From the acute phase to recuperation of pancreatitis, regeneration and re-differentiation of pancreas occur and PAP expression is exclusively an acute response of pancreatitis.
There is no awareness about celiac disease (CD) in Mexico. A 2.9 year old mestizo boy was admitted to a Mexican hospital with muscle cramps and fine tremors. He suffered chronic diarrhea, abdominal distention, hypotrophic limbs, stunting and wasting, and presented hypocalcemia, anemia and high titers of serological markers. Diagnosis of CD was confirmed by a duodenal biopsy. After replacement of calcium and a gluten-free diet, the symptoms resolved within 6 weeks. After 2-months, serum analyses, anthropometric data as well as antibodies titers were normal after 4 years. CD screening tests are needed in chronic diarrhea for any ethnicity patients.
Several studies suggested that branched-chain amino acids (BCAA) improve plasma amino acid imbalance as well as protein metabolism in patients with cirrhosis. However, commercial formulas supplemented with free BCAA have their limitations. We evaluated a modified soy protein diet with covalently bound BCAA (diet M) by comparing it with diets based on casein (diet C) or Hepatic Aid II (diet H; commercial formula) as protein sources. After 3 weeks of bile duct obstruction, 24 Sprague-Dawley rats divided into three groups received diets with 9% (w/w) protein/amino acids for 7 days. Nutritional and clinical parameters were determined. Nitrogen balance and weight gain (g)/protein intake (g) with diet M (0.19 ± 0.31 and 1.33 ± 1.43 g, respectively) were significantly higher (p < 0.05) than with diet H (–0.34 ± 0.20 and –0.34 ± 1.11 g), but comparable to those with diet C (0.04 ± 0.38 and 0.20 ± 0.93 g). Animals on diet M had a significantly (p < 0.05) increased plasma BCAA:aromatic amino acid ratio (1.8 ± 0.3) as compared with those on diets H (1.3 ± 0.1) and C (0.8 ± 0.0). There were no significant differences in organ weight or liver function among the groups. We conclude that the BCAA-modified protein is an attractive option in the nutritional support of patients having cirrhosis.
Autoimmune hepatitis (AIH) is a liver disease that runs a course of chronic and progressive inflammation. This occurs in young children and adolescents. AIH can also be manifested in an acute and aggressive form. Its etiology is unknown. Two varieties have been reported. These are autoimmune hepatitis type 1 (AIH-1) and type 2 (AIH-2). AIH-1 affects children as well as adults and it is related with the presence of antinuclear (ANA) and anti-smooth muscle (ASM) antibodies. AIH-1 is associated with immunological illnesses such as ulcerative colitis, sclerosing cholangitis, arthritis, and vasculitis. AIH-2 is more frequent in children. It presents with liver and kidney microsome (Anti-LKM-1) antibodies and anti-cytosol antibodies (Anti-LC-1). AIH-2 has also been associated with other immunopathies such as polyendocrinopathy, vitiligo, thyroiditis, alopecia and diabetes mellitus type 1 (DM1). This report describes the clinical course of two patients with AIH: a female treated since five years of age and followed during 18 years. After 11 years, the patient developed DM1 and later anorexia nervosa. This patient died due to complications of the latter. The other patient, who was diagnosed with AIH at the age of 10 years, was treated and followed during 10 years. This patient manifested idiopathic thrombocytopenia purpura (IPT) and Hashimoto encephalopathy during the course of the disease. This patient continues to remain under control. The relationship of AIH-1 with other autoimmune processes, such as Diabetes mellitus type 1 (DM1) until now, has been poorly investigated. Also, ITP followed by Hashimoto encephalopathy was a rare association in our patient. It has been considered that these are a consequence of autoimmune dysregulation.
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