Spotted Fever: An Undercover Cause of Hemophagocytic Lymphohistiocytosis in the Immediate Postpartum.

Hemophagocytic lymphohistiocytosis (HLH) is characterized by a dysregulated activation of the immune system that causes fever, cytopenias, organomegalies, and hemophagocytosis. There are infectious, neoplastic, rheumatologic, and miscellaneous causes. Rickettsioses are a neglected cause of HLH. We report a confirmed case of an immunocompetent woman in Mexico with postpartum HLH secondary to spotted fever. We did a review of the literature for search of similar cases. The association between these two diseases was found in postmortem studies, unrelated to postpartum. This diagnosis should be considered in all patients with HLH without an evident cause in areas of epidemiological risk.

[Hereditary mixed polyposis syndrome. First report in Mexico]. / Síndrome de poliposis mixta hereditaria. Primer reporte en México.

OBJECTIVE: Report for first time in Mexico a case of hereditary mixed polyposis and review the literature. BACKGROUND: The hereditary mixed polyposis syndrome (HMPS) is an uncommon condition, distinguished by presence of a different histological pattern of polyps in digestive tract, clinically manifested by diarrhea, anemia and weight loss. CASE REPORT: Male patient, 38 years old, with familiar antecedent (dead sister) with polyps and gastric cancer. With history of a 1 year with bleeding and mucous diarrhea, and weight loss of a 28.6 pounds. Pale at physical examination, without abdominal signs. At blood test with hemoglobin of 9.7 g/dL, and colonoscopy with multiple polyps within colon and rectum, upper endoscopy with a big esophageal polyp and multiple polyps in gastric and duodenal lining smaller than 1 cm. Contrast study of intestine was normal. Histopathologic study of the polyps report mixed pattern of polyps: (hyperplasic-adenomatous, juvenile-adenomatous, adenoma-inflammatory-hyperplasic, hyperplasic-adenomatous with a high degree dysplasia); juvenile in esophagus, and hyperplasic in stomach and duodenum. Patient was undergone to totalproctocolectomy and reconstruction by "J" ileoanal pouch with good outcome, and endoscopic esophageal polypectomy, with actual surveillance.

Enfermedad de Hogkin primaria de bazo: presentación de un caso clínico / Spleen primary Hodgkin disease: a report of a case

En este reporte se comunica el caso de un paciente con una infrecuente manifestación de la enfermedad de Hodgkin. Era un varón con antecedentes de alcoholismo crónico que sufría pancitopenia, derrame pleural y gran esplenomegalia. Al principio se pensó en cirrosis hepática con hiperesplenismo; sin embargo, debido a que no hubo datos de afección hepática y la anemia persistía a pesar de las hemotransfusiones, se decidió la esplenectomía. El estudio histopatológico reveló enfermedad de Hodgkin de variedad celularidad mixta. Más adelante se realizó una biopsia de hueso en la que se encontraron células neoplásicas similares a las encontradas en el bazo. En la revisión de la literatura sólo se identificaron reportes aislados.