Mujer joven con cuadro de hepatitis aguda. ¿Pensamos en todas las situaciones clínicas?

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Área 11 de Atención Primaria de Madrid. Madrid. España" "etiqueta" => "b" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Centro de Salud Alpes. Área 4 de Atención Primaria de Madrid. Madrid. España" "etiqueta" => "c" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Centro de Salud Embajadores. Área 11 de Atención Primaria de Madrid. Madrid. España" "etiqueta" => "d" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: M. Sainz-Maza Aparicio. Centro de Salud Guayaba. EAP Puerta Bonita II. C/ Antonia Rodríguez Sacristán 4. 28044 Madrid." ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-01-20" "fechaAceptado" => "2009-05-25" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec160092" "palabras" => array:3 [ 0 => "reacción adversa medicamentosa" 1 => "amoxicilina/ácido clavulánico" 2 => "hepatitis" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec160093" "palabras" => array:3 [ 0 => "adverse drug reaction" 1 => "amoxycillin/clavulanic acid" 2 => "hepatitis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "En esta ocasión se sugiere una situación clínica relativamente frecuente, como puede ser un cuadro clínico de hepatitis aguda con un comportamiento enzimático que a todos nos sugeriría un proceso infeccioso o incluso un proceso maligno de la encrucijada bilio-pancreática. A veces nos cuesta pensar en otras situaciones, en este caso un efecto secundario de un fármaco de uso muy común y que se presenta con una frecuencia nada despreciable. Aunque el tratamiento y la evolución del cuadro no van a diferir de otros cuadros de hepatitis aguda, el pronóstico es distinto, por lo que debemos conocerlo." ] "en" => array:1 [ "resumen" => "In this case, a relatively frequent clinical condition such as a clinical picture of acute hepatitis with an enzymatic evolution would seem possible, and it is possible that this could even suggest an infectious condition or a malignant process of the bilio-pancreatic area. Sometimes it is difficult for us to consider other possibilities, such as an adverse drug reaction from a very commonly used drug which appears with high frequency. Although the treatment and the course of the disease do not differ from other pictures of acute hepatitis, the prognosis is different. This is the main reason why we need to know it." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determinants of the clinical expresion of amoxicillin-clavulanate hepatotoxicity: a prospective series from Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Lucena" 1 => "R.J. Andrade" 2 => "M.C. Fernández" 3 => "K. Pachkoria" 4 => "G. Peláez" 5 => "J.A. 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