Diagnóstico y tratamiento del esprúe refractario
Diagnosis and Treatment of Refractory Sprue
A. Garridoa,
, F.J. Guerrerob, J.A. Lepec, C. Ortegad, E. Muñoza
Autor para correspondencia
agarridos@interec.org
Correspondencia: Dr. A. Garrido Serrano. Almajarra, 1, Blq. 7, 1.° B. Urbanización Jardines de Santa Eufemia. Tomares. 41940 Sevilla. España.
Correspondencia: Dr. A. Garrido Serrano. Almajarra, 1, Blq. 7, 1.° B. Urbanización Jardines de Santa Eufemia. Tomares. 41940 Sevilla. España.
a Unidad de Digestivo. Servicios de Hospital Comarcal de Riotinto. Huelva. España
b Servicios de Medicina Interna. Hospital Comarcal de Riotinto. Huelva. España
c Servicios de Laboratorio y Análisis Clínico. Hospital Comarcal de Riotinto. Huelva. España
d Servicios de Anatomía Patológica. Hospital Comarcal de Riotinto. Huelva. España
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España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diagnosis and Treatment of Refractory Sprue" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-05-13" "fechaAceptado" => "2002-07-19" "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La enfermedad celíaca es una enteropatía inducida por la ingesta de gluten, caracterizada por atrofia vellositaria que revierte tras la retirada del mismo. Un reducido porcentaje de estos pacientes no responden a la dieta exenta de gluten, o bien, tras un período de remisión, sufren una recaída a pesar de cumplir correctamente el tratamiento: es el denominado esprúe no clasificado o esprúe refractario (ER).</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El pronóstico del ER es grave: los enfermos pueden fallecer a causa de malabsorción grave o desarrollo de linfoma T asociado a enteropatía (LTAE).</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una mujer de 72 años de edad, diagnosticada de ER, que respondió bien al tratamiento con esteroides y dieta exenta de gluten.</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Celiac disease is a gluten-sensitive enteropathy characterized by villous atrophy that is reversed by gluten withdrawal. A minority of these patients is resistant to a gluten-free diet or, after a period of remission, they experience relapse despite continued adherence to treatment, which is called unclassified sprue or refractory sprue.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The prognosis of refractory sprue may be poor: patients may die of severe malabsorption or from the development of an enteropathy-associated T-cell lymphoma.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We report a 72-year-old-woman with a diagnosis of refractory sprue who responded well to treatment with corticosteroids and a gluten-free diet.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 31 | 18 | 49 |
| 2024 Septiembre | 60 | 30 | 90 |
| 2024 Agosto | 41 | 10 | 51 |
| 2024 Julio | 45 | 21 | 66 |
| 2024 Junio | 46 | 13 | 59 |
| 2024 Mayo | 42 | 23 | 65 |
| 2024 Abril | 38 | 16 | 54 |
| 2024 Marzo | 40 | 26 | 66 |
| 2024 Febrero | 30 | 26 | 56 |
| 2024 Enero | 66 | 26 | 92 |
| 2023 Diciembre | 58 | 29 | 87 |
| 2023 Noviembre | 82 | 42 | 124 |
| 2023 Octubre | 92 | 40 | 132 |
| 2023 Septiembre | 38 | 16 | 54 |
| 2023 Agosto | 10 | 14 | 24 |
| 2023 Julio | 34 | 44 | 78 |
| 2023 Junio | 47 | 36 | 83 |
| 2023 Mayo | 40 | 25 | 65 |
| 2023 Abril | 44 | 21 | 65 |
| 2023 Marzo | 42 | 28 | 70 |
| 2023 Febrero | 54 | 16 | 70 |
| 2023 Enero | 64 | 25 | 89 |
| 2022 Diciembre | 41 | 20 | 61 |
| 2022 Noviembre | 52 | 27 | 79 |
| 2022 Octubre | 29 | 28 | 57 |
| 2022 Septiembre | 40 | 42 | 82 |
| 2022 Agosto | 42 | 49 | 91 |
| 2022 Julio | 26 | 15 | 41 |
| 2022 Junio | 19 | 19 | 38 |
| 2022 Mayo | 39 | 47 | 86 |
| 2022 Abril | 45 | 44 | 89 |
| 2022 Marzo | 40 | 23 | 63 |
| 2022 Febrero | 26 | 22 | 48 |
| 2022 Enero | 25 | 21 | 46 |
| 2021 Diciembre | 28 | 27 | 55 |
| 2021 Noviembre | 44 | 33 | 77 |
| 2021 Octubre | 37 | 39 | 76 |
| 2021 Septiembre | 39 | 33 | 72 |
| 2021 Agosto | 32 | 9 | 41 |
| 2021 Julio | 43 | 11 | 54 |
| 2021 Junio | 33 | 15 | 48 |
| 2021 Mayo | 42 | 29 | 71 |
| 2021 Abril | 71 | 75 | 146 |
| 2021 Marzo | 45 | 45 | 90 |
| 2021 Febrero | 94 | 34 | 128 |
| 2021 Enero | 38 | 31 | 69 |
| 2020 Diciembre | 34 | 14 | 48 |
| 2020 Noviembre | 49 | 18 | 67 |
| 2020 Octubre | 24 | 15 | 39 |
| 2020 Septiembre | 26 | 18 | 44 |
| 2020 Agosto | 30 | 15 | 45 |
| 2020 Julio | 34 | 23 | 57 |
| 2020 Junio | 27 | 10 | 37 |
| 2020 Mayo | 66 | 25 | 91 |
| 2020 Abril | 49 | 7 | 56 |
| 2020 Marzo | 33 | 13 | 46 |
| 2020 Febrero | 40 | 8 | 48 |
| 2020 Enero | 37 | 17 | 54 |
| 2019 Diciembre | 62 | 25 | 87 |
| 2019 Noviembre | 23 | 11 | 34 |
| 2019 Octubre | 32 | 16 | 48 |
| 2019 Septiembre | 33 | 9 | 42 |
| 2019 Agosto | 28 | 15 | 43 |
| 2019 Julio | 34 | 25 | 59 |
| 2019 Junio | 75 | 37 | 112 |
| 2019 Mayo | 218 | 183 | 401 |
| 2019 Abril | 88 | 126 | 214 |
| 2019 Marzo | 18 | 40 | 58 |
| 2019 Febrero | 47 | 66 | 113 |
| 2019 Enero | 39 | 48 | 87 |
| 2018 Diciembre | 26 | 43 | 69 |
| 2018 Noviembre | 45 | 9 | 54 |
| 2018 Octubre | 72 | 27 | 99 |
| 2018 Septiembre | 12 | 13 | 25 |
| 2018 Agosto | 6 | 29 | 35 |
| 2018 Julio | 8 | 38 | 46 |
| 2018 Junio | 9 | 17 | 26 |
| 2018 Mayo | 15 | 13 | 28 |
| 2018 Abril | 7 | 16 | 23 |
| 2018 Marzo | 8 | 13 | 21 |
| 2018 Febrero | 9 | 3 | 12 |
| 2018 Enero | 7 | 2 | 9 |
| 2017 Diciembre | 5 | 6 | 11 |
| 2017 Noviembre | 8 | 4 | 12 |
| 2017 Octubre | 15 | 4 | 19 |
| 2017 Septiembre | 15 | 18 | 33 |
| 2017 Agosto | 11 | 10 | 21 |
| 2017 Julio | 16 | 3 | 19 |
| 2017 Junio | 19 | 6 | 25 |
| 2017 Mayo | 30 | 2 | 32 |
| 2017 Abril | 14 | 1 | 15 |
| 2017 Marzo | 19 | 4 | 23 |
| 2017 Febrero | 14 | 1 | 15 |
| 2017 Enero | 8 | 5 | 13 |
| 2016 Diciembre | 12 | 5 | 17 |
| 2016 Noviembre | 47 | 5 | 52 |
| 2016 Octubre | 65 | 2 | 67 |
| 2016 Septiembre | 18 | 10 | 28 |
| 2016 Agosto | 19 | 5 | 24 |
| 2016 Julio | 34 | 4 | 38 |
| 2016 Junio | 41 | 12 | 53 |
| 2016 Mayo | 37 | 12 | 49 |
| 2016 Abril | 33 | 11 | 44 |
| 2016 Marzo | 45 | 7 | 52 |
| 2016 Febrero | 38 | 8 | 46 |
| 2016 Enero | 22 | 5 | 27 |
| 2015 Diciembre | 53 | 4 | 57 |
| 2015 Noviembre | 58 | 5 | 63 |
| 2015 Octubre | 48 | 5 | 53 |
| 2015 Septiembre | 29 | 5 | 34 |
| 2015 Agosto | 49 | 6 | 55 |
| 2015 Julio | 65 | 4 | 69 |
| 2015 Junio | 33 | 3 | 36 |
| 2015 Mayo | 44 | 1 | 45 |
| 2015 Abril | 46 | 6 | 52 |
| 2015 Marzo | 40 | 4 | 44 |
| 2015 Febrero | 24 | 6 | 30 |
| 2015 Enero | 37 | 2 | 39 |
| 2014 Diciembre | 63 | 3 | 66 |
| 2014 Noviembre | 57 | 3 | 60 |
| 2014 Octubre | 66 | 2 | 68 |
| 2014 Septiembre | 42 | 2 | 44 |
| 2014 Agosto | 42 | 3 | 45 |
| 2014 Julio | 44 | 1 | 45 |
| 2014 Junio | 57 | 3 | 60 |
| 2014 Mayo | 45 | 1 | 46 |
| 2014 Abril | 40 | 2 | 42 |
| 2014 Marzo | 44 | 3 | 47 |
| 2014 Febrero | 36 | 0 | 36 |
| 2014 Enero | 35 | 1 | 36 |
| 2013 Diciembre | 45 | 4 | 49 |
| 2013 Noviembre | 52 | 5 | 57 |
| 2013 Octubre | 44 | 3 | 47 |
| 2013 Septiembre | 41 | 4 | 45 |
| 2013 Agosto | 43 | 9 | 52 |
| 2013 Julio | 21 | 0 | 21 |
| 2002 Diciembre | 836 | 0 | 836 |
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