Rev Esp Enferm Dig
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Infectious mononucleosis induced by the Epstein Barr Virus (EBV) is a benign illness that is frequently accompanied by a slight hepatic disfunction. On occasion it may be accompanied by autoimmune hemolytic anemia of little clinical importance. Nevertheless, this association can cause a serious set of symptoms that can put the patient's life in danger if it is not treated quickly. We present the case of a 21-year-old male with infectious mononucleosis and severe jaundice (total bilirubin 40 mg/dl) due to the combination of diseased liver and secondary autoimmune hemolytic anemia, caused by the EBV infection.
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The value of 99mTc-hexamethylpropyleneamine oxime (HMPAO) leukocyte images has been confirmed in patients with Inflammatory Bowel Disease. We performed 121 scintigraphic examination. The results were evaluated by radiologic and/or endoscopic examinations. ⋯ The leucocyte scanning showed clear pathologic activity in the ileum with a sensitivity of 86%. We conclude that 99mTc-leukocyte scintigraphy is the best method to assess the location of active inflammation in patients with less than 15 days of treatment. Scintigraphy was best in the assessment of active disease especially in Crohn's disease of the small bowel.
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Letter Case Reports
[Can be treated with isotretinoin patients with acne and Gilbert's syndrome?].
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Dysphagia is an unusual presenting symptom as of extradigestive tumors. Malignant mesothelioma, is a rare tumor localized in the pleural cavity in 80% of all cases and it rarely appears with dysphagia as first symptom. ⋯ Nuclear Magnetic Resonance established the diagnostic suspicion of malignant mesothelioma which was confirmed by the histologic study of a biopsy taken by thoracotomy. We think of interest to report this case of paraesophageal mesothelioma because of its unusual localization and presentation.