Anticoagulante circulante y lesiones focales hepáticas asociados a marcada semiología sistémica en la lúes secundaria / Circulating anticoagulant and focal liver lesions associated to rich clinical expression inthe secondary syphillis

Un varón de 37 años ingresó en nuestro hospital por un cuadro de 8 semanas de evolución de malestar general, fiebre, artralgias, molestias faríngeas y nasales, cefalalgia holocraneal, fotofobia y náuseas. Con la ducha notó lesiones maculares en palmas de manos y plantas de pies. Un año antes había notado erosiones indoloras en el prepucio. Tenía factores de riesgo para enfermedades de transmisión sexual. La analítica mostró criterios de colestasis disociada, síndrome nefrótico, presencia de anticoagulante circulante, y positividad para la serología reagínica y específica de lúes. En una ecografía abdominal se objetivaron múltiples lesiones pequeñas, centimétricas, ocupantes de espacio. Con 2 semanas de tratamiento con penicilina revirtieron todas las manifestaciones clínicas, analíticas y de imagen. Se comenta la rica expresión semiológica y las peculiaridades de presentar lesiones ocupantes de espacio hepáticas y anticoagulante circulante en un caso de sífilis secundaria

A 37-year-old male was admitted at our hospital for evaluation of clinical presentation of 8 weeks evolution of malaise, fever, sore throat and nose, arthralgias, holocraneal headache, photophobia and nausea. With the shower he noticed spots in palms of hands and plants of feet. A year before had noticed painless erosions in foreskin. He had risk factors for sexual transmission diseases. The analytical showed criteria of dissociated colestasis, nephrotic syndrome, presence of circulating anticoagulant, and positivity for the reaginic and specific serological syphilis. In an abdominal ultrasonic multiple, focal and small liver lesions were watched. With two weeks of treatment with penicillin the clinical manifestations reverted, and the analytical and of image was watched bettering, which dissapeared at the three montnths of treatment. We comment the rich clinical expression and the peculiarities of presenting focal liver lesions and circulating anticoagulant, in a case of secondary syphilis

[Liver fibrosis associated with hepatorenal polycystosis in adults]. / Fibrosis hepática asociada a poliquistosis hepatorrenal del adulto.

OBJECTIVE: A case of hepatic fibrosis in adult polycystic liver disease is reported. This association, commonly present in infancy, is exceptional in the adult polycystic liver disease. PATIENT: We report a 69-years-old female with adult polycystic kidney and liver disease with fatal hepatic failure, portal hypertension and renal failure. An autopsy was performed showing hepatic and renal polycystic disease with hepatic fibrosis. CONCLUSION: Hepatic fibrosis is a rarely associated phenomenon with adult polycystic liver disease. This data may suggest a relation of this entity with infancy fibropolycystic liver disease.