A.E. Balloon Hurtadoa, A. Encinas Basconesb, M.A. Bascones Martínezc
a Family Medicine resident. b Physician. c Pediatrician.
CS Concrete from Korea.
Madrid Health Service, Area 4.
Madrid.
Spain.
1.
A 12-year-old male patient, born with pregnancy and childbirth, neonatal period, maternal breastfeeding for 10 months, normal psychomotor development, rhino-junctivitis treatment, with normal immunizations according to the current varied diet, deficit disorder
Sometimes he has had urticarial lesions that cannot be related to any triggering factor.
Located atopic dermatitis in early childhood
A 43-year-old male and 45 father, healthy.
In September 2007 she was admitted to the emergency department with melena after a 4-hour history of vinegar consumption.
The clinical picture began with melenas, as well as the appearance of a generalized urticaria predominantly affecting the shoulders and abdomen.
Previously the patient reported mild epigastric pain.
Establishment
Temperature: ¡À 1°C, weight: 35 kg, good general condition, well hydrated, good skin and mucous coloration.
There are no exanthema, petechiae or significant lymphadenopathy.
Lesions caused by noise in the abdomen and upper limbs
Pulmonary and cardiovascular abnormalities were normal.
Blurred and depressible abdomen, with no palpable masses or visceromegaly; there is no pain in eruptions; there are no conserved hydroaerial sounds.
Rectal tract: dial spotted, black stool.
Otorhinolaryngology: normal ears and pharynx.
Neurological: collaborator, conscious and oriented, has no neck stiffness or meningeal signs, normal gait and isochoric and normoreactive pupils.
Establishment plan
1. Biochemistry: all parameters are within normal limits, including ferritin and celiac antibodies.
2) Leukocyte count: 1002; 5,180,000/ml; hemoglobin: 14.7 g/dl; hematocrit: 44; total corpuscular volume: E: 84; hemoglobin: 7,900; mean corpuscular: 282,40).
3. Normal coagulation.
4) occult gastrointestinal bleeding: positive.
5. Total IgE: 1,095 KU/l.
Specific IgE by CAP (IgEEmCAP) against horse mackerel: 52.5 KU/l; IgEEmCAP against boqueron: class zero; anisakis: 6.33 KU/l
6. CH50, C3 and C4 supplementation: normal.
7. Cutaneous testing for regular inhalants: positive for grass pollen, olea, arizontal, domestic scar-positive banana, negative for maleza, limit epithelium and cat;
Skin tests for food battery negative for cow's milk and egg; within the limit of positivity for blue fish mixture and white fish mixture; positive for dry fruit mix negative and anisakis, and
Patch tests with foods that are negative for milk and aquaculture, white fish, blue, nuts, lentils, wheat, dog and cat epithelium, calf, coat, guinea fowl
8. Oral endoscopy.
It is characterized by glycogen acanthosis, superficial erosions of 2-3 cm in length, rounded images, small, white, in accumulations in the middle and lower thirds.
Normal cardia, stomach, body and antrum were normal.
Duodenal mucosa without lesions, astral mucosa without lesions, esophageal mucosa with characteristic lesions eosinophilic biopsy somewhat more intense in the middle and upper esophagus.
9. Normal abdominal ultrasound.
1.
Correspondence address: A Pathro Elizabeth Ballón Hurtado amparobahu@hotmail.com
