Acute esophageal necrosis (AEN) is defined as a diffuse blackened aspect of the esophagus observed by upper gastrointestinal endoscopy associated with the histopathological findings of necrosis of the esophageal mucosa. In general, the condition is present in severely compromised patients. Its cause remains unknown but is probably multifactorial. In the present case report we describe the clinical, endoscopic and histopathological characteristics of black esophagus observed in three patients and present a review of the literature.

Of the 264 patients, 88 (32.1%) had SVR whereas 67.9% had nonresponse or relapse. Liver iron deposits were observed in 49.2% of the patients. The factors associated with SVR were hepatitis C virus genotype 2 or 3, transferrin saturation value of 45% or less, and detection of the H63D mutation. HFE mutation was more frequent in patients with iron deposits, but without association with serum iron biochemistry or severity of liver disease. Steatosis was more frequent in patients with liver iron deposits. CONCLUSION THE: H63D mutation was an independent factor associated with SVR in chronic hepatitis C patients, as also were hepatitis C virus genotype 2 or 3 and transferrin saturation value of 45% or less. Moreover, the H63D mutation was associated with liver iron deposits.

The objective of the present study was to report on three distinct forms of presentation of Cryptococcus neoformans infection in three cirrhotic patients. One patient had disseminated cryptococcosis with detection of the fungus in ascitic fluid, cerebrospinal fluid and blood; the second patient had pleural involvement and the third had cutaneous infection caused by C. neoformans.

Introduction. Variable prevalence rates have been reported for Low bone mineral density (LBMD). Objectives. To determine the prevalence of LBMD in cirrhotic patients from a hospital outpatient clinic, to identify clinical and laboratory predictors of LBMD, and to determine the mean age at which LBMD was detected in this population. Methods. We conduced a cross-sectional study with 97 patients with liver cirrhosis for the presence of LBMD using bone densitometry of the lumbar spine and femoral neck. The prevalence of LBMD and mean age at detection of LBMD were evaluated. Correlation of LBMD with clinical-laboratory data was assessed, and uni and multivariate statistical analysis was performed. Results. The prevalence of LBMD was 50.5% in the 97 of the cases. LBMD was more frequent in participants over 50 years old (p = 0.001). There were no significant associations between the presence of LBMD and body mass index (p = 0.9), CHILD-PUGH score (p = 0.23), levels of 25-OH vitamin D (p = 0.5), parathyroid hormone (p = 0.5), calcium (p = 0.1), phosphorus (p = 0.3), and current or past smoking (p = 0.7). Age over 50 years remained a predictor of hepatic osteodystrophy even after adjusting for the other variables. Discussion. In conclusion LBMD was prevalent in the cirrhotic population studied. The age at LBMD diagnosis was between 15 and 20 years less than the osteoporosis screening age of the non-cirrhotic population. There were no clinical-laboratory factors that increased the suspicion of LBMD. Further studies are needed to determine whether these findings can be extrapolated to the cirrhotic population.

ResuMenPresentamos el caso de una mujer de 95 años con lesiones agudas del esófago que tomaba ciprofloxacino por cistitis aguda. La paciente refería dolor y sensación de cuerpo estraño retroesternal asociados con hematemesis y melena, después del segundo día de tratamiento. No había antecedentes personales de trastornos gástricos o esofágicos. La endoscopia digestiva objetivó lesiones sangrantes en el tercio medio del esófago. El uso de ciprofloxacino fue suspendido y se utilizó un inhibidor de la bomba de protones. Una semana más tarde, el aspecto endoscópico del esófago fue considerado normal. Dos únicos casos de lesiones esofágicas inducidas por ciprofloxacino han sido previamente publicados. Se presenta una revisión breve acerca de este tipo de lesiones del esófago, con énfasis a los principales factores de riesgo y medidas de prevención.Palabras clave. Anciano. Ciprofloxacino. Esofagitis inducida por drogas. Endoscopia. aBstRactWe report the case of a 95-year-old woman who had acute esophageal lesions while being treated with oral ciprofloxacin for an acute cystitis. On day 2 of treatment, she reported retroesternal pain with a globus sensation, and presented hematemesis and melena. There was no history of gastric or esophageal disturbances. An upper digestive endoscopy showed bleeding lesions on the middle third of the esophagus. Ciprofloxacin was discontinued and a proton pump inhibitor was administered. One week later, the endoscopic aspect of the esophagus was normal. Only two cases of ciprofloxacin-induced esophageal lesions have been reported previously. A short review of this kind of esophageal injuries is presented, focusing on the main risk factors and preventive measures.