SESARAM - G - Artigos
Permanent URI for this collection
Browse
Recent Submissions
- Portal Cavernoma Cholangiopathy Secondary to Polycythemia Vera: Case Report and Echoendoscopic FindingsPublication . Pereira, Vítor Magno; Costa-Moreira, Pedro; Moutinho-Ribeiro, Pedro; Macedo, Guilherme
- Celiac Disease as a Rare Cause of Membranous Nephropathy: A Case ReportPublication . Pestana, Nicole; Vida, Carlota; Durães, José; Silva, Gil; Vieira, PedroMembranous nephropathy is the most common cause of nephrotic syndrome in adults. A non-negligible number of cases are associated with systemic conditions. We report a case of a 50-year-old man who presented with nephrotic syndrome six months after being diagnosed with celiac disease. Although the patient showed disappearance of circulating immunoglobulin A (IgA) anti-tissue transglutaminase antibodies following a gluten-free diet, he had a sudden onset of nephrotic syndrome presenting with severe hypoalbuminemia. Other secondary causes were promptly excluded leading to the assumption of celiac disease-associated membranous nephropathy with remission after treatment with angiotensin system blockade and a gluten-free diet. The goal of this case report is to alert the clinic towards this rare association aiming for an early diagnosis and adequate selection of long-term therapy.
- "Lynfocytic colitis (Clinical case)".Publication . Sousa, Bruno; Tavares, NelsonA 67-year-old woman, retired, with several associated pathologies, presented at a Nutrition Consultation with complaints of diarrhea and abdominal cramps for approximately five months, medicated during this time by her General Practitioner with Racecadotril and Atyflor®. Awaits consultation of gastroenterology
- Chronic gastritis (Clinical case)Publication . Sousa, Bruno; Tavares, NelsonA 42-year-old heavy-duty driver (from 9 am to 5 pm) with a part-time as a cook (7 pm to 11:30 pm), who has complaints of dyspepsia. He was sent to the Nutrition Consultation by his General Practitioner with Sucralfate, Diazepan and Esomeprazole and diagnosed with chronic gastritis.
- Isolated Congenital Asplenia in an Asymptomatic Patient: A Very Rare DiagnosisPublication . Dinis-Ferreira, Sofia; Lemos, Cláudia; Caldeira, Mónica; Homem-Costa, Miguel; da Luz Brazão, Maria; Aveiro, FernandoIsolated congenital asplenia is a rare condition that mostly manifests in the early years, usually due to fatal systemic infections. In this paper, however, we present a case of a 36-year-old asymptomatic patient who was referred for suspected hyposplenism, with no history of splenectomy. There were no significant changes on physical examination. Blood analysis revealed leukocytosis and thrombocytosis as well as moderate anisopoikilocytosis and red blood cells with Howell-Jolly bodies. No spleen or other malformations were identified on imaging. Individuals with isolated congenital asplenia have an increased susceptibility to invasive infections and sepsis, with rapid clinical decline and a high mortality rate despite treatment.
- A Case of Unexplained Cutaneous Lesions, Cholestatic Hepatitis, and Noncirrhotic Portal Hypertension in a Female PatientPublication . Carvão, Joana; Pereira, Vítor Magno; Jasmins, LuísQuestion: A 57-year old woman with a previous history of contrast-related anaphylaxis was referred to the gastroenterology department with worsening liver function tests. She developed recurrent abdominal pain, diarrhea, significant weight loss, pruriginous generalized skin rash, and increased abdominal volume over 1 year. Physical examination revealed generalized small reddish monomorphic macules on the trunk and thighs (Figure A), hepatosplenomegaly, peripheral lymphadenopathy, and ascites. Blood tests showed normocytic normochromic anemia (hemoglobin 9.4 g/dL), monocytosis (1.3 103/mL), thrombocytopenia (97 103/mL), slight international normalized ratio prolongation, and a marked elevation of cholestasis parameters without jaundice (aspartate aminotransferase, 60 U/L; alanine aminotransferase, 56 U/L; gamma-glutamyl transferase, 324 U/L; and alkaline phosphatase, 1277 U/L). Abdominal Doppler ultrasound examination and a computed tomography scan revealed homogeneous hepatosplenomegaly (without signs of chronic liver disease), signs of portal hypertension without thrombosis of the splenoportal axis, moderate ascites, and intra-abdominal, axillary, and inguinal lymphadenopathies. Upper endoscopy showedesophageal varices and portal hypertensive gastropathy.Laboratory studies for chronic hepatopathy, infectious agents, and angiotensin-converting enzyme were negative. Bone marrow biopsy revealed granulomatous myelitis, and both lymphadenopathy and skin biopsies showed increased mononuclear cells.
- Letter to the Editor: Glomerular Filtration Rate Assessment in Liver Disease (GRAIL): Are We There Yet?Publication . Carvão, Joana; Jasmins, Luís
- Esophageal and Gastroduodenal Hemorrhagic Necrosis: A Unique Finding in the Setting of Septic Shock and Vasopressor UsePublication . Carvão, Joana; Faria, Maria Gorete; Magno Pereira, Vitor; Sousa Andrade, Carla; Fernandes, Nicodemos; Nóbrega, José Júlio; Jasmins, LuísEsophageal and gastroduodenal necrosis are rare conditions with poor prognosis. We describe a case that was diagnosed with upper endoscopy in the setting of severe septic shock. To our knowledge, this is the first case in which esophageal and gastroduodenal necrosis occurred simultaneously in this setting. We discuss the pathophysiology, diagnostic approach, and treatment options of this rare entity.
- Liver Phenotypes of European Adults Heterozygous or Homozygous for Pi∗Z Variant of AAT (Pi∗MZ vs Pi∗ZZ genotype) and NoncarriersPublication . Schneider, Carolin V.; Hamesch, Karim; Gross, Annika; Mandorfer, Mattias; Moeller, Linda S.; Pereira, Vitor; Pons, Monica; Kuca, Pawel; Reichert, Matthias C.; Benini, Federica; Burbaum, Barbara; Voss, Jessica; Gutberlet, Marla; Woditsch, Vivien; Lindhauer, Cecilia; Fromme, Malin; Kümpers, Julia; Bewersdorf, Lisa; Schaefer, Benedikt; Eslam, Mohammed; Bals, Robert; Janciauskiene, Sabina; Carvão, Joana; Neureiter, Daniel; Zhou, Biaohuan; Wöran, Katharina; Bantel, Heike; Geier, Andreas; Dirrichs, Timm; Stickel, Felix; Teumer, Alexander; Verbeek, Jef; Nevens, Frederik; Govaere, Olivier; Krawczyk, Marcin; Roskams, Tania; Haybaeck, Johannes; Lurje, Georg; Chorostowska-Wynimko, Joanna; Genesca, Joan; Reiberger, Thomas; Lammert, Frank; Krag, Aleksander; George, Jacob; Anstee, Quentin M.; Trauner, Michael; Datz, Christian; Gaisa, Nadine T.; Denk, Helmut; Trautwein, Christian; Aigner, Elmar; Strnad, PavelHomozygosity for the Pi∗Z variant of the gene that encodes the alpha-1 antitrypsin peptide (AAT), called the Pi∗ZZ genotype, causes a liver and lung disease called alpha-1 antitrypsin deficiency. Heterozygosity (the Pi∗MZ genotype) is a risk factor for cirrhosis in individuals with liver disease. Up to 4% of Europeans have the Pi∗MZ genotype; we compared features of adults with and without Pi∗MZ genotype among persons without preexisting liver disease.
- Dysphagia in a young female patient: it’s not always that simplePublication . Carvão, Joana; Peixoto, Armando; Rios, Elisabete; Macedo, GuilhermeA 42-year- old female patient was referred to our gastroenterology department with a 4-month history of weekly symptoms of dysphagia for solids and liquids. The patient also reported occasional symptoms of food impaction and heartburn. She denied nausea, vomiting, weight loss or a recent change in bowel habits. The patient was not under any medication. Medical or surgical history was unremarkable. There was no family history of gastrointestinal cancer. Physical examination was normal, and laboratory tests did not reveal anaemia or other abnormalities. She underwent an oesophagogastroduodenoscopy, and the oesophagus is shown in figure 1. Biopsies were performed in the upper and lower parts of the oesophagus and the result is shown in figure 2. Macroscopically and histologically, the stomach was normal. On the same day, the patient underwent a high-resolution manometry (HRM) (Medtronic 36-channel solid-state catheter) with 10 supine liquid swallows (5 mL water each) with the following findings (figure 3).