diff --git "a/data/test.conll" "b/data/test.conll" new file mode 100644--- /dev/null +++ "b/data/test.conll" @@ -0,0 +1,6413 @@ +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +oriunda B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +provincia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Misiones, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Dermatología I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +placas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aspecto I-PRESENT_ILLNESS +verrugoso I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +numerosas I-PRESENT_ILLNESS +pápulas I-PRESENT_ILLNESS +negruzcas I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +superficie, I-PRESENT_ILLNESS +localizadas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +sitios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +apoyo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +pies I-PRESENT_ILLNESS +(punta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dedos, I-PRESENT_ILLNESS +metatarso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +talones), I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +reciente I-PRESENT_ILLNESS +aparición. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Las I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +ocasionaban I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dificultaban I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +deambulación. I-PRESENT_ILLNESS +Realizada B-TREATMENT +la I-TREATMENT +extracción I-TREATMENT +quirúrgica, I-TREATMENT +se B-EXPLORATION +obtuvieron I-EXPLORATION +alrededor I-EXPLORATION +de I-EXPLORATION +20 I-EXPLORATION +tungas I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +extraídas I-EXPLORATION +se I-EXPLORATION +enviaron I-EXPLORATION +al I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +anatomopatología, I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +tungiasis. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +con I-TREATMENT +ivermecti-na I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +200 I-TREATMENT +µg/kg I-TREATMENT +como I-TREATMENT +terapia I-TREATMENT +coadyuvante, I-TREATMENT +debido I-TREATMENT +al I-TREATMENT +gran I-TREATMENT +compromiso I-TREATMENT +cutáneo I-TREATMENT +y I-TREATMENT +la I-TREATMENT +multiplicidad I-TREATMENT +de I-TREATMENT +lesiones. I-TREATMENT +Las B-EVOLUTION +lesiones I-EVOLUTION +evolucionaron I-EVOLUTION +favorablemente I-EVOLUTION +con I-EVOLUTION +resolución I-EVOLUTION +completa. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +internada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +depresión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sensorio. I-PRESENT_ILLNESS +Antecedentes: B-PAST_MEDICAL_HISTORY +recién I-PAST_MEDICAL_HISTORY +nacida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +término, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +adecuado I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ictericia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +incompatibilidad I-PAST_MEDICAL_HISTORY +ABO, I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +luminoterapia I-PAST_MEDICAL_HISTORY +dentro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +primeras I-PAST_MEDICAL_HISTORY +24 I-PAST_MEDICAL_HISTORY +h I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida. I-PAST_MEDICAL_HISTORY +Al I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +egreso I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +valores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +bilirrubina I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +9, I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +mg/dl I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +directa I-PAST_MEDICAL_HISTORY +0, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mg/dl. I-PAST_MEDICAL_HISTORY +Reingresó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Neonatología I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +mes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ictericia I-PAST_MEDICAL_HISTORY +prolongada. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +internación I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +ecografía I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +cuyo I-PAST_MEDICAL_HISTORY +informe I-PAST_MEDICAL_HISTORY +mencionaba I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vías I-PAST_MEDICAL_HISTORY +biliares I-PAST_MEDICAL_HISTORY +intrahepática I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +extrahepáticas, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +dilatación. I-PAST_MEDICAL_HISTORY +Laboratorio: I-PAST_MEDICAL_HISTORY +bilirrubinemia I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +11, I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +mg/dl I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +directa I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +mg/dl, I-PAST_MEDICAL_HISTORY +FAL I-PAST_MEDICAL_HISTORY +257 I-PAST_MEDICAL_HISTORY +UI/L, I-PAST_MEDICAL_HISTORY +TGP I-PAST_MEDICAL_HISTORY +55 I-PAST_MEDICAL_HISTORY +UI/L, I-PAST_MEDICAL_HISTORY +TGO I-PAST_MEDICAL_HISTORY +69 I-PAST_MEDICAL_HISTORY +UI/L. I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +dada I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +continuó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +ambulatorio I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +gastroenterólogo I-PAST_MEDICAL_HISTORY +pediatra, I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +internación I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +hemorragia I-PAST_MEDICAL_HISTORY +intracraneal. I-PAST_MEDICAL_HISTORY +Evolución: B-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +ictericia I-EXPLORATION +generalizada, I-EXPLORATION +hepatomegalia I-EXPLORATION +y I-EXPLORATION +sopor. I-EXPLORATION +Dentro B-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +internación I-EVOLUTION +presentó I-EVOLUTION +episodio I-EVOLUTION +convulsivo I-EVOLUTION +focal I-EVOLUTION +en I-EVOLUTION +hemicuerpo I-EVOLUTION +derecho; I-EVOLUTION +en B-TREATMENT +la I-TREATMENT +tomografía I-TREATMENT +computada I-TREATMENT +cerebral I-TREATMENT +(TC) I-TREATMENT +se I-TREATMENT +constató I-TREATMENT +hematoma I-TREATMENT +subdural I-TREATMENT +que I-TREATMENT +requirió I-TREATMENT +drenaje I-TREATMENT +quirúrgico I-TREATMENT +y I-TREATMENT +asistencia I-TREATMENT +respiratoria I-TREATMENT +mecánica I-TREATMENT +hasta I-TREATMENT +48 I-TREATMENT +h I-TREATMENT +del I-TREATMENT +postoperatorio. I-TREATMENT +Laboratorio B-EXPLORATION +de I-EXPLORATION +ingreso: I-EXPLORATION +GOT I-EXPLORATION +120 I-EXPLORATION +UI/L, I-EXPLORATION +GPT I-EXPLORATION +180 I-EXPLORATION +UI/L, I-EXPLORATION +FAL I-EXPLORATION +1053 I-EXPLORATION +UI/L, I-EXPLORATION +gammaglutamiltranspeptidasa I-EXPLORATION +1119 I-EXPLORATION +UI/L, I-EXPLORATION +LDH I-EXPLORATION +1262 I-EXPLORATION +UI/L, I-EXPLORATION +bilirrubinemia I-EXPLORATION +total I-EXPLORATION +6 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +directa I-EXPLORATION +3, I-EXPLORATION +9 I-EXPLORATION +mg/ I-EXPLORATION +dl, I-EXPLORATION +amonio I-EXPLORATION +51, I-EXPLORATION +8 I-EXPLORATION +mcg/dl, I-EXPLORATION +lactacidemia I-EXPLORATION +7 I-EXPLORATION +mmol/L, I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +59%, I-EXPLORATION +KPTT I-EXPLORATION +100 I-EXPLORATION +segundos I-EXPLORATION +(no I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +administró I-EXPLORATION +vitamina I-EXPLORATION +K I-EXPLORATION +ni I-EXPLORATION +plasma I-EXPLORATION +frasco I-EXPLORATION +congelado I-EXPLORATION +previo I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +toma I-EXPLORATION +de I-EXPLORATION +muestra). I-EXPLORATION +Serologías I-EXPLORATION +para I-EXPLORATION +VIH, I-EXPLORATION +sífilis, I-EXPLORATION +toxoplasmosis, I-EXPLORATION +hepatitis I-EXPLORATION +B, I-EXPLORATION +hepatitis I-EXPLORATION +A I-EXPLORATION +y I-EXPLORATION +citomegalovirus I-EXPLORATION +negativas. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +centellograma I-EXPLORATION +con I-EXPLORATION +HIDA I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +falta I-EXPLORATION +de I-EXPLORATION +captación I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +intrahepático I-EXPLORATION +y I-EXPLORATION +extrahepático, I-EXPLORATION +sin I-EXPLORATION +pasaje I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +al I-EXPLORATION +intestino. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +portoenteroanastomosis I-TREATMENT +por I-TREATMENT +laparoscopia, I-TREATMENT +después I-TREATMENT +de I-TREATMENT +confirmar I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +atresia I-TREATMENT +de I-TREATMENT +vías I-TREATMENT +biliares I-TREATMENT +durante I-TREATMENT +la I-TREATMENT +cirugía. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +presentaba I-EVOLUTION +maduración I-EVOLUTION +neurológica I-EVOLUTION +adecuada I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +edad. I-EVOLUTION +Requirió B-TREATMENT +trasplante I-TREATMENT +hepático I-TREATMENT +cerca I-TREATMENT +del I-TREATMENT +año I-TREATMENT +de I-TREATMENT +edad. I-TREATMENT + I-TREATMENT + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +nacido B-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +término, I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +programada, I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +controlado, I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +talla I-PAST_MEDICAL_HISTORY +acordes I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional. I-PAST_MEDICAL_HISTORY +Antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +otitis I-PAST_MEDICAL_HISTORY +media, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +cirugías, I-PAST_MEDICAL_HISTORY +internaciones I-PAST_MEDICAL_HISTORY +previas I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +alergias. I-PAST_MEDICAL_HISTORY +Inmunizaciones I-PAST_MEDICAL_HISTORY +completas I-PAST_MEDICAL_HISTORY +según I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +calendario I-PAST_MEDICAL_HISTORY +oficial. I-PAST_MEDICAL_HISTORY +Crecimiento I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +desarrollo I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY +Historia B-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +con I-FAMILY_HISTORY +ambos I-FAMILY_HISTORY +padres I-FAMILY_HISTORY +obesos I-FAMILY_HISTORY +con I-FAMILY_HISTORY +cirugía I-FAMILY_HISTORY +bariátrica I-FAMILY_HISTORY +realizada, I-FAMILY_HISTORY +y I-FAMILY_HISTORY +dos I-FAMILY_HISTORY +hermanas I-FAMILY_HISTORY +mayores I-FAMILY_HISTORY +con I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +asma I-FAMILY_HISTORY +e I-FAMILY_HISTORY +hipotiroidismo, I-FAMILY_HISTORY +respectivamente. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Es B-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +síndrome I-DERIVED_FROM/TO +ascítico I-DERIVED_FROM/TO +edematoso. I-DERIVED_FROM/TO +Comenzó B-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +palpebral I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +leve. I-PRESENT_ILLNESS +Dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +después, I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +exantema I-PRESENT_ILLNESS +urticariante I-PRESENT_ILLNESS +generalizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +todo I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuerpo, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +pruriginoso, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +revirtió I-PRESENT_ILLNESS +espontáneamente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +menos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas, I-PRESENT_ILLNESS +apareció I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +bipalpebral I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +pronunciado, I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +irritabilidad. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +pediatra, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +constató I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +respecto I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +previo I-PRESENT_ILLNESS +(2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes). I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +infecciones. I-PAST_MEDICAL_HISTORY +Fue B-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +médico I-DERIVED_FROM/TO +nefrólogo, I-DERIVED_FROM/TO +quien I-DERIVED_FROM/TO +solicitó I-DERIVED_FROM/TO +estudios I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +laboratorio I-DERIVED_FROM/TO +cuyos I-DERIVED_FROM/TO +resultados I-DERIVED_FROM/TO +mostraron I-DERIVED_FROM/TO +marcada I-DERIVED_FROM/TO +hipoproteinemia I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +hipoalbuminemia, I-DERIVED_FROM/TO +hipertrigliceridemia, I-DERIVED_FROM/TO +hipocalcemia I-DERIVED_FROM/TO +leve I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +orina I-DERIVED_FROM/TO +normal. I-DERIVED_FROM/TO +Se I-DERIVED_FROM/TO +trasladó I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +niño I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +tratamiento. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Examen B-EXPLORATION +físico: I-EXPLORATION +niño I-EXPLORATION +lúcido, I-EXPLORATION +vigil, I-EXPLORATION +orientado, I-EXPLORATION +irritable. I-EXPLORATION +TA I-EXPLORATION +109/78 I-EXPLORATION +mm I-EXPLORATION +Hg, I-EXPLORATION +TAM I-EXPLORATION +92 I-EXPLORATION +mm I-EXPLORATION +Hg, I-EXPLORATION +FC I-EXPLORATION +130 I-EXPLORATION +lpm, I-EXPLORATION +FR I-EXPLORATION +32 I-EXPLORATION +rpm, I-EXPLORATION +temperatura I-EXPLORATION +36, I-EXPLORATION +7°C, I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +O2 I-EXPLORATION +96% I-EXPLORATION +respirando I-EXPLORATION +aire I-EXPLORATION +ambiente. I-EXPLORATION +Peso I-EXPLORATION +14, I-EXPLORATION +600 I-EXPLORATION +kg, I-EXPLORATION +palidez I-EXPLORATION +generalizada, I-EXPLORATION +facies I-EXPLORATION +abotagada. I-EXPLORATION +Edema I-EXPLORATION +palpebral I-EXPLORATION +bilateral. I-EXPLORATION +Algunos I-EXPLORATION +crepitantes I-EXPLORATION +basales I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +campos I-EXPLORATION +pulmonares. I-EXPLORATION +Edema I-EXPLORATION +pretibial I-EXPLORATION +bilateral. I-EXPLORATION +Abdomen I-EXPLORATION +globuloso, I-EXPLORATION +distendido, I-EXPLORATION +onda I-EXPLORATION +ascítica I-EXPLORATION +positiva, I-EXPLORATION +sin I-EXPLORATION +hepatoesplenomegalia. I-EXPLORATION +Edema I-EXPLORATION +escrotal I-EXPLORATION +y I-EXPLORATION +suprapúbico. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +particularidades. I-EXPLORATION + I-EXPLORATION +Laboratorio I-EXPLORATION +inicial: I-EXPLORATION +leucocitos: I-EXPLORATION +17 I-EXPLORATION +700/mm3, I-EXPLORATION +fórmula: I-EXPLORATION +27% I-EXPLORATION +neutrófilos, I-EXPLORATION +14% I-EXPLORATION +eosinófilos, I-EXPLORATION +49% I-EXPLORATION +linfocitos, I-EXPLORATION +6% I-EXPLORATION +monocitos I-EXPLORATION +y I-EXPLORATION +4% I-EXPLORATION +linfocitos I-EXPLORATION +atípicos. I-EXPLORATION +Calcio I-EXPLORATION +total I-EXPLORATION +7, I-EXPLORATION +4 I-EXPLORATION +mmol/L I-EXPLORATION +(VN I-EXPLORATION +8, I-EXPLORATION +5-10), I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +3 I-EXPLORATION +g/dl I-EXPLORATION +(VN I-EXPLORATION +6, I-EXPLORATION +6-8, I-EXPLORATION +7), I-EXPLORATION +albúmina I-EXPLORATION +1, I-EXPLORATION +6 I-EXPLORATION +g/dl I-EXPLORATION +(VN I-EXPLORATION +3, I-EXPLORATION +5-3), I-EXPLORATION +IgG I-EXPLORATION +136 I-EXPLORATION +mg/dl I-EXPLORATION +(VN I-EXPLORATION +490-1450), I-EXPLORATION +IgE I-EXPLORATION +140 I-EXPLORATION +UI/ I-EXPLORATION +ml I-EXPLORATION +(VN I-EXPLORATION +hasta I-EXPLORATION +75), I-EXPLORATION +triglicéridos I-EXPLORATION +196 I-EXPLORATION +mg/dl I-EXPLORATION +(N I-EXPLORATION +< I-EXPLORATION +150), I-EXPLORATION +TGO I-EXPLORATION +62 I-EXPLORATION +U/L I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +37), I-EXPLORATION +TGP I-EXPLORATION +43 I-EXPLORATION +U/L I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +41), I-EXPLORATION + I-EXPLORATION +colesterol I-EXPLORATION +total I-EXPLORATION +129 I-EXPLORATION +mg/dl I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +200), I-EXPLORATION +HDL I-EXPLORATION +25 I-EXPLORATION +mg/ I-EXPLORATION +dl I-EXPLORATION +(VN I-EXPLORATION +> I-EXPLORATION +35). I-EXPLORATION +PCR I-EXPLORATION +1, I-EXPLORATION +3mg/dl I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +0, I-EXPLORATION +06). I-EXPLORATION +Orina I-EXPLORATION +normal I-EXPLORATION +sin I-EXPLORATION +proteinuria. I-EXPLORATION +Relación I-EXPLORATION +Prot/Cr I-EXPLORATION +0, I-EXPLORATION +26. I-EXPLORATION +Hormonas I-EXPLORATION +tiroideas I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION +anticuerpos I-EXPLORATION +para I-EXPLORATION +enfermedad I-EXPLORATION +celíaca I-EXPLORATION +negativos. I-EXPLORATION +Prueba I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +tuberculina I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +Al B-EVOLUTION +segundo I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +internación, I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +presentó I-EVOLUTION +dos I-EVOLUTION +picos I-EVOLUTION +febriles, I-EVOLUTION +fauces I-EVOLUTION +congestivas, I-EVOLUTION +subcrepitantes I-EVOLUTION +pulmonares I-EVOLUTION +bibasales I-EVOLUTION +leves. I-EVOLUTION +Radiografía B-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +ecografía I-EXPLORATION +renal I-EXPLORATION +sin I-EXPLORATION +particularidades. I-EXPLORATION +Ecografía I-EXPLORATION +abdominal I-EXPLORATION +sin I-EXPLORATION +visceromegalia, I-EXPLORATION +con I-EXPLORATION +líquido I-EXPLORATION +ascítico I-EXPLORATION +moderado, I-EXPLORATION +mucosa I-EXPLORATION +gástrica I-EXPLORATION +sin I-EXPLORATION +agrandamiento I-EXPLORATION +ni I-EXPLORATION +hipertrofia I-EXPLORATION +de I-EXPLORATION +pliegues. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION +la I-EXPLORATION +etiología I-EXPLORATION +cardiovascular, I-EXPLORATION +renal I-EXPLORATION +o I-EXPLORATION +hepática I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +clínica I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +realizados. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +gastroenteropatía I-EXPLORATION +perdedora I-EXPLORATION +de I-EXPLORATION +proteínas, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +endoscopia I-EXPLORATION +esofagogastroduodenal I-EXPLORATION +con I-EXPLORATION +biopsia, I-EXPLORATION +cuyo I-EXPLORATION +informe I-EXPLORATION +reveló: I-EXPLORATION +esófago I-EXPLORATION +con I-EXPLORATION +cambio I-EXPLORATION +mucoso I-EXPLORATION +a I-EXPLORATION +23 I-EXPLORATION +cm, I-EXPLORATION +mucosa I-EXPLORATION +pálida I-EXPLORATION +y I-EXPLORATION +muy I-EXPLORATION +edematosa; I-EXPLORATION +estómago I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +pliegues I-EXPLORATION +engrosados, I-EXPLORATION +seudopólipos I-EXPLORATION +y I-EXPLORATION +erosiones I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mucosa. I-EXPLORATION +Duodeno I-EXPLORATION +con I-EXPLORATION +pliegues I-EXPLORATION +engrosados I-EXPLORATION +y I-EXPLORATION +mucosa I-EXPLORATION +edematosa. I-EXPLORATION +El I-EXPLORATION +informe I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +correspondió I-EXPLORATION +a I-EXPLORATION +esofagitis, I-EXPLORATION +gastritis I-EXPLORATION +y I-EXPLORATION +duodenitis I-EXPLORATION +crónica I-EXPLORATION +leve I-EXPLORATION +a I-EXPLORATION +moderada I-EXPLORATION +con I-EXPLORATION +frecuentes I-EXPLORATION +eosinófilos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +depuración I-EXPLORATION +de I-EXPLORATION +α1-antitripsina I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +falta I-EXPLORATION +de I-EXPLORATION +accesibilidad I-EXPLORATION +al I-EXPLORATION +método. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +en I-EXPLORATION +sangre, I-EXPLORATION +IgM-IgG I-EXPLORATION +para I-EXPLORATION +CMV: I-EXPLORATION +positivo; I-EXPLORATION +antígeno I-EXPLORATION +temprano: I-EXPLORATION +reactivo; I-EXPLORATION +PCR: I-EXPLORATION +2075 I-EXPLORATION +copias I-EXPLORATION +(no I-EXPLORATION +reactivo I-EXPLORATION +< I-EXPLORATION +750 I-EXPLORATION +copias). I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +analizó I-EXPLORATION +material I-EXPLORATION +de I-EXPLORATION +biopsia I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +detección I-EXPLORATION +del I-EXPLORATION +virus. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +dieta I-TREATMENT +hiperproteica I-TREATMENT +y I-TREATMENT +gastroprotectora. I-TREATMENT +Recibió I-TREATMENT +una I-TREATMENT +infusión I-TREATMENT +intravenosa I-TREATMENT +de I-TREATMENT +albúmina I-TREATMENT +(25% I-TREATMENT +1 I-TREATMENT +g/ I-TREATMENT +kg, I-TREATMENT +una I-TREATMENT +dosis), I-TREATMENT +omeprazol I-TREATMENT +20 I-TREATMENT +mg/día I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +intravenosa I-TREATMENT +y I-TREATMENT +espironolactona I-TREATMENT +3 I-TREATMENT +mg/kg/día I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT +Al I-TREATMENT +no I-TREATMENT +mejorar I-TREATMENT +clínicamente, I-TREATMENT +a I-TREATMENT +los I-TREATMENT +6 I-TREATMENT +días I-TREATMENT +se I-TREATMENT +comenzó I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +ganciclovir I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +intravenosa I-TREATMENT +(5 I-TREATMENT +mg/kg I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas). I-TREATMENT +A I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +horas I-TREATMENT +se I-TREATMENT +rotó I-TREATMENT +a I-TREATMENT +valganciclovir I-TREATMENT +oral I-TREATMENT +(400 I-TREATMENT +mg/día) I-TREATMENT +por I-TREATMENT +la I-TREATMENT +imposibilidad I-TREATMENT +de I-TREATMENT +mantener I-TREATMENT +la I-TREATMENT +venoclisis. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +internación, I-EVOLUTION +dada I-EVOLUTION +la I-EVOLUTION +buena I-EVOLUTION +evolución, I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +otorgó I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +hospitalaria. I-EVOLUTION +Laboratorio B-EXPLORATION +al I-EXPLORATION +alta: I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +4, I-EXPLORATION +6 I-EXPLORATION +g/ I-EXPLORATION +dl I-EXPLORATION +(VN I-EXPLORATION +6, I-EXPLORATION +6-8, I-EXPLORATION +7), I-EXPLORATION +albúmina I-EXPLORATION +2, I-EXPLORATION +6 I-EXPLORATION +g/dl I-EXPLORATION +(VN I-EXPLORATION +3, I-EXPLORATION +5-5), I-EXPLORATION +triglicéridos I-EXPLORATION +254 I-EXPLORATION +mg/dl I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +150). I-EXPLORATION +Carga I-EXPLORATION +viral I-EXPLORATION +para I-EXPLORATION +CMV I-EXPLORATION +< I-EXPLORATION +750 I-EXPLORATION +copias. I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +continuar I-TREATMENT +con I-TREATMENT +dieta I-TREATMENT +hiperproteica, I-TREATMENT +protectores I-TREATMENT +gástricos I-TREATMENT +y I-TREATMENT +valganciclovir I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +6 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +tratamiento. I-TREATMENT +Cuatro B-EXPLORATION +meses I-EXPLORATION +después, I-EXPLORATION +se I-EXPLORATION +repitió I-EXPLORATION +la I-EXPLORATION +endoscopia I-EXPLORATION +esofagogastroduodenal, I-EXPLORATION +cuyo I-EXPLORATION +resultado I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +eritematosa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +antifaz, I-PRESENT_ILLNESS +pequeñas I-PRESENT_ILLNESS +placas I-PRESENT_ILLNESS +redondeadas, I-PRESENT_ILLNESS +ligeramente I-PRESENT_ILLNESS +atróficas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +temporooccipital I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cuello I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +finas I-PRESENT_ILLNESS +telangiectasias I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +superficie. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +genital, I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +eritematosa, I-PRESENT_ILLNESS +atrófica, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +bordes I-PRESENT_ILLNESS +definidos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Madre B-FAMILY_HISTORY +con I-FAMILY_HISTORY +alopecia I-FAMILY_HISTORY +cicatrizal, I-FAMILY_HISTORY +ojo I-FAMILY_HISTORY +seco, I-FAMILY_HISTORY +boca I-FAMILY_HISTORY +seca I-FAMILY_HISTORY +y I-FAMILY_HISTORY +anemia, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +diagnóstico I-FAMILY_HISTORY +de I-FAMILY_HISTORY +su I-FAMILY_HISTORY +enfermedad I-FAMILY_HISTORY +al I-FAMILY_HISTORY +momento I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +consulta. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Exámenes B-EXPLORATION +complementarios: I-EXPLORATION +Hb I-EXPLORATION +11, I-EXPLORATION +2g/dl, I-EXPLORATION +Hto I-EXPLORATION +33%, I-EXPLORATION +TGO I-EXPLORATION +265 I-EXPLORATION +UI/L, I-EXPLORATION +TGP I-EXPLORATION +212 I-EXPLORATION +UI/L, I-EXPLORATION +FAL I-EXPLORATION +927 I-EXPLORATION +UI/L, I-EXPLORATION +C3 I-EXPLORATION +54 I-EXPLORATION +mg/dl, I-EXPLORATION +C4 I-EXPLORATION +2 I-EXPLORATION +mg/dl, I-EXPLORATION +FAN I-EXPLORATION ++ I-EXPLORATION +1/1000 I-EXPLORATION +patrón I-EXPLORATION +moteado I-EXPLORATION +grueso I-EXPLORATION +y I-EXPLORATION +anti I-EXPLORATION +La I-EXPLORATION +positivo I-EXPLORATION +(paciente), I-EXPLORATION +FAN I-EXPLORATION ++ I-EXPLORATION +1/2000 I-EXPLORATION +patrón I-EXPLORATION +homogéneo I-EXPLORATION +y I-EXPLORATION +anti I-EXPLORATION +La I-EXPLORATION +y I-EXPLORATION +anti I-EXPLORATION +Ro I-EXPLORATION +positivos I-EXPLORATION +(madre) I-EXPLORATION + I-EXPLORATION +Estudio I-EXPLORATION +histopatológico: I-EXPLORATION +capa I-EXPLORATION +córnea I-EXPLORATION +engrosada, I-EXPLORATION +epidermis I-EXPLORATION +adelgazada, I-EXPLORATION +intensa I-EXPLORATION +vacuolización I-EXPLORATION +de I-EXPLORATION +queratinocitos I-EXPLORATION +basales, I-EXPLORATION +en I-EXPLORATION +dermis I-EXPLORATION +infiltrado I-EXPLORATION +mononuclear I-EXPLORATION +difuso. I-EXPLORATION +Membrana I-EXPLORATION +basal I-EXPLORATION +engrosada. I-EXPLORATION +IFD I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +Valoración I-EXPLORATION +cardiológica I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Tratamiento: B-TREATMENT +Hidrocortisona I-TREATMENT +1% I-TREATMENT +tópico, I-TREATMENT +Pimecrolimus I-TREATMENT +1%. I-TREATMENT +Desaparición B-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +eritematosas I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +lesiones I-EVOLUTION +atróficas I-EVOLUTION +con I-EVOLUTION +puntillado I-EVOLUTION +petequial I-EVOLUTION +en I-EVOLUTION +cuero I-EVOLUTION +cabelludo, I-EVOLUTION +normalizando I-EVOLUTION +las I-EVOLUTION +enzimas I-EVOLUTION +hepáticas I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION + I-EVOLUTION +Luego, I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +madre I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +realizó I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +Síndrome I-EVOLUTION +(Sme.) I-EVOLUTION +de I-EVOLUTION +Sjögren. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +77 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +ojos I-PRESENT_ILLNESS +(AO), I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +agudeza I-PRESENT_ILLNESS +visual I-PRESENT_ILLNESS +(AV). I-PRESENT_ILLNESS +Asimismo, I-PRESENT_ILLNESS +comenta I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +lleva I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +notando I-PRESENT_ILLNESS +molestias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +manera I-PRESENT_ILLNESS +alterna I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +uno I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +ojo. I-PRESENT_ILLNESS + B-FAMILY_HISTORY +No I-FAMILY_HISTORY +presenta I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés I-FAMILY_HISTORY +y B-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +isquémica I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con: I-PAST_MEDICAL_HISTORY +Pravastatina I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +horas, I-PAST_MEDICAL_HISTORY +Atenolol I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +mg/12 I-PAST_MEDICAL_HISTORY +horas, I-PAST_MEDICAL_HISTORY +Ranipril I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mg/12 I-PAST_MEDICAL_HISTORY +horas, I-PAST_MEDICAL_HISTORY +Acido I-PAST_MEDICAL_HISTORY +acetilsalicílico I-PAST_MEDICAL_HISTORY +100 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +horas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Lorazepam I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +horas. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Como B-PRESENT_ILLNESS +antecedente I-PRESENT_ILLNESS +personal I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +próximo, I-PRESENT_ILLNESS +señalar I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +empezar I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +problemas I-PRESENT_ILLNESS +oculares I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +ingresada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +medicina I-PRESENT_ILLNESS +interna I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Neumonía I-PRESENT_ILLNESS +neumocócica I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +lóbulo I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +tratada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +Moxifloxacino I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dosis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +400 I-PRESENT_ILLNESS +mg/24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +días, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +buena I-PRESENT_ILLNESS +respuesta. I-PRESENT_ILLNESS +Tras I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +alta I-PRESENT_ILLNESS +hospitalaria, I-PRESENT_ILLNESS +ya I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +antibiótico, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +comienza I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +referir I-PRESENT_ILLNESS +molestias I-PRESENT_ILLNESS +oculares I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +manera I-PRESENT_ILLNESS +alterna I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +AO. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +una I-EXPLORATION +AV I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +(OD) I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +6 I-EXPLORATION +que I-EXPLORATION +mejora I-EXPLORATION +a I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +con I-EXPLORATION +corrección I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(OI) I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +3 I-EXPLORATION +que I-EXPLORATION +mejora I-EXPLORATION +a I-EXPLORATION +0, I-EXPLORATION +6 I-EXPLORATION +con I-EXPLORATION +corrección. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +destaca I-EXPLORATION +una I-EXPLORATION +reacción I-EXPLORATION +inflamatoria I-EXPLORATION +en I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +de I-EXPLORATION +AO I-EXPLORATION +(Fenómeno I-EXPLORATION +de I-EXPLORATION +tyndall I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION ++1 I-EXPLORATION +y I-EXPLORATION +proteínas I-EXPLORATION ++1), I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +fuerte I-EXPLORATION +dispersión I-EXPLORATION +de I-EXPLORATION +pigmento I-EXPLORATION +(+/++) I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +deposita I-EXPLORATION +en I-EXPLORATION +todas I-EXPLORATION +las I-EXPLORATION +estructuras: I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +endotelio I-EXPLORATION +corneal I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +difusa, I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +iris, I-EXPLORATION +sinequias I-EXPLORATION +posteriores I-EXPLORATION +y I-EXPLORATION +malla I-EXPLORATION +trabecular. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tensión I-EXPLORATION +ocular I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +en I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +8 I-EXPLORATION +mmHg I-EXPLORATION +en I-EXPLORATION +OI. I-EXPLORATION +El I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo, I-EXPLORATION +bajo I-EXPLORATION +midriasis I-EXPLORATION +farmacológica, I-EXPLORATION +era I-EXPLORATION +normal, I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +reacción I-EXPLORATION +inflamatoria I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cámara I-EXPLORATION +vítrea. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +historia I-EXPLORATION +clínica, I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +protocolo I-EXPLORATION +de I-EXPLORATION +uveítis I-EXPLORATION +seguido I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +departamento, I-EXPLORATION +que I-EXPLORATION +incluyó I-EXPLORATION +una I-EXPLORATION +anamnesis I-EXPLORATION +por I-EXPLORATION +aparatos I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +solicitud I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +exploraciones I-EXPLORATION +complementarias I-EXPLORATION +dirigidas, I-EXPLORATION +sistemático I-EXPLORATION +de I-EXPLORATION +sangre, I-EXPLORATION +bioquímica, I-EXPLORATION +VDRL, I-EXPLORATION +FTA-abs I-EXPLORATION +y I-EXPLORATION +placa I-EXPLORATION +de I-EXPLORATION +tórax. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +midriáticos I-TREATMENT +y I-TREATMENT +corticoides I-TREATMENT +tópicos I-TREATMENT +cediendo B-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +en I-EXPLORATION +pocos I-EXPLORATION +días, I-EXPLORATION +manteniéndose, I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +sucesivas I-EXPLORATION +revisiones, I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +pigmento I-EXPLORATION +en I-EXPLORATION +numerosas I-EXPLORATION +estructuras I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +manteniendo I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION +de I-EXPLORATION +14 I-EXPLORATION +mmHg I-EXPLORATION +en I-EXPLORATION +AO. I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +exploraciones I-EXPLORATION +complementarias I-EXPLORATION +realizadas I-EXPLORATION +no I-EXPLORATION +detectaron I-EXPLORATION +ninguna I-EXPLORATION +alteración I-EXPLORATION +significativa. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +holocraneal I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +presentaba I-EXPLORATION +hipoestesia I-EXPLORATION +de I-EXPLORATION +miembro I-EXPLORATION +superior I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +dudosa I-EXPLORATION +rigidez I-EXPLORATION +de I-EXPLORATION +nuca, I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +signos I-EXPLORATION +meníngeos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +cerebral I-EXPLORATION +era I-EXPLORATION +normal, I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +(LCR) I-EXPLORATION +mostró I-EXPLORATION +hiperproteinorraquia, I-EXPLORATION +hipoglucorraquia I-EXPLORATION +y I-EXPLORATION +pleocitosis I-EXPLORATION +(98% I-EXPLORATION +linfocitos). I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +meningitis I-TREATMENT +vírica I-TREATMENT +o I-TREATMENT +bacteriana I-TREATMENT +decapitada, I-TREATMENT +se I-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +intravenoso I-TREATMENT +con I-TREATMENT +aciclovir, I-TREATMENT +ceftriaxona I-TREATMENT +y I-TREATMENT +ampicilina. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +días I-EVOLUTION +presentó I-EVOLUTION +disminución I-EVOLUTION +de I-EVOLUTION +conciencia, I-EVOLUTION +midriasis I-EVOLUTION +arreactiva I-EVOLUTION +bilateral I-EVOLUTION +y I-EVOLUTION +parálisis I-EVOLUTION +bilateral I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +pares I-EVOLUTION +craneales I-EVOLUTION +III, I-EVOLUTION +IV, I-EVOLUTION +VI, I-EVOLUTION +VII, I-EVOLUTION +IX I-EVOLUTION +y I-EVOLUTION +X. I-EVOLUTION +La B-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION +(RMN) I-EXPLORATION +mostró I-EXPLORATION +realce I-EXPLORATION +lepto I-EXPLORATION +y I-EXPLORATION +paquimeníngeo I-EXPLORATION +e I-EXPLORATION +hidrocefalia I-EXPLORATION +tetraventricular. I-EXPLORATION +A B-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT +microbiológicos I-TREATMENT +no I-TREATMENT +concluyentes I-TREATMENT +(hemocultivos, I-TREATMENT +Mantoux, I-TREATMENT +Tinción I-TREATMENT +tinta I-TREATMENT +china I-TREATMENT +y I-TREATMENT +Ziehl I-TREATMENT +de I-TREATMENT +LCR: I-TREATMENT +todos I-TREATMENT +negativos), I-TREATMENT +y I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +leptomeningitis I-TREATMENT +tuberculosa I-TREATMENT +se I-TREATMENT +modificó I-TREATMENT +el I-TREATMENT +tratamiento, I-TREATMENT +pautándose I-TREATMENT +inicialmente I-TREATMENT +isoniacida I-TREATMENT +600 I-TREATMENT +mg/día I-TREATMENT +(más I-TREATMENT +vitamina I-TREATMENT +B6), I-TREATMENT +etambutol I-TREATMENT +22 I-TREATMENT +mg/kg/día I-TREATMENT +y I-TREATMENT +rifampicina I-TREATMENT +600 I-TREATMENT +mg/día; I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +horas I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +etambutol I-TREATMENT +y I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +pirazinamida I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +g/día, I-TREATMENT +estreptomicina I-TREATMENT +1g/día I-TREATMENT +y I-TREATMENT +dexametasona I-TREATMENT +24 I-TREATMENT +mg/día I-TREATMENT +sustituyendo I-TREATMENT +la I-TREATMENT +ampicilina I-TREATMENT +por I-TREATMENT +cotrimoxazol. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +12 I-EVOLUTION +días I-EVOLUTION +la I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +(AV) I-EVOLUTION +bajó I-EVOLUTION +a I-EVOLUTION +amaurosis I-EVOLUTION +bilateral I-EVOLUTION +con I-EVOLUTION +alucinaciones I-EVOLUTION +visuales. I-EVOLUTION +La B-EXPLORATION +funduscopia I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Los I-EXPLORATION +potenciales I-EXPLORATION +visuales I-EXPLORATION +evocados I-EXPLORATION +(PEV) I-EXPLORATION +mostraron I-EXPLORATION +una I-EXPLORATION +onda I-EXPLORATION +P100 I-EXPLORATION +muy I-EXPLORATION +degradada I-EXPLORATION +con I-EXPLORATION +latencia I-EXPLORATION +muy I-EXPLORATION +aumentada, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +estimulación I-EXPLORATION +mono I-EXPLORATION +y I-EXPLORATION +binocular. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +meningitis I-EXPLORATION +tuberculosa I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +mediante I-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +en I-EXPLORATION +medio I-EXPLORATION +Lowestein. I-EXPLORATION + I-EXPLORATION +Durante B-TREATMENT +6 I-TREATMENT +meses I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +tuberculostático I-TREATMENT +(rifampicina I-TREATMENT +y I-TREATMENT +piridoxina) I-TREATMENT +y I-TREATMENT +dexametasona. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +AV I-EVOLUTION +mejoró I-EVOLUTION +lentamente I-EVOLUTION +y B-EXPLORATION +al I-EXPLORATION +año I-EXPLORATION +presenta I-EXPLORATION +la I-EXPLORATION +siguiente I-EXPLORATION +exploración: I-EXPLORATION +AV I-EXPLORATION +bilateral: I-EXPLORATION +1/1, I-EXPLORATION +leve I-EXPLORATION +midriasis I-EXPLORATION +reactiva, I-EXPLORATION +sin I-EXPLORATION +restricciones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +extrínseca I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +leve I-EXPLORATION +palidez I-EXPLORATION +papilar I-EXPLORATION +sin I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +excavación. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +perimetría I-EXPLORATION +computarizada I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +reducción I-EXPLORATION +concéntrica I-EXPLORATION +con I-EXPLORATION +respeto I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +10º I-EXPLORATION +centrales, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +una I-EXPLORATION +reducción I-EXPLORATION +concéntrica I-EXPLORATION +en I-EXPLORATION +hemicampo I-EXPLORATION +temporal I-EXPLORATION +y I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +nasal. I-EXPLORATION +Los I-EXPLORATION +PVE I-EXPLORATION +demuestran I-EXPLORATION +una I-EXPLORATION +notable I-EXPLORATION +mejoría I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION +P100 I-EXPLORATION +en I-EXPLORATION +voltaje, I-EXPLORATION +latencia I-EXPLORATION +y I-EXPLORATION +morfología. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +afáquica B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ambos I-PAST_MEDICAL_HISTORY +ojos I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cataratas I-PAST_MEDICAL_HISTORY +veinte I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +desarrolló I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +glaucoma I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +(OD). I-PRESENT_ILLNESS +Ante B-TREATMENT +la I-TREATMENT +falta I-TREATMENT +de I-TREATMENT +control I-TREATMENT +de I-TREATMENT +su I-TREATMENT +presión I-TREATMENT +intraocular I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +médico, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +implantación I-TREATMENT +de I-TREATMENT +un I-TREATMENT +dispositivo I-TREATMENT +de I-TREATMENT +drenaje I-TREATMENT +valvulado I-TREATMENT +de I-TREATMENT +Ahmed, I-TREATMENT +con I-TREATMENT +parche I-TREATMENT +de I-TREATMENT +esclera I-TREATMENT +recubriendo I-TREATMENT +el I-TREATMENT +trayecto I-TREATMENT +extraocular I-TREATMENT +del I-TREATMENT +tubo I-TREATMENT +y I-TREATMENT +el I-TREATMENT +extremo I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +localizado I-TREATMENT +en I-TREATMENT +cámara I-TREATMENT +anterior. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente. I-EVOLUTION +La I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +(AV) I-EVOLUTION +postoperatoria I-EVOLUTION +era I-EVOLUTION +de I-EVOLUTION +0, I-EVOLUTION +5 I-EVOLUTION +en I-EVOLUTION +OD I-EVOLUTION +y I-EVOLUTION +0, I-EVOLUTION +2 I-EVOLUTION +en I-EVOLUTION +ojo I-EVOLUTION +izquierdo I-EVOLUTION +(OI). I-EVOLUTION +La B-TREATMENT +presión I-TREATMENT +intraocular I-TREATMENT +en I-TREATMENT +OD I-TREATMENT +era I-TREATMENT +de I-TREATMENT +12 I-TREATMENT +mmHg I-TREATMENT +en I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +tartrato I-TREATMENT +de I-TREATMENT +brimonidina I-TREATMENT +0, I-TREATMENT +2%. I-TREATMENT +El I-TREATMENT +cuerpo I-TREATMENT +valvular I-TREATMENT +estaba I-TREATMENT +situado I-TREATMENT +en I-TREATMENT +el I-TREATMENT +cuadrante I-TREATMENT +temporal I-TREATMENT +superior I-TREATMENT +y I-TREATMENT +la I-TREATMENT +ampolla I-TREATMENT +era I-TREATMENT +amplia I-TREATMENT +y I-TREATMENT +de I-TREATMENT +paredes I-TREATMENT +finas. I-TREATMENT +El I-TREATMENT +tubo I-TREATMENT +quedaba I-TREATMENT +situado I-TREATMENT +en I-TREATMENT +cámara I-TREATMENT +anterior I-TREATMENT +y I-TREATMENT +libre I-TREATMENT +de I-TREATMENT +vítreo. I-TREATMENT +Acudió B-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +nueve I-EVOLUTION +meses I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +cirugía I-EVOLUTION +siendo I-EVOLUTION +diagnosticada I-EVOLUTION +de I-EVOLUTION +conjuntivitis I-EVOLUTION +aguda I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OD, I-EVOLUTION +se B-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +medidas I-TREATMENT +higiénicas I-TREATMENT +y I-TREATMENT +colirio I-TREATMENT +de I-TREATMENT +tobramicina I-TREATMENT +1 I-TREATMENT +gota/8 I-TREATMENT +horas I-TREATMENT +(Tobrex I-TREATMENT +solución I-TREATMENT +Gotas I-TREATMENT +oft. I-TREATMENT +0, I-TREATMENT +3%; I-TREATMENT +Alcon I-TREATMENT +Cusi; I-TREATMENT +Barcelona; I-TREATMENT +España) I-TREATMENT +y I-TREATMENT +lágrimas I-TREATMENT +artificiales I-TREATMENT +a I-TREATMENT +demanda. I-TREATMENT +Cuatro B-EVOLUTION +días I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION +acudió I-EVOLUTION +a I-EVOLUTION +revisión I-EVOLUTION +presentando I-EVOLUTION +una I-EVOLUTION +AV I-EVOLUTION +de I-EVOLUTION +movimiento I-EVOLUTION +de I-EVOLUTION +manos. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +biomicroscopía I-EXPLORATION +presentaba I-EXPLORATION +hiperemia I-EXPLORATION +3-4 I-EXPLORATION ++, I-EXPLORATION +blebitis, I-EXPLORATION +no I-EXPLORATION +seidel, I-EXPLORATION +edema I-EXPLORATION +corneal I-EXPLORATION +difuso I-EXPLORATION +de I-EXPLORATION +3+, I-EXPLORATION +tyndall I-EXPLORATION +4+, I-EXPLORATION +plastrón I-EXPLORATION +de I-EXPLORATION +fibrina I-EXPLORATION +en I-EXPLORATION +cámara I-EXPLORATION +anterior, I-EXPLORATION +no I-EXPLORATION +hipopion I-EXPLORATION +y I-EXPLORATION +PIO I-EXPLORATION +de I-EXPLORATION +35 I-EXPLORATION +mm I-EXPLORATION +Hg. I-EXPLORATION +La I-EXPLORATION +conjuntiva I-EXPLORATION +que I-EXPLORATION +recubría I-EXPLORATION +el I-EXPLORATION +tubo I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +filtrante I-EXPLORATION +parecía I-EXPLORATION +íntegra. I-EXPLORATION +El I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +visualizaba I-EXPLORATION +por I-EXPLORATION +opacidad I-EXPLORATION +de I-EXPLORATION +medios. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +aparecían I-EXPLORATION +ecos I-EXPLORATION +de I-EXPLORATION +baja I-EXPLORATION +densidad, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +desprendimiento I-EXPLORATION +de I-EXPLORATION +retina. I-EXPLORATION +Ante B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +una I-TREATMENT +endoftalmitis I-TREATMENT +aguda I-TREATMENT +tardía, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +iniciar I-TREATMENT +el I-TREATMENT +protocolo I-TREATMENT +existente I-TREATMENT +en I-TREATMENT +el I-TREATMENT +hospital, I-TREATMENT +con I-TREATMENT +la I-TREATMENT +obtención I-TREATMENT +de I-TREATMENT +muestras I-TREATMENT +de I-TREATMENT +humor I-TREATMENT +acuoso I-TREATMENT +y I-TREATMENT +vítreo, I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +intravenoso I-TREATMENT +a I-TREATMENT +base I-TREATMENT +de I-TREATMENT +ceftazidima I-TREATMENT +1 I-TREATMENT +gramo/8 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +1 I-TREATMENT +gramo/12 I-TREATMENT +horas, I-TREATMENT +inyección I-TREATMENT +intravítrea I-TREATMENT +de I-TREATMENT +ceftazidima I-TREATMENT +2, I-TREATMENT +25 I-TREATMENT +mg/0, I-TREATMENT +1 I-TREATMENT +ml I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +1 I-TREATMENT +mg/0, I-TREATMENT +1 I-TREATMENT +ml I-TREATMENT +y I-TREATMENT +colirio I-TREATMENT +tópico I-TREATMENT +reforzado I-TREATMENT +50 I-TREATMENT +mg/ml I-TREATMENT +de I-TREATMENT +vancomicina I-TREATMENT +y I-TREATMENT +ceftazidima I-TREATMENT +cada I-TREATMENT +hora. I-TREATMENT +A B-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION +del I-EXPLORATION +cultivo I-EXPLORATION +fue I-EXPLORATION +Haemophilus I-EXPLORATION +influenzae I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +vancomicina I-EXPLORATION +y I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +betalactámicos, I-EXPLORATION +quinolonas, I-EXPLORATION +rifamicina, I-EXPLORATION +aminoglicósidos I-EXPLORATION +y I-EXPLORATION +tetraciclinas I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +una I-TREATMENT +quinolona I-TREATMENT +intravenosa I-TREATMENT +y I-TREATMENT +tópica, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +inyección I-TREATMENT +intravítrea I-TREATMENT +de I-TREATMENT +ceftazidima I-TREATMENT +y I-TREATMENT +decadrán. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +72 I-TREATMENT +horas, I-TREATMENT +y I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +mala I-TREATMENT +evolución, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +retirada I-TREATMENT +del I-TREATMENT +dispositivo I-TREATMENT +de I-TREATMENT +drenaje, I-TREATMENT +lavado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cámara I-TREATMENT +anterior, I-TREATMENT +e I-TREATMENT +inyección I-TREATMENT +de I-TREATMENT +ceftazidima I-TREATMENT +subconjuntival I-TREATMENT +e I-TREATMENT +intravítrea. I-TREATMENT +La I-TREATMENT +mala I-TREATMENT +visualización I-TREATMENT +desestimó I-TREATMENT +la I-TREATMENT +práctica I-TREATMENT +de I-TREATMENT +vitrectomía. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +cuatro I-TREATMENT +días, I-TREATMENT +la I-TREATMENT +AV I-TREATMENT +era I-TREATMENT +de I-TREATMENT +no I-TREATMENT +percepción I-TREATMENT +de I-TREATMENT +luz I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +eviscerar. I-TREATMENT + I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +bebedor I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +350 I-PAST_MEDICAL_HISTORY +gr/alcohol/día, I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +cajetilla/día, I-PAST_MEDICAL_HISTORY +ExUDVP I-PAST_MEDICAL_HISTORY +(heroína I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cocaína), I-PAST_MEDICAL_HISTORY +VHB I-PAST_MEDICAL_HISTORY ++, I-PAST_MEDICAL_HISTORY +VHC I-PAST_MEDICAL_HISTORY ++, I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +-, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +multifactorial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Child I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +datos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +portal. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +brusca I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +AV I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-EXPLORATION +estudio I-EXPLORATION +oftalmológico I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +AV I-EXPLORATION +de I-EXPLORATION +movimiento I-EXPLORATION +de I-EXPLORATION +manos I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +(AO), I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +con I-EXPLORATION +infiltrados I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +posterior I-EXPLORATION +y I-EXPLORATION +desprendimiento I-EXPLORATION +seroso I-EXPLORATION +macular. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Además I-EXPLORATION +presentaba I-EXPLORATION +fiebre I-EXPLORATION +de I-EXPLORATION +38, I-EXPLORATION +4ºC I-EXPLORATION +y I-EXPLORATION +discreto I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +con I-EXPLORATION +hepatomegalia I-EXPLORATION +de I-EXPLORATION +dos I-EXPLORATION +traveses I-EXPLORATION +de I-EXPLORATION +dedo. I-EXPLORATION + I-EXPLORATION +Ante B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +pancreatitis I-DERIVED_FROM/TO +aguda I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Medicina I-DERIVED_FROM/TO +Interna, I-DERIVED_FROM/TO +que B-EXPLORATION +confirmada I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +tras I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +de I-EXPLORATION +laboratorio: I-EXPLORATION +Leucocitos I-EXPLORATION +12, I-EXPLORATION +4 I-EXPLORATION +(4, I-EXPLORATION +8-10, I-EXPLORATION +8 I-EXPLORATION +x103 I-EXPLORATION +ul); I-EXPLORATION +Neutrófilos I-EXPLORATION +88% I-EXPLORATION +(42,2-75,2); I-EXPLORATION +Volumen I-EXPLORATION +Corpuscular I-EXPLORATION +Medio I-EXPLORATION +111 I-EXPLORATION +fl I-EXPLORATION +(85,9-95,9); I-EXPLORATION +Bilirrubina I-EXPLORATION +total I-EXPLORATION +8, I-EXPLORATION +23 I-EXPLORATION +mg/dl I-EXPLORATION +(0,2-1,0); I-EXPLORATION +Amilasa I-EXPLORATION +1.523 I-EXPLORATION +u/l I-EXPLORATION +(55-201); I-EXPLORATION +GOT I-EXPLORATION +200 I-EXPLORATION +u/l I-EXPLORATION +(5-45); I-EXPLORATION +GPT I-EXPLORATION +227 I-EXPLORATION +u/l I-EXPLORATION +(5-45); I-EXPLORATION +GGT I-EXPLORATION +1.346 I-EXPLORATION +u/l I-EXPLORATION +(3-52); I-EXPLORATION +Fosfatasa I-EXPLORATION +Alcalina I-EXPLORATION +1.159 I-EXPLORATION +u/l I-EXPLORATION +(98-295); I-EXPLORATION +Fibrinógeno I-EXPLORATION +157 I-EXPLORATION +mg/dl I-EXPLORATION +(200-400) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +imagen I-EXPLORATION +[tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +(TAC) I-EXPLORATION +y I-EXPLORATION +ecografía I-EXPLORATION +abdominales I-EXPLORATION +que I-EXPLORATION +muestran I-EXPLORATION +hepatopatía I-EXPLORATION +grasa I-EXPLORATION +y I-EXPLORATION +infiltración I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +peripancreático, I-EXPLORATION +especialmente I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +altura I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +del I-EXPLORATION +páncreas, I-EXPLORATION +donde I-EXPLORATION +la I-EXPLORATION +infiltración I-EXPLORATION +continúa I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +espacio I-EXPLORATION +pararrenal I-EXPLORATION +anterior I-EXPLORATION +izquierdo]. I-EXPLORATION +La I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +mostraba I-EXPLORATION +inicialmente I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +no I-EXPLORATION +perfusión I-EXPLORATION +capilar, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +correspondían I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +exudados, I-EXPLORATION +seguidas I-EXPLORATION +de I-EXPLORATION +difusión I-EXPLORATION +en I-EXPLORATION +tiempos I-EXPLORATION +tardíos I-EXPLORATION +y I-EXPLORATION +efectos I-EXPLORATION +pantalla I-EXPLORATION +provocados I-EXPLORATION +por I-EXPLORATION +las I-EXPLORATION +hemorragias I-EXPLORATION +retinianas. I-EXPLORATION +La B-TREATMENT +resolución I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +digestivo I-TREATMENT +fue I-TREATMENT +favorable I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +mediante I-TREATMENT +sueroterapia, I-TREATMENT +dieta I-TREATMENT +absoluta I-TREATMENT +y I-TREATMENT +antibioticoterapia, I-TREATMENT +con B-EVOLUTION +rápida I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +clínica I-EVOLUTION +e I-EVOLUTION +importante I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +analítica I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +semanas, I-EVOLUTION +aunque B-EXPLORATION +un I-EXPLORATION +mes I-EXPLORATION +después I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +encefalopatía I-EXPLORATION +de I-EXPLORATION +Wernicke I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +craneal I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +había I-EVOLUTION +recuperado I-EVOLUTION +una I-EVOLUTION +AV I-EVOLUTION +de I-EVOLUTION +1 I-EVOLUTION +en I-EVOLUTION +AO I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +estudio I-EVOLUTION +de I-EVOLUTION +fondo I-EVOLUTION +de I-EVOLUTION +ojo I-EVOLUTION +solo I-EVOLUTION +mostraba I-EVOLUTION +algún I-EVOLUTION +pigmento I-EVOLUTION +residual. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestras I-PRESENT_ILLNESS +consultas I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +ocular I-PRESENT_ILLNESS +unilateral I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +unas I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cierto I-PRESENT_ILLNESS +grado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +agudeza I-PRESENT_ILLNESS +visual. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +presenta I-EXPLORATION +inyección I-EXPLORATION +ciliar, I-EXPLORATION +midriasis I-EXPLORATION +media I-EXPLORATION +arreactiva I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION +de I-EXPLORATION +53 I-EXPLORATION +mm I-EXPLORATION +Hg. I-EXPLORATION +Ante B-EVOLUTION +este I-EVOLUTION +cuadro I-EVOLUTION +se I-EVOLUTION +establece I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +presuntivo I-EVOLUTION +de I-EVOLUTION +ataque I-EVOLUTION +agudo I-EVOLUTION +de I-EVOLUTION +glaucoma I-EVOLUTION +de I-EVOLUTION +ángulo I-EVOLUTION +estrecho I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +procede I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +toma I-EVOLUTION +de I-EVOLUTION +imágenes I-EVOLUTION +mediante I-EVOLUTION +BMU I-EVOLUTION +y I-EVOLUTION +OCT. I-EVOLUTION +El B-EXPLORATION +OCT I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +cierre I-EXPLORATION +angular I-EXPLORATION +con I-EXPLORATION +contacto I-EXPLORATION +entre I-EXPLORATION +la I-EXPLORATION +malla I-EXPLORATION +trabecular I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +más I-EXPLORATION +periférica I-EXPLORATION +del I-EXPLORATION +iris I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +cuatro I-EXPLORATION +cuadrantes. I-EXPLORATION +De I-EXPLORATION +igual I-EXPLORATION +forma I-EXPLORATION +la I-EXPLORATION +BMU I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +disposición I-EXPLORATION +similar I-EXPLORATION +del I-EXPLORATION +ángulo I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +360º. I-EXPLORATION +Se B-TREATMENT +instaura I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +correspondiente I-TREATMENT +para I-TREATMENT +posteriormente I-TREATMENT +realizar I-TREATMENT +unas I-TREATMENT +iridotomías I-TREATMENT +bilaterales I-TREATMENT +con I-TREATMENT +láser I-TREATMENT +YAG. I-TREATMENT +Tras B-EXPLORATION +las I-EXPLORATION +iridotomías I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +un I-EXPLORATION +OCT I-EXPLORATION +de I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +que I-EXPLORATION +nos I-EXPLORATION +muestra I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +iridotomía I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION +del I-EXPLORATION +ataque I-EXPLORATION +agudo I-EXPLORATION +de I-EXPLORATION +glaucoma I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +permeable, I-EXPLORATION +siendo B-TREATMENT +necesario I-TREATMENT +retratar I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +con I-TREATMENT +nuevos I-TREATMENT +impactos. I-TREATMENT +Tras B-EVOLUTION +este I-EVOLUTION +segundo I-EVOLUTION +tratamiento I-EVOLUTION +se I-EVOLUTION +realiza I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +OCT I-EVOLUTION +que, I-EVOLUTION +esta I-EVOLUTION +vez I-EVOLUTION +sí, I-EVOLUTION +muestra I-EVOLUTION +permeabilidad I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +iridotomía, I-EVOLUTION +apertura I-EVOLUTION +del I-EVOLUTION +ángulo I-EVOLUTION +y I-EVOLUTION +profundización I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cámara I-EVOLUTION +anterior. I-EVOLUTION + I-EVOLUTION + +Una B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +fue B-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +confirmar I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +presencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +síndrome I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Susac, I-DERIVED_FROM/TO +debido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +pérdida I-DERIVED_FROM/TO +visual I-DERIVED_FROM/TO +bilateral. I-DERIVED_FROM/TO +La B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alteraciones I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +equilibrio, I-PAST_MEDICAL_HISTORY +ataxia, I-PAST_MEDICAL_HISTORY +incontinencia I-PAST_MEDICAL_HISTORY +fecal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +urinaria, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY +auditiva I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +recibiendo I-PAST_MEDICAL_HISTORY +corticoides, I-PAST_MEDICAL_HISTORY +nimodipino I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anticoagulantes. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +neurológico I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION +paraparesia I-EXPLORATION +espástica, I-EXPLORATION +hiperreflexia I-EXPLORATION +tendinosa I-EXPLORATION +y I-EXPLORATION +disfunción I-EXPLORATION +genitourinaria. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION +que I-EXPLORATION +incluía I-EXPLORATION +hemograma, I-EXPLORATION +bioquímica I-EXPLORATION +general, I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +globular, I-EXPLORATION +enzima I-EXPLORATION +conversor I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +angiotensina I-EXPLORATION +y I-EXPLORATION +coagulación I-EXPLORATION +resultaba I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +de I-EXPLORATION +lúes, I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana, I-EXPLORATION +herpes I-EXPLORATION +simple, I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva, I-EXPLORATION +factor I-EXPLORATION +reumatoide, I-EXPLORATION +anticoagulante I-EXPLORATION +lúpico, I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares, I-EXPLORATION +anticardiolipina, I-EXPLORATION +y I-EXPLORATION +antifosfolípido I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +electrocardiograma, I-EXPLORATION +ecocardiografía I-EXPLORATION +y I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +craneal I-EXPLORATION +no I-EXPLORATION +presentaban I-EXPLORATION +alteraciones. I-EXPLORATION +El I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +(LCR) I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +claro I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +presión I-EXPLORATION +de I-EXPLORATION +apertura I-EXPLORATION +normal, I-EXPLORATION +con I-EXPLORATION +ligero I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +proteínas, I-EXPLORATION +y I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +fórmula I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +para I-EXPLORATION +borrelia, I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +Epstein-Barr, I-EXPLORATION +citomegalovirus I-EXPLORATION +y I-EXPLORATION +lúes, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cultivos I-EXPLORATION +habituales I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +La I-EXPLORATION +detección I-EXPLORATION +de I-EXPLORATION +bandas I-EXPLORATION +oligoclonales I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +mismo I-EXPLORATION +también I-EXPLORATION +resultó I-EXPLORATION +negativa. I-EXPLORATION +La I-EXPLORATION +Resonancia I-EXPLORATION +Magnética I-EXPLORATION +Nuclear I-EXPLORATION +(RMN) I-EXPLORATION +cerebral I-EXPLORATION +mostraba I-EXPLORATION +múltiples I-EXPLORATION +áreas I-EXPLORATION +focales I-EXPLORATION +de I-EXPLORATION +hiperintensidad I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +sustancia I-EXPLORATION +blanca I-EXPLORATION +periventricular I-EXPLORATION +y I-EXPLORATION +pericallosa, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +regiones I-EXPLORATION +del I-EXPLORATION +centro I-EXPLORATION +semioval. I-EXPLORATION +Los I-EXPLORATION +tests I-EXPLORATION +audiométricos I-EXPLORATION +estándares I-EXPLORATION +revelaron I-EXPLORATION +pérdida I-EXPLORATION +auditiva I-EXPLORATION +neurosensorial, I-EXPLORATION +asimétrica, I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +izquierdo, I-EXPLORATION +para I-EXPLORATION +las I-EXPLORATION +bajas I-EXPLORATION +frecuencias. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica, I-EXPLORATION +su I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +20/25 I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +La I-EXPLORATION +campimetría I-EXPLORATION +de I-EXPLORATION +Goldmann I-EXPLORATION +(Haag-Streit, I-EXPLORATION +Berna, I-EXPLORATION +Suiza) I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +cuadrantanopsia I-EXPLORATION +inferior I-EXPLORATION +bitemporal. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +biomicroscopía I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +hallazgos I-EXPLORATION +destacables. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +funduscópico I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +microangiopatía I-EXPLORATION +retiniana I-EXPLORATION +periférica, I-EXPLORATION +apreciándose I-EXPLORATION +amputación I-EXPLORATION +de I-EXPLORATION +vasos I-EXPLORATION +con I-EXPLORATION +cúmulos I-EXPLORATION +de I-EXPLORATION +microaneurismas I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +inflamación I-EXPLORATION +o I-EXPLORATION +células I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +vítreo, I-EXPLORATION +ni I-EXPLORATION +envainamiento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +vasos I-EXPLORATION +retinianos. I-EXPLORATION +La I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +(AGF) I-EXPLORATION +demostró I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +isquemia I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +áreas I-EXPLORATION +correspondientes I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +oclusiones I-EXPLORATION +arteriolares. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +Susac I-EXPLORATION +se I-EXPLORATION +basó I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +asociación I-EXPLORATION +de I-EXPLORATION +encefalopatía I-EXPLORATION +con I-EXPLORATION +hallazgos I-EXPLORATION +típicos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +RMN, I-EXPLORATION +microangiopatía I-EXPLORATION +retiniana I-EXPLORATION +y I-EXPLORATION +pérdida I-EXPLORATION +auditiva I-EXPLORATION +neurosensorial. I-EXPLORATION + I-EXPLORATION +Debido B-TREATMENT +a I-TREATMENT +la I-TREATMENT +evidente I-TREATMENT +isquemia I-TREATMENT +retiniana I-TREATMENT +periférica I-TREATMENT +apreciada I-TREATMENT +en I-TREATMENT +la I-TREATMENT +AGF, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +fotocoagulación I-TREATMENT +retiniana I-TREATMENT +con I-TREATMENT +láser I-TREATMENT +en I-TREATMENT +las I-TREATMENT +áreas I-TREATMENT +isquémicas I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +profiláctica, I-TREATMENT +manteniéndose I-TREATMENT +estable I-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +visual I-TREATMENT +desde I-TREATMENT +entonces. I-TREATMENT +Al B-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +habido I-EVOLUTION +variaciones I-EVOLUTION +significativas I-EVOLUTION +tanto I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +estado I-EVOLUTION +neurológico I-EVOLUTION +como I-EVOLUTION +auditivo. I-EVOLUTION + I-EVOLUTION + +Varón, B-PRESENT_ILLNESS +hijo B-PAST_MEDICAL_HISTORY +único, I-PAST_MEDICAL_HISTORY +nacido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cuarenta I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cesárea. I-PAST_MEDICAL_HISTORY +Como B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +destacar I-FAMILY_HISTORY +que I-FAMILY_HISTORY +su I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +presentaba I-FAMILY_HISTORY +diabetes I-FAMILY_HISTORY +mellitus I-FAMILY_HISTORY +no I-FAMILY_HISTORY +insulinodependiente I-FAMILY_HISTORY +desde I-FAMILY_HISTORY +los I-FAMILY_HISTORY +17 I-FAMILY_HISTORY +años I-FAMILY_HISTORY +y I-FAMILY_HISTORY +no I-FAMILY_HISTORY +existir I-FAMILY_HISTORY +consaguinidad I-FAMILY_HISTORY +entre I-FAMILY_HISTORY +los I-FAMILY_HISTORY +padres. I-FAMILY_HISTORY + I-FAMILY_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida, I-PRESENT_ILLNESS +sufre I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +parada I-PRESENT_ILLNESS +cardiorrespiratoria, I-PRESENT_ILLNESS +(diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cardiomiopatía I-PRESENT_ILLNESS +dilatada) I-PRESENT_ILLNESS +(1). I-PRESENT_ILLNESS +Durante B-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +hospitalario I-EVOLUTION +comienza I-EVOLUTION +con I-EVOLUTION +fotofobia I-EVOLUTION +y I-EVOLUTION +nistagmus I-EVOLUTION +intermitente, I-EVOLUTION +y B-EXPLORATION +se I-EXPLORATION +recomienda I-EXPLORATION +revisión I-EXPLORATION +oftalmológica I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +lugar I-EXPLORATION +de I-EXPLORATION +origen. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +niño I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +retraso I-EXPLORATION +psicomotor I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +Resonancia I-EXPLORATION +Magnética I-EXPLORATION +Nuclear I-EXPLORATION +(RMN) I-EXPLORATION +y B-TREATMENT +comienza I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +año I-TREATMENT +de I-TREATMENT +vida I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +estimulación I-TREATMENT +precoz, I-TREATMENT +consiguiendo I-TREATMENT +en I-TREATMENT +ocho I-TREATMENT +meses I-TREATMENT +los I-TREATMENT +objetivos I-TREATMENT +propuestos. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +RMN I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +pequeñas I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION +en I-EXPLORATION +T2 I-EXPLORATION +y I-EXPLORATION +FLAIR I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +regiones I-EXPLORATION +periatriales I-EXPLORATION +y I-EXPLORATION +sustancia I-EXPLORATION +blanca I-EXPLORATION +temporal. I-EXPLORATION + I-EXPLORATION +A B-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +dos I-DERIVED_FROM/TO +años I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +ecográfico I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +oftalmológico. I-DERIVED_FROM/TO +Se B-EXPLORATION +solicita I-EXPLORATION +un I-EXPLORATION +ERG I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +respuestas, I-EXPLORATION +y I-EXPLORATION +Potenciales I-EXPLORATION +Evocados I-EXPLORATION +Visuales I-EXPLORATION +(PEV) I-EXPLORATION +normales. I-EXPLORATION +Oftalmoscópicamente I-EXPLORATION +muestra I-EXPLORATION +nistagmus I-EXPLORATION +con I-EXPLORATION +fotofobia I-EXPLORATION +intensa. I-EXPLORATION +El I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Como I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +clínico I-EXPLORATION +es I-EXPLORATION +sugestivo I-EXPLORATION +de I-EXPLORATION +Síndrome I-EXPLORATION +de I-EXPLORATION +Alström, I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +genético I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +tras I-EXPLORATION +analizar I-EXPLORATION +los I-EXPLORATION +exones I-EXPLORATION +10, I-EXPLORATION +16 I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +segmento I-EXPLORATION +del I-EXPLORATION +exón I-EXPLORATION +8 I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +ALMS-1 I-EXPLORATION +(3) I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +encuentran I-EXPLORATION +las I-EXPLORATION +mutaciones I-EXPLORATION +descritas I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +momento, I-EXPLORATION +amplificado I-EXPLORATION +por I-EXPLORATION +PCR I-EXPLORATION +y I-EXPLORATION +secuenciación I-EXPLORATION +automatizada, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +detectan I-EXPLORATION +mutaciones, I-EXPLORATION +sin I-EXPLORATION +embargo, I-EXPLORATION +estos I-EXPLORATION +resultados I-EXPLORATION +no I-EXPLORATION +excluyen I-EXPLORATION +el I-EXPLORATION +diagnóstico. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +«Síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +puntos I-PAST_MEDICAL_HISTORY +blancos I-PAST_MEDICAL_HISTORY +evanescentes» I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ambos I-PAST_MEDICAL_HISTORY +ojos I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +corticoterapia I-PAST_MEDICAL_HISTORY +oral. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +agudeza I-PRESENT_ILLNESS +visual I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +de I-EXPLORATION +3/10 I-EXPLORATION +con I-EXPLORATION +reacción I-EXPLORATION +inflamatoria I-EXPLORATION +en I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +desprendimiento I-EXPLORATION +de I-EXPLORATION +retina I-EXPLORATION +exudativo I-EXPLORATION +bilateral. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +corticoideo I-TREATMENT +oral I-TREATMENT +a I-TREATMENT +altas I-TREATMENT +dosis I-TREATMENT +(80 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +prednisona), I-TREATMENT +constatándose I-TREATMENT +una I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +inicial. I-TREATMENT +Al B-EVOLUTION +mes I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +una I-EVOLUTION +recidiva I-EVOLUTION +del I-EVOLUTION +desprendimiento I-EVOLUTION +de I-EVOLUTION +retina I-EVOLUTION +foveal I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +ojo I-EVOLUTION +izquierdo, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +asocia I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +tratamiento I-EVOLUTION +CyA I-EVOLUTION +(dosis I-EVOLUTION +inicial I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +mg/kg/día). I-EVOLUTION +Tras I-EVOLUTION +nueve I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +de I-EVOLUTION +unidad I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +ojo I-EVOLUTION +derecho I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +8/10 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +ojo I-EVOLUTION +izquierdo I-EVOLUTION +con I-EVOLUTION +movilización I-EVOLUTION +pigmentaria I-EVOLUTION +en I-EVOLUTION +cuatro I-EVOLUTION +cuadrantes I-EVOLUTION +y I-EVOLUTION +fibrosis I-EVOLUTION +subretiniana. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +carcinoma I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +células I-DERIVED_FROM/TO +sebáceas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ojo I-DERIVED_FROM/TO +derecho I-DERIVED_FROM/TO +intervenido I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +seis I-DERIVED_FROM/TO +ocasiones. I-DERIVED_FROM/TO +Debutó B-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +pediculada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +conjuntiva I-PRESENT_ILLNESS +tarsal I-PRESENT_ILLNESS +superior. I-PRESENT_ILLNESS +La B-EXPLORATION +biopsia I-EXPLORATION +realizada I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +carcinoma I-EXPLORATION +sebáceo. I-EXPLORATION +Se B-TREATMENT +hicieron I-TREATMENT +varias I-TREATMENT +ampliaciones I-TREATMENT +de I-TREATMENT +márgenes I-TREATMENT +quirúrgicos I-TREATMENT +de I-TREATMENT +lamela I-TREATMENT +posterior I-TREATMENT +de I-TREATMENT +párpado I-TREATMENT +superior I-TREATMENT +derecho, I-TREATMENT +hasta I-TREATMENT +encontrar I-TREATMENT +límites I-TREATMENT +libre I-TREATMENT +de I-TREATMENT +tumor. I-TREATMENT +Las B-EXPLORATION +piezas I-EXPLORATION +se I-EXPLORATION +informaron I-EXPLORATION +como I-EXPLORATION +carcinoma I-EXPLORATION +sebáceo I-EXPLORATION +con I-EXPLORATION +diseminación I-EXPLORATION +pagetoide. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +refería I-EVOLUTION +inflamación I-EVOLUTION +crónica I-EVOLUTION +palpebral I-EVOLUTION +y I-EVOLUTION +conjuntival. I-EVOLUTION +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destacaba I-EXPLORATION +leve I-EXPLORATION +engrosamiento I-EXPLORATION +de I-EXPLORATION +tercio I-EXPLORATION +externo I-EXPLORATION +del I-EXPLORATION +borde I-EXPLORATION +libre I-EXPLORATION +de I-EXPLORATION +párpado I-EXPLORATION +superior I-EXPLORATION +derecho. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +biomicroscopía I-EXPLORATION +presentaba: I-EXPLORATION +conjuntiva I-EXPLORATION +bulbar I-EXPLORATION +superior I-EXPLORATION +irregular I-EXPLORATION +y I-EXPLORATION +muy I-EXPLORATION +eritematosa, I-EXPLORATION +área I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +amplitud I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +una I-EXPLORATION +desestructuración I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arquitectura I-EXPLORATION +limbar, I-EXPLORATION +con I-EXPLORATION +infiltración I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +empalizadas I-EXPLORATION +de I-EXPLORATION +Vogt I-EXPLORATION +por I-EXPLORATION +cordones I-EXPLORATION +amarillentos I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +sebáceo I-EXPLORATION +y I-EXPLORATION +conjuntivalización I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +corneal I-EXPLORATION +superior, I-EXPLORATION +acortamiento I-EXPLORATION +de I-EXPLORATION +fórnix I-EXPLORATION +superior I-EXPLORATION +y I-EXPLORATION +simbléfaron I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +del I-EXPLORATION +canto I-EXPLORATION +externo. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +afectación I-EXPLORATION +ganglionar I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +cráneo, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +tórax I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +blefarectomía I-TREATMENT +en I-TREATMENT +cuña I-TREATMENT +de I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +engrosada I-TREATMENT +del I-TREATMENT +párpado I-TREATMENT +superior I-TREATMENT +derecho I-TREATMENT +y I-TREATMENT +mapeo I-TREATMENT +de I-TREATMENT +biopsias I-TREATMENT +conjuntivales. I-TREATMENT +La B-EXPLORATION +pieza I-EXPLORATION +principal I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +carcinoma I-EXPLORATION +sebáceo. I-EXPLORATION +Las I-EXPLORATION +muestras I-EXPLORATION +conjuntivales I-EXPLORATION +estaban I-EXPLORATION +libres I-EXPLORATION +de I-EXPLORATION +tumor. I-EXPLORATION + I-EXPLORATION +Ampliamos B-TREATMENT +la I-TREATMENT +blefarectomía I-TREATMENT +y I-TREATMENT +esperamos I-TREATMENT +a I-TREATMENT +poder I-TREATMENT +instaurar I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +superficie I-TREATMENT +ocular I-TREATMENT +con I-TREATMENT +colirio I-TREATMENT +de I-TREATMENT +mitomicina I-TREATMENT +C. I-TREATMENT +No B-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +seguir I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +caso I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +decidió I-EVOLUTION +seguir I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +ciudad I-EVOLUTION +de I-EVOLUTION +residencia. I-EVOLUTION + I-EVOLUTION + +Un B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +diplopía I-PRESENT_ILLNESS +binocular I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +instauración I-PRESENT_ILLNESS +subaguda I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +menos I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +atribuida I-PRESENT_ILLNESS +inicialmente I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +efectos I-PRESENT_ILLNESS +secundarios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +quimioterapia. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ciclos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +carboxiplatino/taxol I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +radioterapia I-PAST_MEDICAL_HISTORY +concomitante I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +células I-PAST_MEDICAL_HISTORY +grandes I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +T2N3M0 I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica, I-EXPLORATION +la I-EXPLORATION +AV I-EXPLORATION +mejor I-EXPLORATION +corregida I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +9 I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +(OD) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(OI). I-EXPLORATION +Ambas I-EXPLORATION +pupilas I-EXPLORATION +estaban I-EXPLORATION +en I-EXPLORATION +midriasis I-EXPLORATION +media I-EXPLORATION +con I-EXPLORATION +escasa I-EXPLORATION +reactividad I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +y I-EXPLORATION +convergencia. I-EXPLORATION +Respecto I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +extrínseca, I-EXPLORATION +se I-EXPLORATION +objetivaba I-EXPLORATION +una I-EXPLORATION +exotropía I-EXPLORATION +de I-EXPLORATION +-50 I-EXPLORATION +dp I-EXPLORATION +(dioptrías I-EXPLORATION +prismátricas) I-EXPLORATION +con I-EXPLORATION +dominancia I-EXPLORATION +OD I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +capacidad I-EXPLORATION +de I-EXPLORATION +fijación I-EXPLORATION +alternante. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +una I-EXPLORATION +limitación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +supraducciones I-EXPLORATION +(+++) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +aducción I-EXPLORATION +(++) I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +conservación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +abducción. I-EXPLORATION +El I-EXPLORATION +OI I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +ptosis I-EXPLORATION +palpebral I-EXPLORATION +casi I-EXPLORATION +total I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +severa I-EXPLORATION +limitación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +supraducciones I-EXPLORATION +(+++), I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +aducción I-EXPLORATION +(++) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +infraducciones I-EXPLORATION +(+++) I-EXPLORATION +con I-EXPLORATION +conservación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +abducción. I-EXPLORATION +La I-EXPLORATION +biomicroscopía I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +tensión I-EXPLORATION +ocular I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +(AO). I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +tampoco I-EXPLORATION +se I-EXPLORATION +hallaron I-EXPLORATION +alteraciones I-EXPLORATION +patológicas. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +mostraba I-EXPLORATION +ninguna I-EXPLORATION +alteración I-EXPLORATION +clínica. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +cerebral I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +solitaria I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +suelo I-EXPLORATION +del I-EXPLORATION +III I-EXPLORATION +ventrículo. I-EXPLORATION +Dicha I-EXPLORATION +lesión I-EXPLORATION +tenía I-EXPLORATION +un I-EXPLORATION +aspecto I-EXPLORATION +anular I-EXPLORATION +hiperintenso, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +porción I-EXPLORATION +central I-EXPLORATION +hipointensa I-EXPLORATION +sugestiva I-EXPLORATION +de I-EXPLORATION +necrosis, I-EXPLORATION +y I-EXPLORATION +afectaba I-EXPLORATION +bilateralmente I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +núcleos I-EXPLORATION +y I-EXPLORATION +fascículos I-EXPLORATION +del I-EXPLORATION +III I-EXPLORATION +nervio I-EXPLORATION +craneal I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +mesencéfalo I-EXPLORATION +central. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +hispana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +queja I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +visión I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +(OI). I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destaca I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +(AV) I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +05 I-EXPLORATION +en I-EXPLORATION +OI. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +(FO) I-EXPLORATION +del I-EXPLORATION +OI I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +papilar I-EXPLORATION +elevada, I-EXPLORATION +polipoidea, I-EXPLORATION +intensamente I-EXPLORATION +pigmentada I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +ristras I-EXPLORATION +de I-EXPLORATION +pigmento I-EXPLORATION +móvil I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +vítrea. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +angiofluoresceingrafía I-EXPLORATION +(AFG) I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +un I-EXPLORATION +efecto I-EXPLORATION +pantalla. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +sólida. I-EXPLORATION +En I-EXPLORATION +modo I-EXPLORATION +A I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +reflectividad I-EXPLORATION +interna I-EXPLORATION +muy I-EXPLORATION +elevada I-EXPLORATION +sin I-EXPLORATION +movimiento I-EXPLORATION +vascular I-EXPLORATION +espontáneo. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +aquel I-EXPLORATION +momento I-EXPLORATION +fueron I-EXPLORATION +consultados I-EXPLORATION +varios I-EXPLORATION +expertos. I-EXPLORATION +Unos I-EXPLORATION +se I-EXPLORATION +inclinaron I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +melanoma I-EXPLORATION +maligno I-EXPLORATION +y I-EXPLORATION +otros I-EXPLORATION +por I-EXPLORATION +melanocitoma. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +decisión I-TREATMENT +adoptada I-TREATMENT +fue I-TREATMENT +seguir I-TREATMENT +observando I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente. I-TREATMENT +A B-EVOLUTION +lo I-EVOLUTION +largo I-EVOLUTION +de I-EVOLUTION +diecinueve I-EVOLUTION +años I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +aumentó I-EVOLUTION +paulatinamente I-EVOLUTION +de I-EVOLUTION +tamaño I-EVOLUTION +sin I-EVOLUTION +cambios I-EVOLUTION +rápidos I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +configuración I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +melanocitoma I-EVOLUTION +seguía I-EVOLUTION +siendo I-EVOLUTION +el I-EVOLUTION +más I-EVOLUTION +apropiado. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +acabó I-EVOLUTION +por I-EVOLUTION +perder I-EVOLUTION +completamente I-EVOLUTION +la I-EVOLUTION +visión I-EVOLUTION +del I-EVOLUTION +OI I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +funduscopia I-EVOLUTION +llegó I-EVOLUTION +a I-EVOLUTION +ser I-EVOLUTION +impracticable, I-EVOLUTION +al I-EVOLUTION +principio I-EVOLUTION +a I-EVOLUTION +causa I-EVOLUTION +del I-EVOLUTION +pigmento I-EVOLUTION +vítreo I-EVOLUTION +y I-EVOLUTION +posteriormente I-EVOLUTION +por I-EVOLUTION +una I-EVOLUTION +catarata. I-EVOLUTION + I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +19 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +visita I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +empezó I-EVOLUTION +a I-EVOLUTION +aquejar I-EVOLUTION +intenso I-EVOLUTION +dolor I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +glaucoma I-EVOLUTION +agudo I-EVOLUTION +con I-EVOLUTION +inflamación I-EVOLUTION +en I-EVOLUTION +cámara I-EVOLUTION +anterior I-EVOLUTION +y I-EVOLUTION +seclusión I-EVOLUTION +pupilar I-EVOLUTION +sin I-EVOLUTION +rubeosis I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +enucleación. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +anatomopatológico I-EXPLORATION +del I-EXPLORATION +globo I-EXPLORATION +ocular I-EXPLORATION +: I-EXPLORATION +el I-EXPLORATION +ángulo I-EXPLORATION +camerular I-EXPLORATION +está I-EXPLORATION +abierto, I-EXPLORATION +contiene I-EXPLORATION +abundantes I-EXPLORATION +macrófagos I-EXPLORATION +llenos I-EXPLORATION +de I-EXPLORATION +pigmento I-EXPLORATION +que I-EXPLORATION +infiltran I-EXPLORATION +la I-EXPLORATION +malla I-EXPLORATION +trabecular, I-EXPLORATION +rodean I-EXPLORATION +el I-EXPLORATION +canal I-EXPLORATION +de I-EXPLORATION +Schlemm, I-EXPLORATION +tapizan I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +iris, I-EXPLORATION +y I-EXPLORATION +aparecen I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +cristalino, I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +procesos I-EXPLORATION +ciliares I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +vítreo I-EXPLORATION +anterior. I-EXPLORATION +El I-EXPLORATION +cristalino I-EXPLORATION +es I-EXPLORATION +cataratoso. I-EXPLORATION +Emergiendo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +del I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +y I-EXPLORATION +extendiéndose I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +retina I-EXPLORATION +yuxtapapilar I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +densamente I-EXPLORATION +pigmentado I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +grandes I-EXPLORATION +poliédricas I-EXPLORATION +con I-EXPLORATION +citoplasma I-EXPLORATION +abundante I-EXPLORATION +y I-EXPLORATION +núcleos I-EXPLORATION +picnóticos I-EXPLORATION +pequeños. I-EXPLORATION +La I-EXPLORATION +mayoría I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +son I-EXPLORATION +anucleoladas I-EXPLORATION +pero I-EXPLORATION +unas I-EXPLORATION +pocas I-EXPLORATION +tienen I-EXPLORATION +nucléolos I-EXPLORATION +pequeños. I-EXPLORATION +El I-EXPLORATION +tumor I-EXPLORATION +muestra I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +superficie, I-EXPLORATION +con I-EXPLORATION +siembra I-EXPLORATION +de I-EXPLORATION +macrófagos I-EXPLORATION +llenos I-EXPLORATION +de I-EXPLORATION +pigmento I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +membrana I-EXPLORATION +limitante I-EXPLORATION +interna I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +vítreo. I-EXPLORATION +En I-EXPLORATION +algunas I-EXPLORATION +áreas I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +células I-EXPLORATION +fusiformes I-EXPLORATION +intensamente I-EXPLORATION +pigmentadas. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +pigmentadas I-EXPLORATION +en I-EXPLORATION +muchas I-EXPLORATION +áreas I-EXPLORATION +se I-EXPLORATION +extienden I-EXPLORATION +a I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +membrana I-EXPLORATION +limitante I-EXPLORATION +interna I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +retina I-EXPLORATION +llegando I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +ora I-EXPLORATION +serrata. I-EXPLORATION +Las I-EXPLORATION +preparaciones I-EXPLORATION +decoloradas I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +muestran I-EXPLORATION +características I-EXPLORATION +citológicas I-EXPLORATION +benignas I-EXPLORATION +propias I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +del I-EXPLORATION +melanocitoma. I-EXPLORATION +El I-EXPLORATION +tumor I-EXPLORATION +no I-EXPLORATION +revela I-EXPLORATION +actividad I-EXPLORATION +mitótica, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +melanoma I-EXPLORATION +maligno I-EXPLORATION +ni I-EXPLORATION +de I-EXPLORATION +extensión I-EXPLORATION +extraocular. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitido I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +visión I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +(OD) I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +escotoma I-PRESENT_ILLNESS +central I-PRESENT_ILLNESS +relativo, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +oftalmológicos I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +familiares I-PAST_MEDICAL_HISTORY +conocidos. I-PAST_MEDICAL_HISTORY +Diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buen I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +metabólico, I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +mejor I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +con I-EXPLORATION +corrección I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +inicial I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +4/10 I-EXPLORATION +en I-EXPLORATION +OD I-EXPLORATION +(+1, I-EXPLORATION +75; I-EXPLORATION +-1.00×95o) I-EXPLORATION +y I-EXPLORATION +8/10 I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(OI) I-EXPLORATION +(+1, I-EXPLORATION +75; I-EXPLORATION +-1, I-EXPLORATION +50×85o). I-EXPLORATION +La I-EXPLORATION +biomicroscopia I-EXPLORATION +del I-EXPLORATION +polo I-EXPLORATION +anterior I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +amarillenta, I-EXPLORATION +sobreelevada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +macular I-EXPLORATION +del I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +alteración I-EXPLORATION +pigmentaria I-EXPLORATION +macular I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OI. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +retinopatía I-EXPLORATION +diabética I-EXPLORATION +en I-EXPLORATION +ninguno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +ojos. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +de I-EXPLORATION +coherencia I-EXPLORATION +óptica I-EXPLORATION +(OCT) I-EXPLORATION +mostraba, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +macular I-EXPLORATION +del I-EXPLORATION +OD, I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +reflectividad I-EXPLORATION +media, I-EXPLORATION +por I-EXPLORATION +encima I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +banda I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +pigmentario, I-EXPLORATION +con I-EXPLORATION +levantamiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +retina I-EXPLORATION +neurosensorial, I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +fluido I-EXPLORATION +intrarretiniano I-EXPLORATION +ni I-EXPLORATION +subretiniano. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +(AGF) I-EXPLORATION +podía I-EXPLORATION +comprobarse I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +hiperfluorescente I-EXPLORATION +con I-EXPLORATION +centro I-EXPLORATION +de I-EXPLORATION +hipofluorescencia, I-EXPLORATION +que I-EXPLORATION +aumentaba I-EXPLORATION +de I-EXPLORATION +intensidad I-EXPLORATION +en I-EXPLORATION +fases I-EXPLORATION +tardías I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +difusión I-EXPLORATION +del I-EXPLORATION +contraste, I-EXPLORATION +que I-EXPLORATION +confirmaría I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +DFVA. I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION +electrofisiológicas, I-EXPLORATION +tanto I-EXPLORATION +el I-EXPLORATION +electrorretinograma I-EXPLORATION +como I-EXPLORATION +el I-EXPLORATION +electrooculograma, I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +partir I-EXPLORATION +de I-EXPLORATION +ese I-EXPLORATION +momento I-EXPLORATION +se I-EXPLORATION +establecieron I-EXPLORATION +controles I-EXPLORATION +oftalmológicos I-EXPLORATION +periódicos, I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +la I-EXPLORATION +regresión I-EXPLORATION +progresiva I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +viteliforme I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +evolución I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +atrofia I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +pigmentario I-EXPLORATION +macular I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD. I-EXPLORATION +La I-EXPLORATION +visión I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OI I-EXPLORATION +se I-EXPLORATION +mantuvo I-EXPLORATION +estable I-EXPLORATION +(7/10), I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION +de I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +alteraciones I-EXPLORATION +pigmentarias I-EXPLORATION +maculares I-EXPLORATION +eran I-EXPLORATION +cada I-EXPLORATION +vez I-EXPLORATION +más I-EXPLORATION +evidentes. I-EXPLORATION + I-EXPLORATION +Dos B-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +visita, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +consulta I-EVOLUTION +por I-EVOLUTION +disminución I-EVOLUTION +brusca I-EVOLUTION +de I-EVOLUTION +visión I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OI I-EVOLUTION +(2/10), I-EVOLUTION +coincidiendo I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +desprendimiento I-EVOLUTION +macular I-EVOLUTION +serohemorrágico I-EVOLUTION +en I-EVOLUTION +dicho I-EVOLUTION +ojo. I-EVOLUTION +La B-EXPLORATION +OCT I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +importante I-EXPLORATION +levantamiento I-EXPLORATION +macular I-EXPLORATION +con I-EXPLORATION +desprendimiento I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +pigmentario, I-EXPLORATION +quistes I-EXPLORATION +intrarretinianos I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +subretiniano I-EXPLORATION +(LSR) I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +bordes I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión. I-EXPLORATION +Mediante I-EXPLORATION +AGF I-EXPLORATION +se I-EXPLORATION +comprobó I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +membrana I-EXPLORATION +neovascular I-EXPLORATION +oculta I-EXPLORATION +con I-EXPLORATION +difusión I-EXPLORATION +tardía I-EXPLORATION +del I-EXPLORATION +colorante. I-EXPLORATION +En B-TREATMENT +este I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +tratamiento I-TREATMENT +en I-TREATMENT +el I-TREATMENT +OI I-TREATMENT +con I-TREATMENT +ranibizumab I-TREATMENT +intravítreo, I-TREATMENT +a I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +habitualmente I-TREATMENT +utilizada I-TREATMENT +para I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +degeneración I-TREATMENT +macular I-TREATMENT +exudativa I-TREATMENT +(0,5mg/0,05ml). I-TREATMENT + I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +4 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +inyección I-EVOLUTION +la I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +había I-EVOLUTION +mejorado I-EVOLUTION +a I-EVOLUTION +3/10 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OI, I-EVOLUTION +con I-EVOLUTION +reabsorción I-EVOLUTION +prácticamente I-EVOLUTION +completa I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +hemorragia I-EVOLUTION +macular, I-EVOLUTION +apreciándose I-EVOLUTION +una I-EVOLUTION +mínima I-EVOLUTION +cantidad I-EVOLUTION +de I-EVOLUTION +LSR I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +tomografía. I-EVOLUTION +Tras I-EVOLUTION +8 I-EVOLUTION +semanas, I-EVOLUTION +la I-EVOLUTION +AV I-EVOLUTION +era I-EVOLUTION +de I-EVOLUTION +4/10, I-EVOLUTION +comprobándose I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +OCT I-EVOLUTION +una I-EVOLUTION +disminución I-EVOLUTION +importante I-EVOLUTION +del I-EVOLUTION +grosor I-EVOLUTION +macular I-EVOLUTION +central I-EVOLUTION +con I-EVOLUTION +mínima I-EVOLUTION +fibrosis I-EVOLUTION +subretiniana. I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +meses, I-EVOLUTION +la I-EVOLUTION +visión I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OI I-EVOLUTION +había I-EVOLUTION +descendido I-EVOLUTION +(2/10), I-EVOLUTION +evidenciándose I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +OCT I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +espesor I-EVOLUTION +macular I-EVOLUTION +superior I-EVOLUTION +a I-EVOLUTION +100micras, I-EVOLUTION +con I-EVOLUTION +presencia I-EVOLUTION +de I-EVOLUTION +líquido I-EVOLUTION +subretiniano, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +segunda I-TREATMENT +inyección I-TREATMENT +de I-TREATMENT +ranibizumab. I-TREATMENT +La B-EVOLUTION +respuesta I-EVOLUTION +a I-EVOLUTION +esta I-EVOLUTION +segunda I-EVOLUTION +inyección I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +12 I-EVOLUTION +semanas I-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +comprobar I-EVOLUTION +la I-EVOLUTION +reabsorción I-EVOLUTION +completa I-EVOLUTION +del I-EVOLUTION +fluido I-EVOLUTION +subretiniano, I-EVOLUTION +quedando I-EVOLUTION +una I-EVOLUTION +mínima I-EVOLUTION +fibrosis I-EVOLUTION +subretiniana I-EVOLUTION +como I-EVOLUTION +resultado I-EVOLUTION +del I-EVOLUTION +cierre I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +membrana I-EVOLUTION +neovascular. I-EVOLUTION + I-EVOLUTION +Doce I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +última I-EVOLUTION +inyección I-EVOLUTION +la I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +se I-EVOLUTION +mantiene I-EVOLUTION +estable I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OI I-EVOLUTION +(6/10), I-EVOLUTION +sin I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +reactivación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +membrana I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +derivadas I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +intravítreo. I-EVOLUTION + I-EVOLUTION + +Embarazada B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +multípara B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tres, I-PAST_MEDICAL_HISTORY +serología I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +negativo, I-PAST_MEDICAL_HISTORY +cursó I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sífilis I-PAST_MEDICAL_HISTORY +latente I-PAST_MEDICAL_HISTORY +precoz I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +semana I-PAST_MEDICAL_HISTORY +28 I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +(VDRL I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +reactivo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación, I-PAST_MEDICAL_HISTORY +VDRL I-PAST_MEDICAL_HISTORY +1: I-PAST_MEDICAL_HISTORY +128 I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +28 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +VDRL I-PAST_MEDICAL_HISTORY +1: I-PAST_MEDICAL_HISTORY +32 I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +31 I-PAST_MEDICAL_HISTORY +semanas, I-PAST_MEDICAL_HISTORY +MHA-TP I-PAST_MEDICAL_HISTORY +(microhemagglutination-Treponema I-PAST_MEDICAL_HISTORY +pallidum I-PAST_MEDICAL_HISTORY +test) I-PAST_MEDICAL_HISTORY +positivo. I-PAST_MEDICAL_HISTORY +Tratada I-PAST_MEDICAL_HISTORY +junto I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +pareja I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +inicio I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +trabajo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +parto. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sífilis I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +embarazos I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pareja I-PAST_MEDICAL_HISTORY +estable I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +rotura I-PRESENT_ILLNESS +prematura I-PRESENT_ILLNESS +ovular I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +administrándose B-TREATMENT +corticoides I-TREATMENT +y I-TREATMENT +6 I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +ampicilina. I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +RPR I-EXPLORATION +en I-EXPLORATION +parto I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +no I-EXPLORATION +reactivo I-EXPLORATION +(no I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +VDRL). I-EXPLORATION + I-EXPLORATION +Nació B-EVOLUTION +RN I-EVOLUTION +por I-EVOLUTION +parto I-EVOLUTION +vaginal I-EVOLUTION +de I-EVOLUTION +34 I-EVOLUTION +semanas, I-EVOLUTION +pequeño I-EVOLUTION +para I-EVOLUTION +la I-EVOLUTION +edad I-EVOLUTION +gestacional I-EVOLUTION +(PEG) I-EVOLUTION +peso I-EVOLUTION +de I-EVOLUTION +1.920 I-EVOLUTION +g, I-EVOLUTION +con I-EVOLUTION +cianosis I-EVOLUTION +generalizada, I-EVOLUTION +sin I-EVOLUTION +esfuerzo I-EVOLUTION +respiratorio, I-EVOLUTION +APGAR I-EVOLUTION +6-8, I-EVOLUTION +requiriendo B-TREATMENT +ventilación I-TREATMENT +a I-TREATMENT +presión I-TREATMENT +positiva. I-TREATMENT +Cursó I-TREATMENT +con I-TREATMENT +enfermedad I-TREATMENT +de I-TREATMENT +membrana I-TREATMENT +hialina I-TREATMENT +(EMH) I-TREATMENT +administrándose I-TREATMENT +surfactante, I-TREATMENT +sin I-TREATMENT +embargo, I-TREATMENT +por I-TREATMENT +compromiso I-TREATMENT +respiratorio I-TREATMENT +progresivo I-TREATMENT +debió I-TREATMENT +conectarse I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica. I-TREATMENT +Evolucionó B-EVOLUTION +grave I-EVOLUTION +con I-EVOLUTION +altos I-EVOLUTION +requerimientos I-EVOLUTION +de I-EVOLUTION +oxígeno, I-EVOLUTION +con I-EVOLUTION +deterioro I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +se I-EVOLUTION +agregó I-EVOLUTION +ictericia I-EVOLUTION +generalizada, I-EVOLUTION +petequias I-EVOLUTION +múltiples, I-EVOLUTION +sangrado I-EVOLUTION +en I-EVOLUTION +sitios I-EVOLUTION +de I-EVOLUTION +punción I-EVOLUTION +e I-EVOLUTION +hipertensión I-EVOLUTION +pulmonar I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +debió I-TREATMENT +iniciarse I-TREATMENT +drogas I-TREATMENT +vasoactivas. I-TREATMENT +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba: I-EXPLORATION +abdomen I-EXPLORATION +globuloso, I-EXPLORATION +hepato-esplenomegalia I-EXPLORATION +(ambos I-EXPLORATION +en I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +bajo I-EXPLORATION +reborde I-EXPLORATION +costal), I-EXPLORATION +petequias, I-EXPLORATION +edema I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +extremidades, I-EXPLORATION +y I-EXPLORATION +descamación I-EXPLORATION +palmo-plantar. I-EXPLORATION +Inició B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +sódica I-TREATMENT +y I-TREATMENT +gentamicina I-TREATMENT +i.v. I-TREATMENT +por I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +sepsis I-TREATMENT +precoz. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +recibió I-EXPLORATION +resultado I-EXPLORATION +del I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +del I-EXPLORATION +RN I-EXPLORATION +1: I-EXPLORATION +64, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +(PL) I-EXPLORATION +en I-EXPLORATION +ese I-EXPLORATION +momento I-EXPLORATION +por I-EXPLORATION +gravedad I-EXPLORATION +y I-EXPLORATION +trombocitopenia I-EXPLORATION +marcada. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +iniciales I-EXPLORATION +se I-EXPLORATION +muestran I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tabla I-EXPLORATION +1. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +asumió I-EXPLORATION +diagnóstico I-EXPLORATION +probable I-EXPLORATION +de I-EXPLORATION +sífilis I-EXPLORATION +congénita I-EXPLORATION +y I-EXPLORATION +sepsis I-EXPLORATION +precoz, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +completar I-EXPLORATION +estudio I-EXPLORATION +para I-EXPLORATION +pesquisa I-EXPLORATION +de I-EXPLORATION +daño I-EXPLORATION +multisistémico. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ecocardiografía, I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +ecografía I-EXPLORATION +cerebral I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +normales. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Completó B-EVOLUTION +tratamiento I-EVOLUTION +antibiótico I-EVOLUTION +con I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +gentamicina I-EVOLUTION +iv I-EVOLUTION +y I-EVOLUTION +14 I-EVOLUTION +de I-EVOLUTION +penicilina I-EVOLUTION +sódica I-EVOLUTION +iv., I-EVOLUTION +lográndose I-EVOLUTION +disminuir I-EVOLUTION +progresivamente I-EVOLUTION +las I-EVOLUTION +drogas I-EVOLUTION +vasoactivas I-EVOLUTION +hasta I-EVOLUTION +su I-EVOLUTION +suspensión. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +transaminasas I-EXPLORATION +elevadas I-EXPLORATION +y I-EXPLORATION +hepatomegalia I-EXPLORATION +se I-EXPLORATION +completó I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +Hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +negativas. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +citomegalovirus I-EXPLORATION +(CMV). I-EXPLORATION +Se I-EXPLORATION +logró I-EXPLORATION +realizar I-EXPLORATION +PL I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +28 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +vida, I-EXPLORATION +resultando I-EXPLORATION +citoquímico I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +(LCR) I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +VDRL I-EXPLORATION +no I-EXPLORATION +reactivo, I-EXPLORATION +con I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +de I-EXPLORATION +1: I-EXPLORATION +32. I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +huesos I-EXPLORATION +largos I-EXPLORATION +y I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +alteraciones. I-EXPLORATION +Durante B-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +del I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +clínico, I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +pruebas I-EVOLUTION +hepáticas I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +mal I-EVOLUTION +incremento I-EVOLUTION +ponderal. I-EVOLUTION + I-EVOLUTION + +Adolescente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +16 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +rural I-PAST_MEDICAL_HISTORY +lejana, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +altura I-PAST_MEDICAL_HISTORY +superior I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +2.500 I-PAST_MEDICAL_HISTORY +m I-PAST_MEDICAL_HISTORY +sobre I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +mar, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Departamento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Nariño-Colombia, I-PAST_MEDICAL_HISTORY +con B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +consistente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +El B-EXPLORATION +paciente I-EXPLORATION +nunca I-EXPLORATION +antes I-EXPLORATION +había I-EXPLORATION +tenido I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +salud. I-EXPLORATION + I-EXPLORATION +Ingresó I-EXPLORATION +al I-EXPLORATION +Hospital I-EXPLORATION +con I-EXPLORATION +disnea I-EXPLORATION +de I-EXPLORATION +pequeños I-EXPLORATION +esfuerzos, I-EXPLORATION +cianosis I-EXPLORATION +peribucal, I-EXPLORATION +conjuntivas I-EXPLORATION +hipercrómicas I-EXPLORATION +y I-EXPLORATION +soplo I-EXPLORATION +holosistólico I-EXPLORATION +en I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +focos I-EXPLORATION +grado I-EXPLORATION +IV/VI, I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +tricuspídeo, I-EXPLORATION +con I-EXPLORATION +reforzamiento I-EXPLORATION +de I-EXPLORATION +segundo I-EXPLORATION +ruido. I-EXPLORATION +En I-EXPLORATION +abdomen, I-EXPLORATION +masa I-EXPLORATION +no I-EXPLORATION +móvil, I-EXPLORATION +con I-EXPLORATION +bordes I-EXPLORATION +definidos, I-EXPLORATION +con I-EXPLORATION +diámetro I-EXPLORATION +de I-EXPLORATION +14 I-EXPLORATION +x I-EXPLORATION +15 I-EXPLORATION +cm, I-EXPLORATION +indolora, I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +dorso I-EXPLORATION +izquierdo I-EXPLORATION +llegando I-EXPLORATION +hasta I-EXPLORATION +hipogastrio. I-EXPLORATION +Dedos I-EXPLORATION +en I-EXPLORATION +palillo I-EXPLORATION +de I-EXPLORATION +tambor I-EXPLORATION +y I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION +grado I-EXPLORATION +I. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +hospitalizar I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +abdominal, I-EXPLORATION +diagnóstico I-EXPLORATION +y I-EXPLORATION +compensación I-EXPLORATION +de I-EXPLORATION +patología I-EXPLORATION +cardiovascular. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +mostró I-EXPLORATION +marcado I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +glóbulos I-EXPLORATION +rojos I-EXPLORATION +(9.320.000/mm3), I-EXPLORATION +hemoglobina I-EXPLORATION +de I-EXPLORATION +19, I-EXPLORATION +9 I-EXPLORATION +g/dL, I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +66%, I-EXPLORATION +glóbulos I-EXPLORATION +blancos I-EXPLORATION +3.500/mm3, I-EXPLORATION +plaquetas I-EXPLORATION +48.000/mm3, I-EXPLORATION +ácido I-EXPLORATION +úrico I-EXPLORATION +10, I-EXPLORATION +5 I-EXPLORATION +mg/dL. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +ecocardiograma I-EXPLORATION +reportó I-EXPLORATION +dilatación I-EXPLORATION +severa I-EXPLORATION +de I-EXPLORATION +cavidades I-EXPLORATION +derechas, I-EXPLORATION +insuficiencia I-EXPLORATION +tricuspídea I-EXPLORATION +e I-EXPLORATION +hipertensión I-EXPLORATION +pulmonar I-EXPLORATION +(HTP) I-EXPLORATION +severa I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +suprasistémico, I-EXPLORATION +(presión I-EXPLORATION +sistólica I-EXPLORATION +arterial I-EXPLORATION +pulmonar- I-EXPLORATION +PSAP: I-EXPLORATION +115 I-EXPLORATION +mmHg). I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +con I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +endovenoso, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +grandes I-EXPLORATION +masa I-EXPLORATION +tumoral I-EXPLORATION +intrarrenales I-EXPLORATION +bilaterales, I-EXPLORATION +de I-EXPLORATION +mayor I-EXPLORATION +tamaño I-EXPLORATION +gran I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION +exofítico I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +marcado I-EXPLORATION +adelgazamiento I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +riñones. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +mostró I-EXPLORATION +además I-EXPLORATION +adenopatías I-EXPLORATION +retroperitoneales I-EXPLORATION +múltiples I-EXPLORATION +y I-EXPLORATION +lesiones I-EXPLORATION +osteolíticas I-EXPLORATION +vertebrales. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +pulmonar. I-EXPLORATION + I-EXPLORATION +Por B-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +HTP I-TREATMENT +severa I-TREATMENT +con I-TREATMENT +signos I-TREATMENT +clínicos I-TREATMENT +de I-TREATMENT +hipoxia I-TREATMENT +crónica, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +administró I-TREATMENT +sildenafil I-TREATMENT +y I-TREATMENT +oxígeno I-TREATMENT +como I-TREATMENT +vasodilatadores I-TREATMENT +pulmonares, I-TREATMENT +furosemida I-TREATMENT +para I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +su I-TREATMENT +sobrecarga I-TREATMENT +hídrica I-TREATMENT +y I-TREATMENT +alopurinol I-TREATMENT +como I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +hiperuricemia I-TREATMENT +para I-TREATMENT +prevenir I-TREATMENT +lesión I-TREATMENT +renal. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +médula I-EXPLORATION +ósea I-EXPLORATION +reportó I-EXPLORATION +hiperplasia I-EXPLORATION +eritroide I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +infiltración, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION +linfoma. I-EXPLORATION +Por I-EXPLORATION +riesgo I-EXPLORATION +anestésico, I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +HTP, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +renal I-EXPLORATION +con I-EXPLORATION +Trucut I-EXPLORATION +guiada I-EXPLORATION +por I-EXPLORATION +Ecografía, I-EXPLORATION +cuyo I-EXPLORATION +reporte I-EXPLORATION +de I-EXPLORATION +patología I-EXPLORATION +confirmó I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +HEM. I-EXPLORATION + I-EXPLORATION +Se B-EVOLUTION +ha I-EVOLUTION +realizado I-EVOLUTION +seguimiento I-EVOLUTION +durante I-EVOLUTION +8 I-EVOLUTION +meses, I-EVOLUTION +sin I-EVOLUTION +cambios I-EVOLUTION +significativos I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +evolución. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +epilepsia I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +extensa I-PAST_MEDICAL_HISTORY +alteración I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +desarrollo I-PAST_MEDICAL_HISTORY +cortical I-PAST_MEDICAL_HISTORY +hemisférico I-PAST_MEDICAL_HISTORY +derecho. I-PAST_MEDICAL_HISTORY +Presentó B-PRESENT_ILLNESS +estatus I-PRESENT_ILLNESS +epiléptico I-PRESENT_ILLNESS +refractario I-PRESENT_ILLNESS +que B-TREATMENT +re I-TREATMENT +quirió I-TREATMENT +ingreso I-TREATMENT +a I-TREATMENT +Unidad I-TREATMENT +de I-TREATMENT +Cuidados I-TREATMENT +Intensivos I-TREATMENT +para I-TREATMENT +soporte I-TREATMENT +vital I-TREATMENT +y I-TREATMENT +tratamiento, I-TREATMENT +el I-TREATMENT +que I-TREATMENT +incluyó I-TREATMENT +como I-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +tercera I-TREATMENT +línea I-TREATMENT +infusión I-TREATMENT +intravenosa I-TREATMENT +continua I-TREATMENT +de I-TREATMENT +propofol I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +progresivas I-TREATMENT +hasta I-TREATMENT +alcanzar I-TREATMENT +una I-TREATMENT +tasa I-TREATMENT +10 I-TREATMENT +mg/kg/h. I-TREATMENT +Cursó B-EVOLUTION +con I-EVOLUTION +compromiso I-EVOLUTION +hemodinámico I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +iniciado I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +alza I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +creatinifosfokinasa I-EVOLUTION +(CK), I-EVOLUTION +acidosis I-EVOLUTION +metabólica I-EVOLUTION +y I-EVOLUTION +lactacidemia I-EVOLUTION +elevada, I-EVOLUTION +y B-TREATMENT +luego I-TREATMENT +de I-TREATMENT +descartar I-TREATMENT +otras I-TREATMENT +causas I-TREATMENT +se I-TREATMENT +planteó I-TREATMENT +el I-TREATMENT +dianóstico I-TREATMENT +de I-TREATMENT +SIP I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +droga, I-TREATMENT +logrando B-EVOLUTION +esta I-EVOLUTION +bilización I-EVOLUTION +hemodinámica I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +base I-PAST_MEDICAL_HISTORY +leucemia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +precisaba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +transfusiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +derivados I-PAST_MEDICAL_HISTORY +hemáticos I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cierta I-PAST_MEDICAL_HISTORY +frecuencia. I-PAST_MEDICAL_HISTORY +Tras B-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +constitucional I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +detectado I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +pared I-PRESENT_ILLNESS +costal I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +múcor. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Planteamos B-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +para I-TREATMENT +resecar I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +con I-TREATMENT +3 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +margen. I-TREATMENT +Al I-TREATMENT +estar I-TREATMENT +situada I-TREATMENT +en I-TREATMENT +la I-TREATMENT +proximidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +línea I-TREATMENT +axilar I-TREATMENT +anterior, I-TREATMENT +llevamos I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +con I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +de I-TREATMENT +músculo I-TREATMENT +dorsal I-TREATMENT +ancho I-TREATMENT +con I-TREATMENT +isla I-TREATMENT +de I-TREATMENT +piel I-TREATMENT +desepidermizada I-TREATMENT +de I-TREATMENT +8 I-TREATMENT +por I-TREATMENT +12 I-TREATMENT +cm I-TREATMENT +; I-TREATMENT +se I-TREATMENT +anclaron I-TREATMENT +puntos I-TREATMENT +de I-TREATMENT +sutura I-TREATMENT +desde I-TREATMENT +los I-TREATMENT +bordes I-TREATMENT +costales I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +dermis I-TREATMENT +del I-TREATMENT +colgajo, I-TREATMENT +para I-TREATMENT +así I-TREATMENT +dar I-TREATMENT +continuidad I-TREATMENT +a I-TREATMENT +la I-TREATMENT +propia I-TREATMENT +pared I-TREATMENT +costal. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +recibió I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +una I-EVOLUTION +semana I-EVOLUTION +más I-EVOLUTION +tarde, I-EVOLUTION +sin I-EVOLUTION +problemas I-EVOLUTION +ventilatorios I-EVOLUTION +ni I-EVOLUTION +respiración I-EVOLUTION +paradójica. I-EVOLUTION +No I-EVOLUTION +han I-EVOLUTION +aparecido I-EVOLUTION +recidivas I-EVOLUTION +ni I-EVOLUTION +complicaciones I-EVOLUTION +tras I-EVOLUTION +24 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticada B-PAST_MEDICAL_HISTORY +clínicamente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +miocardiopatía I-PAST_MEDICAL_HISTORY +hipertrófica I-PAST_MEDICAL_HISTORY +obstructiva I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antiarrítmicos I-PAST_MEDICAL_HISTORY +(Amiodarona) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +betabloqueantes I-PAST_MEDICAL_HISTORY +(Propanolol). I-PAST_MEDICAL_HISTORY +La B-FAMILY_HISTORY +madre I-FAMILY_HISTORY +había I-FAMILY_HISTORY +fallecido I-FAMILY_HISTORY +súbitamente I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +48 I-FAMILY_HISTORY +años I-FAMILY_HISTORY +por I-FAMILY_HISTORY +la I-FAMILY_HISTORY +misma I-FAMILY_HISTORY +enfermedad. I-FAMILY_HISTORY +Una B-PRESENT_ILLNESS +noche I-PRESENT_ILLNESS +salió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +cenar I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +compañeros I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +trabajo I-PRESENT_ILLNESS +regresando I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +domicilio I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +madrugada. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +manifestó I-PRESENT_ILLNESS +ninguna I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acostó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +sofá I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +salón. I-PRESENT_ILLNESS +Poco I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +perro I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ladrar I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +padre I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +levantó I-PRESENT_ILLNESS +encontrándola I-PRESENT_ILLNESS +inconsciente. I-PRESENT_ILLNESS +Se B-EVOLUTION +avisó I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +servicios I-EVOLUTION +de I-EVOLUTION +emergencia I-EVOLUTION +061 I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +limitaron I-EVOLUTION +a I-EVOLUTION +constatar I-EVOLUTION +el I-EVOLUTION +fallecimiento. I-EVOLUTION + I-EVOLUTION \ No newline at end of file