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Biomedical subjects

M A Martín Scapa

Publications and source records attributed to M A Martín Scapa.

14 recordsLinked to original sources

[Controversies about the clinical management of Whipple's disease].

BACKGROUND: There are a lot of controversies related to the diagnostic and therapeutic management of Whipple s disease. PATIENTS: We present 4 cases of Whipple's disease, collected from the Gastroenterology Service of the Hospital Ramon y Cajal, from Madrid. RESULTS: The average age was 69. The first symptoms were in order of frequency, arthralgias, loss of weight, arthritis, diarrhoea, fever, epigastric pain and neurologic symptoms. Three were treated with trimethoprim-sulphamethoxazol and one with cefixime. There were no recurrences. CONCLUSIONS: The endoscopic appearance of the duodenum is fundamental for the suspicion of the disease. The initial parenteral treatment may consist of ceftriaxone and try to avoid using streptomycine because of its toxicity, followed by oral trimethoprim-sulphamethoxazol. As an alternative to the latter, cefixime is usually effective. The typical findings of the duodenum biopsy can persist several months or years after finishing the treatment, decreasing the value of endoscopic pursuit after treatment.

Aged↗

[Extrahepatic portal hypertension: spleno-portal thrombosis secondary to protein C deficiency].

Portal vein thrombosis (PVT) is the most frequent cause of hypertension portal extrahepatic. It is a rare disorder an the main risk factors are cirrhosis, hepatobiliary malignancies and prothrombotic disorders, which have been identified as major risk. Therapy with anticoagulants must to be considered in acute portal thrombosis or chronic one and proven hypercoagulability. We present the case of a twenty-nine years old patient, with extrahepatic portal hypertension secondary to portal and splenic vein thrombosis, who was diagnosed because of splenomegaly and a coagulation disorder. A protein C deficiency were discovered and anticoagulation and beta-blocker therapy were initiated. One year later the patient had not presented complications concerning to the disease or to the treatment.

Adult↗

[Vascular involvement of the colon in a patient with chronic hepatitis C virus infection].

We describe a case of vasculitis with colonic involvement/alterations associated with hepatitis C virus infection. Both the association of hepatitis C with vasculitis type periarteritis nodosa and the prominent involvement of the colon are infrequent. The presentation of this case--fever of unknown origin--as well as the difficulties of treating a patient who is a hepatitis C virus carrier are discussed.

Colonic Diseases↗

Collagenous colitis in Spain: a report of nine new cases.

BACKGROUND: collagenous colitis is a clinicopathological entity that causes chronic watery diarrhea. The patients are predominantly women in the sixth or seventh decade of life. Radiological and endoscopic studies are usually normal or nonspecific. It is diagnosed by the presence in colonic biopsies of a thickened subepithelial band of collagen and an inflammatory infiltrate in the mucosa. METHODS: 9 cases diagnosed in our hospital and 18 previously described in Spain have been reviewed. RESULTS: all the cases showed chronic watery diarrhea. In 17 patients symptoms were present since at least one year before diagnosis. Five of the 27 patients had been taking nonsteroidal antiinflammatory drugs. Rheumatological and autoimmune diseases were found in 6 patients. Colonoscopy was normal or showed nonspecific findings except in one of our patients, in which aphthous ulcers and pseudomembranes were found. Different treatments had been employed, including antidiarrheal agents, sulfasalazine, 5-ASA and omeprazole. CONCLUSIONS: collagenous colitis is uncommon but should be considered in patients with long-standing chronic watery, nonbloody diarrhea. Collagenous colitis is probably more common than we think, as biopsies are not usually taken in cases of chronic diarrhea with normal endoscopic findings.

Adult↗

[Adult celiac disease presenting as tetany].

Tetany is a rare form of presentation of adult celiac disease. We present three patients with spontaneous episodes of tetania who were finally diagnosed of celiac disease. All were women. In two of them an unexplained chronic anemia was previously detected. The origin of tetania was severe hypocalcemia and hypomagnesemia. After intravenous restoration of calcium and posterior free gluten diet with supplements, clinical and biological remission was achieved. In the presence of isolated tetania or unexplained anemia resistant to treatment an adult celiac disease must be disclosed.

Adult↗

[Bacteriuria in primary biliary cirrhosis].

The high incidence of significant bacteriuria observed in 30 patients diagnosed of primary biliary cirrhosis in our department is studied. Although a significant increase in general infections has not been described in this type of liver disease, of probable autoimmune nature, the high incidence of bacteriuria in these patients has been previously reported. Possible predisposing factors are evaluated; we observed that there was a significant increase in the frequency of bacteriuria with age, but there was no relationship between the incidence of infection and the histologic stage of the disease.

Adult↗