Gloria Catherine Perez Mingan

Objective: we present a case of Vogt-Koyanagi-Harada syndrome in a young patient with no relevant past medical history. Case: a 23-year-old female patient who presented with a one-month progressive visual acuity loss. Right eye fundus examination revealed serous retinal detachment with a subtotal focal area of transparent sub-retinal fluid, macular involvement, and a whitish nasal temporal sub-retinal lesion. Left eye fundus examination, revealed funnel-shaped total anterior retinal detachment without proliferative vitreoretinopathy. Discussion and conclusions: a significant alteration in cerebrospinal fluid was evidenced in addition to abovesaid findings. Vogt-Koyanagi-Harada syndrome was diagnosed. Treatment based on systemic corticosteroids was administered, achieving improvement in symptoms. Given Vogt-Koyanagi-Harada syndrome´s difficult diagnosis and infrequent presentation, proper knowledge of the disease is essential for ensuring an adequate approach and an appropriate treatment for these patients.

Background/Objectives: This study aimed to investigate the association of IL-6 with steatotic liver disease (SLD) and liver fibrosis (LF) in rheumatoid arthritis (RA) patients at a rheumatology center in Cartagena de Indias, Colombia. Methods: This was a cross-sectional study that included RA and non-RA cases. The level of cellular expression of interleukin 6 (IL-6) was evaluated by flow cytometry in peripheral blood leukocytes, and the presence of SLD and LF was detected by elastosonography. The main outcome was to establish the association between the levels of cellular expression of IL-6 and the development of SLD and LF. Results: This study included 47 cases of RA and 34 cases on-RA, with a mean age of 54 and 55 years, respectively. The frequency of SLD was 55.3% in RA and 38.2% in non-RA. The frequency of LF was 12.8% in RA and 14.7% in non-RA, with no statistical difference. The levels of cellular expression of IL-6 were significantly higher in RA compared to non-RA. Cellular expression of IL-6 was associated with the presence of SLD (54% vs. 30.3%; p = 0.002). This association was not maintained in RA cases (49.5% vs. 47.6%; p = 0.571). No association was found between cellular expression of IL-6 and LF in the total population (43.8% vs. 42.7%; p = 0.813) nor in RA cases (59.41% vs. 48.3%; p = 0.526). Conclusions: IL-6 levels were related to SLD in the evaluated sample, and RA was not a risk factor for SLD or LF. The prognostic role of IL-6 for SLD in patients with RA requires further studies.

Skin cancer is an entity that has a progressive increase in its incidence worldwide; In the spectrum of this disease, malignant melanoma is one of the most aggressive neoplasms; the literature describes 4 subtypes, among which we find superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma and nodular melanoma. The latter is still in its early stages and can generate distal metastatic involvement; its etiology is multifactorial and among the main risk factors is exposure to ultraviolet (UV) radiation. The lesion initially presents as a nodule that grows progressively and its diagnosis is mainly through biopsy; timely treatment reduces the risk of aesthetic and systemic complications. We present a case of a 42-year-old male patient with clinical and histopathological symptoms corresponding to nodular melanoma in the acral region associated with lymph node and lung metastasis.

Los lipomas colónicos son tumores benignos que se originan en el tejido mesenquimal y se consideran el segundo tumor benigno más común en el colon, después de los pólipos adenomatosos. Tienden a afectar más a mujeres y su localización más frecuente es el colon derecho. Por lo general, estos lipomas no presentan síntomas, pero cuando alcanzan un tamaño considerable pueden causar manifestaciones. También pueden dar lugar a complicaciones como obstrucción, intususcepción y perforación. Dado que sus características radiológicas son similares a la grasa, pueden ser visualizados mediante tomografía computarizada, aunque el diagnóstico definitivo se realiza mediante colonoscopia, donde se observa una masa grasa con forma ovalada y capacidad elástica. Las lesiones pueden ser extirpadas endoscópicamente o quirúrgicamente. La expulsión espontánea de un lipoma por vía rectal es rara y su mecanismo aún no está completamente comprendido. Aunque la literatura establece un punto de corte de 2 cm para decidir entre resección endoscópica o laparoscópica, la primera está en aumento y puede ampliar este límite. En casos grandes, como el reportado en este artículo, se recomienda una resección quirúrgica. Este caso particular se destaca por ser el lipoma de colon más grande reportado hasta ahora (13 cm) expulsado espontáneamente.

La intususcepción intestinal en pacientes adultos es una entidad infrecuente, la cual corresponde alrededor del 5% de todas las causas de obstrucción intestinal. Su diagnóstico no es fácil, dado lo poco especifico de los síntomas de los pacientes que la presentan; este se sustenta principalmente en los hallazgos de los estudios de imagen. El manejo quirúrgico es la piedra angular del tratamiento de esta patología, y su éxito va a estar determinado por el diagnóstico oportuno y la experticia del cirujano tratante. En este artículo se presenta el caso de un paciente masculino de 62 años, que consulta por cuadro de dolor abdominal inespecífico y síntomas urinarios irritativos, el cual por persistencia del dolor abdominal pese al manejo medico es llevado a cirugía, donde se diagnostica de manera intraoperatoria una invaginación intestinal a nivel de íleon distal.