimated potential for malignant transformation. RESULTS: Immunohistochemical analysis revealed strong correlations regarding the expression estimation and staining-intensity distribution (SID) scores between the two proteins. Although there was no relationship between marker immunoexpression and SID scores regarding clinical parameters, statistically significant variations for these parameters were evident regarding some histologic criteria or for risk stratification subtypes. CONCLUSION: The findings of this study could suggest the relationship of a DNA mismatch repair deficiency with high-risk subtypes of PA and the implication of its role in the origin and progression of these subtypes.