Annali Italiani di Medicina Interna

S Mansueto

Annali italiani di medicina interna

biondo era e bello e di gentile aspetto

比翁多既英俊又温文尔雅

We describe a 68-year-old male patient, treated with amoxicillin-clavulanic acid for 18 days and oral anticoagulants. He developed a cholestatic hepatitis with conjugated bilirubin of 11 mg/dL and a concomitant overdose of oral anticoagulants (INR 7). Nausea, vomiting, jaundice and large ecchymoses occurred 41 days after treatment with amoxicillin-clavulanic acid; the clinical manifestations resolved within 1 week and the liver tests returned to normal 48 days after therapy withdrawal. The mechanism of the amoxicillin-clavulanate-induced hepatitis is probably immunoallergic; this complication occurs mainly in subjects with a metabolic and/or immunologic idiosyncrasy. The pharmacokinetics of this antibiotic, which is not directly metabolized by cytochrome P450, may be affected by the concomitant use of drugs under cytochrome P450 control. When using amoxicillin-clavulanic acid, one should take into account its potential hepatic toxicity and possible interaction with oral anticoagulants. However, it appears to be crucial to follow the correct indications for both drugs. In fact, in the patient described above amoxicillin-clavulanic acid was wrongly administered as prophylaxis after a cutaneous biopsy of the nose. The same occurred with the oral anticoagulants prescribed to the patient for a single episode of paroxysmal atrial fibrillation which had occurred one year previously.

Cristiana Cauli

Lara Fenu

Andrea Perra

Francesco Marongiu

[Amoxicillin-clavulanic acid and oral anticoagulants: a possible dangerous association].

[阿莫西林-克拉维酸与口服抗凝剂：可能的危险关联]

Iron overload diseases are due to a progressive increase in total body iron stores that leads to deposition of iron in parenchymal organs and to subsequent damage to these organs. The commonest inherited form of iron overload is hereditary hemochromatosis (HH), an autosomal recessive disorder affecting the white population. Although in the western world and in northern Europe the majority of cases of HH are associated with an HFE gene mutation (C282Y and H63D), there are families with a familial iron overload disorder in whom neither the C282Y nor the H63D mutations were found. Recently, other forms of HH that are not related to HFE, but are due to mutations in genes coding iron transport proteins (ferroportin-1, TfR2, hepcidin) have been described. The clinical presentation of the disorder is highly variable, depending on the severity of iron overload. In fact, the inappropriate absorption and deposition of dietary iron may result in the development of hepatic and non-hepatic end-organ injury, leading to liver cirrhosis, hepatocellular carcinoma, diabetes, arthritis, skin pigmentation and cardiac diseases. HH and its sequelae are preventable with an early diagnosis and treatment. Patients with evidence of iron overload, a family history of HH or other risk factors should be screened by genotype testing for the HFE mutation. Nowadays, HH is recognized as being a complex genetic disease with probable significant environmental and genetic modifying factors, such as hepatitis C virus infection and alcohol abuse, and it has been shown that HFE mutations represent an independent risk factor for fibrosis and cirrhosis in chronic hepatitis C.

Anna Licata

Virna Brucato

Vito Di Marco

Franco Barbaria

Antonio Craxì

[Iron overload disease: recent findings].

[铁过载疾病：最新研究进展]

A 22-year-old woman presented with effort dyspnea unresponsive to bronchodilators. Harsh respiratory sounds were audible at the neck. Thoracic and cardiac evaluation was normal. Spirometry revealed an obstructive ventilatory defect, and the flow-volume loop indicated upper airway obstruction. Bronchoscopy and tracheal computed tomography revealed a stenosis of the subglottic larynx. A biopsy specimen of the stenotic area of the trachea showed a normal mucosa and non-specific chronic inflammation. The tracheal stenosis was managed by means of endobronchial laser therapy, which led to the resolution of the patient's symptoms. As we could not identify any specific pathogenetic process, our final diagnosis was idiopathic subglottic tracheal stenosis.

出版信息	出版商: CEPI s.r.l.，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 1986，原创研究文献占比: ，自引率:， Gold OA占比:

Annali Italiani di Medicina Interna

期刊引文格式

有 1 位以上作者的期刊

有 2 位作者的期刊

有 3 位作者的期刊

有 5 位以上作者的期刊

书籍引用格式

学位论文引用格式

网页引用格式

专利引用格式

手工熬夜修改参考文献？研飞自动匹配期刊，一键轻松成稿，支持 Word/WPS

投稿经验分享

biondo era e bello e di gentile aspetto

biondo era e bello e di gentile aspetto

biondo era e bello e di gentile aspetto

biondo era e bello e di gentile aspetto

biondo era e bello e di gentile aspetto

[Amoxicillin-clavulanic acid and oral anticoagulants: a possible dangerous association].

[Iron overload disease: recent findings].

Adult idiopathic subglottic stenosis: a diagnostic and therapeutic challenge.

biondo era e bello e di gentile aspetto

biondo era e bello e di gentile aspetto