Paciente con hipercalcemia y tumor de células de los islotes pancreáticos (paratirinoma) / Patient with hypercalcemia and islet cell carcinoma of the pancreas (parathyrimoma)

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[Human fascioliasis with atypical severe presentation. Treatment with triclabendazole]. / Fascioliasis humana con presentación atípica y grave. Tratamiento con triclabendazol.

BACKGROUND: Fascioliasis is a zoonosis mainly involving sheep but which occasionally may be found in man as an accidental host. It is acquired by the consumption of herbs (watercress, wild endive, and dandelion) contaminated with metacercarias. The adult phase is established in the biliary tree. Most of the human infections are asymptomatic or with unspecific self limited abdominal symptoms making diagnosis difficult. METHODS: A case of human fascioliasis is of note because of two aspects: a) the infrequent, severe life threatening form of presentation: recurrent subcapsular hepatic hematomas, and b) favorable evolution of the patient on treatment with triclabendazol (to date its use is not approved in humans). RESULTS: Resistance to treatment with praziquantel was observed at a dosis of 75 mg/day for 2 days, being repeated 15 days later with no response. The patient was posteriorly treated with 10 mg/kg of a single dosis of triclabendazol following approval as "compassive use" with a favorable clinical response. CONCLUSIONS: This unusual disease requires a high index of suspicion to achieve diagnosis. Treatment with triclabendazol should be studied as a possible treatment of choice given is efficacy, absence of adverse effects and comfortable dosage.

[Sweet syndrome: presentation of an atypical case and review of the literature]. / Síndrome de Sweet: presentación de un caso atípico y revisión de la literatura.

In 1964 Sweet described a new syndrome which was characterized by pyrexia, neutrophilia, and the abrupt appearance of erythematous, painful, cutaneous plaques, primarily on the upper extremities, head, and neck. Histologically, the prominent feature is a dense dermal infiltrate of neutrophils, without signs of vasculitis, with a prompt response to steroid therapy. Since then up to 150 cases have been reported, being actually considered an immune mechanism responsible of this syndrome and we now have criterions for the diagnosis of it. We report a patient with Sweet's syndrome (SS): who has all the diagnostic criterions, whose main interest is having suffered from erythema nodosum three years before; this is the second case we have found in the English literature, and we also discuss some peculiarities.

[Vasculitis caused by hypersensitivity: an analysis of 60 patients]. / Vasculitis por hipersensibilidad: análisis de 60 pacientes.

Sixty cases of hypersensitivity vasculitis are revised analyzing their possible etiology, clinical course, analytical and histological alterations, evolution, and treatment. Thirty of these cases corresponded to Schönlein Henoch purpura (SH). The results of this subgroup (SH) are compared to other hypersensitivity vasculitis (HV).

[Disseminated intravascular coagulation in systemic lupus erythematosus]. / Coagulación intravascular diseminada en el lupus eritematoso sistémico.

A patient with systemic lupus erythematosus (SLE) who developed disseminated intravascular coagulation during the beginning of SLE is presented. No other cause responsible for the producing of DIC was found. After treatment with corticoids, and cyclophosphamide the DIC was rapidly settled. This case supports the need for a complete blood test in patients with SLE who show coagulation alterations.