scholarly journals Tuberculosis de la vía biliar

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Ángel Pierini ◽  
Leandro Pierini ◽  
Guillermo Ruiz ◽  
Alejandro García Hevia ◽  
Rodrigo Meneghini
Keyword(s):  
Bile Duct ◽  
Clinical Case ◽  
Histopathological Study ◽  
Rare Entity ◽  
Imaging Diagnosis ◽  
C Reactive Protein ◽  
Bile Duct Resection ◽  
Reactive Protein ◽  
Large Animals ◽  
Bile Duct Tumors

Biliary TBC is a rare entity, possibly underdiagnosed and is, therefore, a diagnostic and therapeutic challenge today, due to the increase in its incidence in the population. There are no pathognomonic characteristics of imaging diagnosis of biliary TBC; for this reason, it is obtained by histopathological study of the piece. We present the clinical case of a 29-year-old female patient who consults for progressive jaundice, choluria, and pruritus. As the only antecedent of hierarchy, she is the veterinary of large animals. The patient is studied with laboratory, ultrasound and magnetic resonance, with suspected bile duct tumors. Surgical behavior is decided with gallbladder and bile duct resection and biliodigestive anastomosis with pathological anatomy and PCR (C-reactive protein) that reports TBC of the bile duct.

scholarly journals 13-valent Pneumococcal Conjugate Vaccine and Haemophilus Influenzae-Tetanus Toxoid Conjugate Vaccine in Patient with Systemic Juvenile Idiopathic Arthritis Receiving Tocilizumab: Clinical Case

2019 ◽  
Vol 18 (3) ◽  
pp. 180-186
Author(s):  
Ekaterina I. Alekseeva ◽  
Dar’ya D. Van’kova ◽  
Tatyana M. Dvoryakovskaya ◽  
Kseniya B. Isaeva ◽  
Rina V. Denisova ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Tetanus Toxoid ◽  
Pneumococcal Conjugate Vaccine ◽  
Clinical Case ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Infectious Complications ◽  
C Reactive Protein ◽  
Reactive Protein

Background. Vaccination coverage in patients with rheumatic diseases remains extremely low. Moreover, infections are the leading cause of death in such patients. Respiratory infections mortality is 2–5 times higher in adults with rheumatoid arthritis than in overall population. The most frequent infectious complications in patients receiving Tocilizumab (first-line drug for treatment of patients with systemic juvenile idiopathic arthritis (SJIA)) are pneumonia and acute sinusitis. Their clinical course differs: slight clinical presentation, reference ranges of laboratory tests of disease activity (ESR, C-reactive protein), significant changes in lungs and paranasal sinuses according to the computer tomography. Infectious complications development can cause aggravation of prior disease itself or due to temporary immunosuppressive therapy cessation. Clinical Case Description. The experience of immunization with 13-valent pneumococcal conjugate vaccine (PCV13) and haemophilus influenzae-tetanus toxoid conjugate vaccine in the 1,5 years old boy with SJIA receiving interleukin-6 receptor monoclonal antibody Tocilizumab is presented. The result of such vaccination was increase of pneumococcal and haemophilus influenzae antibodies levels by more than two times. Meanwhile vaccination had no negative impact on the prior disease course: the levels of predictors of prior disease aggravation such as protein S100 and highly sensitive C-reactive protein did not increase significantly in comparison with the period before vaccination. Conclusion. The efficiency and safety of immunization with PCV13 and haemophilus influenzae-tetanus toxoid conjugate vaccine in the child with SJIA receiving Tocilizumab is presented.

scholarly journals HEMOPHAGOSYTIC SYNDROME IN A CHILD WITH SEPSIS CAUSED BY SERRATIA PROTEAMACULANS

2019 ◽  
Vol 11 (1) ◽  
pp. 98-103
Author(s):  
Kh. S. Khaertynov ◽  
V. A. Anokhin ◽  
S. A. Lubin ◽  
A. Kh. Khaertynova
Keyword(s):  
Blood Cells ◽  
Clinical Case ◽  
Hemophagocytic Syndrome ◽  
Cytotoxic Agents ◽  
Infusion Therapy ◽  
Blood Levels ◽  
Elevated Blood ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Serratia Proteamaculans

A clinical case of development of secondary hemophagocytic syndrome is presented on the background of sepsis caused by Serratia proteamaculans, in a child of monthly age, culminating in recovery. Hemophagocytic syndrome in the child developed on the 32nd day of life and was accompanied by fever, hepatosplenomegaly, anemia, thrombocytopenia, elevated blood levels of triglycerides and ferritin. Blood culture was positive for Serratia proteamaculans. Isolate of Serratia proteamaculans was resistant to aminopenicillins (including protected ones), 1–4 generations of cephalosporins and aminoglycosides but sensitive to ciprofloxacin and moderately sensitive to imipenem and meropenem. The duration of fever in the child was seven days, thrombocytopenia, hyperfertritinemia and hypertriglyceridemia – 28 days. The normalization of the indices of ferritin, triglycerides and platelets coincided with the reduction of bacteremia and high values of the C-reactive protein. The duration of bacteremia was three weeks: the isolation of Serratia proteamaculans from the blood occurred three times. Elevated levels of C-reactive protein in the blood were noted for 30 days. Reduced hemoglobin and red blood cells counts were noted for eight weeks. Positive dynamics of the hemophagocytic syndrome occurred as a result of measures aimed at treating sepsis – antibiotic therapy with imipenem in combination with ciprofloxacin, appointed by the decision of the medical commission on the basis of the sensitivity of Serratia proteamaculans to antibiotics, intravenous immunoglobulin, and infusion therapy. Glucocorticosteroids and cytotoxic agents (etoposide, cyclosporin A) have not been used in this case.

scholarly journals Diagnostic Value of Endoscopic Retrograde Cholangiopancreatography Combined with Serum C-Reactive Protein, CEA and IL-6 in Occult Common Bile Duct Stones

2021 ◽  
Author(s):  
ShiJun Lu ◽  
XueLi Liu ◽  
WeiGuo Wu
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Diagnostic Value ◽  
Bile Duct Stones ◽  
Research Subjects ◽  
C Reactive Protein ◽  
Endoscopic Retrograde ◽  
Reactive Protein ◽  
Diagnosis Rate

Abstract Objective: To investigate the diagnostic value of ERCP combined with CRP, CEA and IL-6 in serum in Occult Common bile duct stones (CBDS). Methods: 80 cases of patients with occult CBDS treated in our hospital were selected as the research subjects, and the diagnosis rates of ERCP alone or ERCP combined with CRP, CEA and IL-6 in serum were compared. Results: Versus ERCP alone, the diagnosis rate of combined diagnosis was clearly higher (P < 0.05). Versus patients without CBDS, the levels of CRP, CEA and IL-6 in serum in CBDS patients were apparently elevated (P < 0.05). The levels of CRP, CEA and IL-6 in serum were of high value in the diagnosis of CBDS in patients with occult CBDS (P < 0.05). Conclusion: ERCP combined with CRP, CEA and IL-6 in serum is of high value in re-diagnosis of Occult CBDS.

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