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Biomedical subjects

F Larraín

Publications and source records attributed to F Larraín.

9 recordsLinked to original sources

[Autoimmune hepatitis in a girl with presence of anti-LKM1 antibodies].

Autoimmune hepatitis is an inflammatory liver disease characterized by dense mononuclear cell infiltrate in the portal tract, and serologically by the presence of non-organ and liver-specific autoantibodies and increased levels of gammaglobulins in the absence of a known etiology. Three subgroups of autoimmune hepatitis have been recognized, depending on the nature of the autoantibody present in the serum: Type 1 autoimmune hepatitis, associated with smooth-muscle (SMA) or antinuclear antibody (ANA) seropositivity; type 2, with anti-liver/kidney microsome antibody (anti-LKM1), and type 3, with the absence of ANA, SMA and anti-LKM1 and presence of other autoantibodies such as anti-soluble liver antigen (SLA). Subtypes of chronic autoimmune hepatitis have clinically different features and prognoses. An 8 year old female patient presented mild jaundice of insidious onset. The liver was tender and enlarged. Serologic markers for A, B, C, E, Epstein Barr and cytomegalovirus were negative. The liver biopsy showed a histological picture consistent with chronic active hepatitis. High titers of anti-liver/kidney-microsome antibody were found by indirect immunofluorescence test, and this finding was confirmed by Western blot against specific liver microsome antigens. Therapy with prednisolone induced a clinical and biochemical remission after four weeks. The suspension of therapy under strict medical control produced a rapid relapse of clinical and biochemical features. The reinitiation of prednisolone was successful, and an alternate-day program was started and maintained until 8 months follow-up.

Autoantibodies↗

[Factitious gastrointestinal hemorrhage in 3 school-age girls].

Three female patients aged 9, 13 and 14 years, respectively, seen by the authors over a 1-year period presented with the complaint of recurrent hematemesis (2 patients) or melena (1 patient). The (presumed) bleeding episodes had only been seen by the respective patient and one parent (the mother in two cases and the father in one). In two cases, the other parent was antagonistic with the reported situation. A clear symbiosis had been forged between the index case and the allied parent. Two patients had previously been seen in several hospitals and had undergone various diagnostic tests, including esophagogastroduodenoscopies, all of which had proved normal. Two girls had attempted suicide. Two of the mothers had a depressive disorder. Re-evaluation of the patients by the authors again ruled out any cause for the presumed bleeding or any sequelae originating from it. The patients and their parents were referred to a psychiatric service but this was only complied by one family; the other two repeatedly avoided attending the psychiatric clinic. Awareness of this pattern of presentation and of the psychiatric profiles of the patients and their families is critical for practitioners in order to recognize factitious illness whenever a patient with a history of gastrointestinal bleeding presents with incongruous or illogical medical history and clinical findings.

Adolescent↗

[Extrahepatic portal hypertension. Azygos-portal disconnection].

The partial or complete obstruction of portal vein and or one of its branches is the most frequent cause of portal hypertension in children. A patient with extrahepatic portal hypertension and progressive course is presented, with great development of esophagogastric varices and multiple episodes of upper gastrointestinal hemorrhage. At the age of 9 years he was submitted to an azygos-portal disconnection by abdominal route, with manual transection of the esophagus, covered and protected by a gastric fundoplication. Postoperative endoscopic control demonstrated significant reduction in the size of esophageal varices and disappearance of gastric varices. Eleven months after surgery the patient was asymptomatic and a new endoscopic control showed no recurrence of varices.

Azygos Vein↗

[Evolutionary study of 81 children with celiac disease].

A review of 81 children with celiac disease over a period of 5 years is presented. These cases were seen at the Gastroenterological Unit of the Hospital de Nińos Roberto del Río, during years 1970 through 1972. 62% of the patients (50) were placed under control of their disease, the rest were studied and diagnosed only for other centers. The short term evolution was good in 48 children (96%), while the medium and long term evolution, 2 to 5 years, was good only in 56% of the patients. This evolution was in direct relationship to the fulfillment of the dietary indications. The therapeutic test was positive among the studied group. A delay was observed in 80% of the cases that lasted from 1 to 6 months. The clinical and laboratory features of the group are analyzed, and the working method is described.

Biopsy↗

[Wilson's disease].

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Ceruloplasmin↗

[Digestive hormones].

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Cholecystokinin↗