Safety and effectiveness of direct-acting antiviral drugs in the treatment of hepatitis C in patients with inflammatory bowel disease.

BACKGROUND AND AIMS: Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs. METHODS: Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period. RESULTS: We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs. CONCLUSIONS: We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.

Una rara causa de dolor abdominal en un niño sano / A rare cause of abdominal pain in a healthy child

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Acute neonatal appendicitis: a diagnosis to consider in abdominal sepsis.

Appendicitis in the neonatal period is extremely rare. Its low incidence together with non-specific clinical symptoms often mean the diagnosis is delayed, leading to increased rates of peritonitis and mortality. We report the case of a 33-week premature infant, small for gestational age (1180 g at birth), clinically stable and receiving exclusive enteral feeding, who presented clinical manifestations of necrotizing enterocolitis at 14 days of life. Acute phase reactants were elevated and abdominal radiography showed pneumoperitoneum. Laparotomy revealed acute perforated appendicitis without intestinal involvement and purulent fluid in the peritoneum, for which appendectomy was performed. Neonatal acute appendicitis should be considered in the differential diagnosis of abdominal sepsis since early diagnosis and treatment significantly reduce associated morbidity and mortality.

Malaria congénita por Plasmodium vivax: un caso incidental en contexto de sepsis neonatal / A case of congenital malaria by Plasmodium vivax: an incidental case within the context of neonatal sepsis

La malaria congénita es una patología relativamente rara en el contexto de las patologías neonatales. Presentamos el caso de una lactante de 20 días de vida con malaria congénita por Plasmodium vivax cuyo diagnóstico fue realizado de forma incidental al analizar una muestra de laboratorio en el estudio de sepsis neonatal. La paciente era procedente de una zona no endémica de Colombia pero con antecedente materno de malaria gestacional diagnosticada al 7º mes, la cual no fue tratada por omisión de la paciente. Las manifestaciones clínicas fueron inespecíficas, similares a las de una sepsis neonatal y el tratamiento antimalárico fue realizado con cloroquina, con adecuada respuesta clínica, confirmada mediante negativización de gota gruesa al finalizar el tratamiento. Se considera de gran importancia tenerla malaria congénita cada vez más en cuenta como diagnóstico diferencial de la sepsis neonatal sobre todo en pacientes procedentes de zonas de riesgo o endémicas (AU)

Congenital malaria is a disease relatively rare in the context of neonatal pathologies. We report the case of an infant of twenty days of life with malaria congenital whose a plasmodium vivax, the diagnosis was made incidentally while processing a laboratory sample in the context of neonatal sepsis. The patient was from non-endemic area but with no previously know maternal history of gestational malaria seven months, which was no treated by omission of the la patient. The nonspecific clinical manifestations were similar to those of neonatal sepsis and antimalarial treatment with chloroquine was carried out with adequate clinical response and confirmed by thick smear negative at the end of treatment. Hence it is considered very important to have more and more into account as differencial diagnosis in patient from risk areas besides the differential diagnosis of neonatal sepsis (AU)