Scientific Letter
A gastrointestinal complication of Mycoplasma infection to take into account
Una complicación digestiva de la infección por Mycoplasma a tener en cuenta
Read
14353
Timeswas read the article
1642
Total PDF
12711
Total HTML
Share statistics
array:25 [ "pii" => "S234128791930136X" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.07.009" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2494" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2019;91:199-200" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 673 "formatos" => array:3 [ "EPUB" => 38 "HTML" => 568 "PDF" => 67 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S1695403318303126" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2018.07.002" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2494" "copyright" => "Asociación Española de Pediatría" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2019;91:199-200" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5922 "formatos" => array:3 [ "EPUB" => 156 "HTML" => 5039 "PDF" => 727 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Una complicación digestiva de la infección por <span class="elsevierStyleItalic">Mycoplasma</span> a tener en cuenta" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "199" "paginaFinal" => "200" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "A gastrointestinal complication of <span class="elsevierStyleItalic">Mycoplasma</span> infection to take into account" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eva Carvajal Roca, Rosa Fornes Vivas, Marisa Tronchoni Belda" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Eva" "apellidos" => "Carvajal Roca" ] 1 => array:2 [ "nombre" => "Rosa" "apellidos" => "Fornes Vivas" ] 2 => array:2 [ "nombre" => "Marisa" "apellidos" => "Tronchoni Belda" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S234128791930136X" "doi" => "10.1016/j.anpede.2018.07.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791930136X?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318303126?idApp=UINPBA00005H" "url" => "/16954033/0000009100000003/v1_201909040642/S1695403318303126/v1_201909040642/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2341287919301206" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.06.013" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2491" "copyright" => "Asociación Española de Pediatría" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2019;91:201-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 381 "formatos" => array:3 [ "EPUB" => 52 "HTML" => 257 "PDF" => 72 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Impact of training sessions on the treatment of bronchospasm episodes in the emergency department" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "201" "paginaFinal" => "202" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Impacto de unas sesiones formativas en el tratamiento de los episodios de broncoespasmo en urgencias" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1607 "Ancho" => 2199 "Tamanyo" => 207228 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Percentage of patients given each of the treatments by month.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Patrícia Bolívar Ruiz, José Luis Fernández Arribas, María Natalí Campo Fernández, Roberto Velasco Zúñiga" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Patrícia" "apellidos" => "Bolívar Ruiz" ] 1 => array:2 [ "nombre" => "José Luis" "apellidos" => "Fernández Arribas" ] 2 => array:2 [ "nombre" => "María Natalí" "apellidos" => "Campo Fernández" ] 3 => array:2 [ "nombre" => "Roberto" "apellidos" => "Velasco Zúñiga" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403318303096" "doi" => "10.1016/j.anpedi.2018.06.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318303096?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919301206?idApp=UINPBA00005H" "url" => "/23412879/0000009100000003/v1_201909010924/S2341287919301206/v1_201909010924/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287919300286" "issn" => "23412879" "doi" => "10.1016/j.anpede.2019.01.004" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2570" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;91:189-98" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1854 "formatos" => array:3 [ "EPUB" => 96 "HTML" => 1496 "PDF" => 262 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Rebound (reactive) thymic hyperplasia after chemotherapy in children with lymphoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "189" "paginaFinal" => "198" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hiperplasia tímica de rebote posquimioterapia en niños con linfoma" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1057 "Ancho" => 2083 "Tamanyo" => 166396 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(a and b) CT and GA-67 scan images of two rebound thymic hyperplasia (RTH) patients, corresponding to patient numbers 1 and 2 from <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ashraf Fouda, Shaimaa Kandil, Gihad Hamid, Khadijah Boujettif, Mohamed Mahfouz, Mohamed Abdelaziz" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ashraf" "apellidos" => "Fouda" ] 1 => array:2 [ "nombre" => "Shaimaa" "apellidos" => "Kandil" ] 2 => array:2 [ "nombre" => "Gihad" "apellidos" => "Hamid" ] 3 => array:2 [ "nombre" => "Khadijah" "apellidos" => "Boujettif" ] 4 => array:2 [ "nombre" => "Mohamed" "apellidos" => "Mahfouz" ] 5 => array:2 [ "nombre" => "Mohamed" "apellidos" => "Abdelaziz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403318305514" "doi" => "10.1016/j.anpedi.2018.10.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318305514?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300286?idApp=UINPBA00005H" "url" => "/23412879/0000009100000003/v1_201909010924/S2341287919300286/v1_201909010924/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "A gastrointestinal complication of <span class="elsevierStyleItalic">Mycoplasma</span> infection to take into account" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "199" "paginaFinal" => "200" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Eva Carvajal Roca, Rosa Fornes Vivas, Marisa Tronchoni Belda" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Eva" "apellidos" => "Carvajal Roca" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "Rosa" "apellidos" => "Fornes Vivas" "email" => array:1 [ 0 => "rfornes@comv.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Marisa" "apellidos" => "Tronchoni Belda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Casa de Salud, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una complicación digestiva de la infección por <span class="elsevierStyleItalic">Mycoplasma</span> a tener en cuenta" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present a case of protein-losing enteropathy (PLE) in the context of infection by <span class="elsevierStyleItalic">Mycoplasma</span> that we consider of interest because this disease is rare in childhood and no cases involving this aetiological agent have been previously reported in the literature.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a girl aged 3 years that presented to the emergency department with recurrent vomiting of 5 days’ duration, soft stools and asthenia in the past 3 days. She had a fever that peaked the day before admission (38<span class="elsevierStyleHsp" style=""></span>°C) and an adequate urine output.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient had no perinatal history of interest. She had been formula-fed and introduced complementary foods without evidence of intolerance. The vaccinations were up to date (the patient had not received the vaccine against rotavirus). Her father had thalassaemia minor.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In the physical examination at admission, the patient weighed 14.3<span class="elsevierStyleHsp" style=""></span>kg and had a body temperature of 36.8<span class="elsevierStyleHsp" style=""></span>°C. Her general health condition was normal, with mild asthenia. Her nutritional and hydration status were both adequate. She had no exanthema or petechiae. The appearance of the oral cavity and pharynx was normal. Regular heart sounds with no murmurs. Lung sounds evinced good ventilation with a mild cough. The abdomen was soft and not tender, without masses or evidence of organ enlargement. The patient was conscious and alert, and exhibited no meningeal or focal neurologic signs.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The blood tests performed at admission revealed a normal complete blood count and a mixed acid-base disorder with hyponatraemia and hypochloraemia (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The patient was admitted with a diagnosis of gastroenteritis to receive intravenous (IV) fluids.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Treatment started with standard fluid therapy. Since the patient exhibited only modest improvement of hyponatraemia, oliguria, food refusal and asthenia, her hydration status was reassessed, with ordering of serial arterial blood tests and replacement of fluids. The hyponatraemia persisted despite resolution of vomiting and IV administration of adequate doses of sodium. On day 2 of admission, the patient developed symptoms of a common cold and abdominal distension, and on day 3 developed peripheral swelling, mainly in the eyelid area, a relentless cough and dysphonia, with increased abdominal distension. Additional laboratory tests were ordered that revealed hypoproteinaemia with hypoalbuminaemia, hyponatraemia and hypouricaemia with normal serum creatinine and chloride levels (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The results of Labstix strip urine test were negative.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patient underwent an abdominal ultrasound scan, whose sole abnormal finding was free fluid in the pelvis. Suspicion of PLE led to strict monitoring of fluid balance and measurement of alpha-1 antitrypsin in stool on 3 consecutive days, along with a request for an upper gastrointestinal endoscopy. Treatment with a dry high-protein diet was initiated, with IV administration of a proton pump inhibitor and fluids as needed based on the fluid balance. The evaluation was completed with serologic tests, which detected infection by <span class="elsevierStyleItalic">Mycoplasma</span> with a higher IgM antibody titre in the sample obtained 24<span class="elsevierStyleHsp" style=""></span>h before admission compared to the follow-up test performed on day 4 of admission. Specific PCR could not be performed due to lack of a sample (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The level of alpha-1 antitrypsin was elevated (2.27<span class="elsevierStyleHsp" style=""></span>mg/g), which confirmed the suspected diagnosis of PLE, while the only possible aetiological agent identified was <span class="elsevierStyleItalic">Mycoplasma</span>, which led to initiation of azithromycin while awaiting the results of the endoscopy, which was scheduled for day 5 of admission.</p><p id="par0045" class="elsevierStylePara elsevierViewall">On day 5, the patient exhibited significant clinical improvement, with resolution of the oedema and negative fluid balances and a gradual increase in the repeat measurements of serum protein levels. The scheduled endoscopy was cancelled due to this obvious improvement.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Mycoplasma</span> genus comprises the smallest self-replicating microorganisms ever described, which are responsible for several infections. <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> is a recognised cause of atypical pneumonia that is endemic worldwide and affects children as well as adults. It has been associated with other diseases, such as pleuropericarditis, pleuritis, reactive arthritis, predominantly cutaneous vasculitis, cold urticaria, lymphocytic meningitis, disseminated encephalomyelitis, Guillain–Barré syndrome, Adie syndrome and, infrequently and only in adults, PLE.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The term PLE encompasses several infrequent diseases that share an excessive protein loss through the gastrointestinal tract, resulting in hyponatraemia possibly associated with oedema, ascites, pleural effusion and pericardial effusion.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The main diseases that cause PLE are parasitic infection, amyloidosis, ulcerative jejunoileitis, intestinal lymphoma intestinal, bacterial overgrowth, coeliac disease, Whipple disease, lymphangiectasia, amyloidosis, Crohn disease, Ménétrier disease, eosinophilic gastritis, erosive gastritis, stomach cancer, lymphoma, ulcerative colitis, and colon cancer.</p><p id="par0065" class="elsevierStylePara elsevierViewall">It is characterised by hypertrophy of the gastric folds of the fundus and body, mucosal hypersecretion, protein loss and hypochlorhydria.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Its pathophysiology has not been established, with different authors suggesting the possibility of infectious, autoimmune, endocrine and genetic aetiologies, and it is associated with an increased risk of stomach cancer (10%–15%).<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">This disease is rare in childhood, usually manifesting before age 6 years with a sudden onset, persistent oedema and a benign outcome.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> In most of the published literature, cytomegalovirus (CMV) is considered the most probable aetiological agent, and <span class="elsevierStyleItalic">Helicobacter pylori</span> is another likely cause. Pathogens that are involved less frequently and have not been described in the literature include <span class="elsevierStyleItalic">M. pneumoniae</span>, <span class="elsevierStyleItalic">Giardia intestinalis</span> and herpes simplex.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The initial presentation is nonspecific, similar to that of a viral illness, with appearance of peripheral oedema once hypoalbuminaemia has developed. Hypoproteinaemia and hypoalbuminaemia are typically present, and faecal alpha-1-antitrypsin is a sensitive and specific marker of protein loss in the gastrointestinal tract.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">There is no specific treatment for this disease. Spontaneous resolution usually occurs within 5 weeks from onset. The treatment plan is based on the causative pathogen. The management includes a diet rich in protein, antisecretory drugs, octreotide, anticholinergic drugs and possibly monoclonal antibodies.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Surgical treatment is indicated in case of uncontrolled protein loss, bleeding, location near the cardia or dysplasia, as it eliminates the risk of malignant transformation. The right approach remains controversial, and the intervention should be adapted to the location and severity of the dysplasia.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Carvajal Roca E, Fornes Vivas R, Tronchoni Belda M. Una complicación digestiva de la infección por <span class="elsevierStyleItalic">Mycoplasma</span> a tener en cuenta. An Pediatr (Barc). 2019;91:199–200.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Day 1 of admission \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Day 3 of admission \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Day 6 of admission \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leucocytes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12,000<span class="elsevierStyleHsp" style=""></span>mg/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7200<span class="elsevierStyleHsp" style=""></span>mg/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8000<span class="elsevierStyleHsp" style=""></span>mg/L \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haemoglobin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Platelets \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">389,000<span class="elsevierStyleHsp" style=""></span>mg/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">271,000<span class="elsevierStyleHsp" style=""></span>mg/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">459,000<span class="elsevierStyleHsp" style=""></span>mg/L \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">pH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CO<span class="elsevierStyleInf">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44.1<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">O<span class="elsevierStyleInf">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.8<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Na \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">131<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">137<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">K \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.13<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.44<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102<span class="elsevierStyleHsp" style=""></span>mEquiv./L \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anion gap \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−4<span class="elsevierStyleHsp" style=""></span>mmol/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−2<span class="elsevierStyleHsp" style=""></span>mmol/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calcium \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.3<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total protein \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Albumin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.68<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.71<span class="elsevierStyleHsp" style=""></span>g/dL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alfa-1 antitrypsin in stool \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.27<span class="elsevierStyleHsp" style=""></span>mg/g stools \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.18<span class="elsevierStyleHsp" style=""></span>mg/g stools \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2113222.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Laboratory tests performed in our hospital to assess the patient during acute illness.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">24<span class="elsevierStyleHsp" style=""></span>h before admission \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Day 4 of admission \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cytomegalovirus (IgM/IgG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> (IgM/IgG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IgM 10<span class="elsevierStyleHsp" style=""></span>IU/mL (0–14)IgG negative (0–25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IgM 23<span class="elsevierStyleHsp" style=""></span>IU/mL (0–14)IgG negative (0–25) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Toxoplasma (IgM/IgG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Mycoplasma tuberculosis</span> (IgM/IgG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not ordered \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Epstein–Barr virus (IgM/IgG) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Helicobacter pylori</span> antigen in stool \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not ordered \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCR for <span class="elsevierStyleItalic">Mycoplasma</span> and enterovirus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not ordered \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No sample \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2113223.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Microbiological tests performed in the patient during acute illness.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastropatía hipertrófica perdedora de proteínas. Enfermedad de Ménétrier. Caso clínico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Kirberg" 1 => "B. Rodríguez" 2 => "F. Donoso" 3 => "M. Kirhman" 4 => "M. Noriel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4067/S0370-41062014000100011" "Revista" => array:6 [ "tituloSerie" => "Rev Chil Pediatr" "fecha" => "2014" "volumen" => "85" "paginaInicial" => "80" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25079188" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beyond gastritis and before cancer: the strange case of Ménétrier's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Famularo" 1 => "M.R. Sajeva" 2 => "L. Gasbarrone" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11739-010-0471-9" "Revista" => array:6 [ "tituloSerie" => "Intern Emerg Med" "fecha" => "2011" "volumen" => "6" "paginaInicial" => "369" "paginaFinal" => "371" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20949332" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Doença de Ménétrier: Regressão Completa após Erradicação do Helicobacter Pylori" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Ramos" 1 => "M. Herrera" 2 => "D. Hervias" 3 => "P. Duarte" 4 => "C. Vicente" 5 => "C. Casteleiro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Port Gastrenterol" "fecha" => "2008" "volumen" => "15" "paginaInicial" => "118" "paginaFinal" => "121" "itemHostRev" => array:3 [ "pii" => "S0165032715000385" "estado" => "S300" "issn" => "01650327" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad de Ménétrier asociada a infección por citomegalovirus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B. Fernández Caamaño" 1 => "E. Ramos Boluda" 2 => "E. Martínez-Ojinaga Nodal" 3 => "M. Molina Arias" 4 => "J. Sarría Osés" 5 => "G. Prieto Bozano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2015" "volumen" => "82" "paginaInicial" => "113" "paginaFinal" => "116" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad de Ménétrier" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Baños Madrid" 1 => "F. Alemán Lorca" 2 => "S. Chacón Martínez" 3 => "J.L. Rodríguez Agudo" 4 => "C. Ballester Rosique" 5 => "E. Olmo Brieba" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Col Gastroenterol" "fecha" => "2007" "volumen" => "22" "paginaInicial" => "217" "paginaFinal" => "219" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Doença de Ménétrier da infância – uma causa de hypoalbuminemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Couto Guerra" 1 => "A. Sarmento" 2 => "M. Figueiredo" 3 => "L. Morais" 4 => "H. Ferreira" 5 => "L. Marques" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Pediatr Port" "fecha" => "2008" "volumen" => "39" "paginaInicial" => "146" "paginaFinal" => "148" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009100000003/v1_201909010924/S234128791930136X/v1_201909010924/en/main.assets" "Apartado" => array:4 [ "identificador" => "38181" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009100000003/v1_201909010924/S234128791930136X/v1_201909010924/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791930136X?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 86 | 6 | 92 |
| 2024 October | 451 | 47 | 498 |
| 2024 September | 346 | 31 | 377 |
| 2024 August | 373 | 64 | 437 |
| 2024 July | 422 | 34 | 456 |
| 2024 June | 401 | 43 | 444 |
| 2024 May | 355 | 40 | 395 |
| 2024 April | 252 | 36 | 288 |
| 2024 March | 294 | 23 | 317 |
| 2024 February | 251 | 26 | 277 |
| 2024 January | 306 | 21 | 327 |
| 2023 December | 304 | 22 | 326 |
| 2023 November | 248 | 24 | 272 |
| 2023 October | 189 | 26 | 215 |
| 2023 September | 152 | 21 | 173 |
| 2023 August | 140 | 15 | 155 |
| 2023 July | 149 | 29 | 178 |
| 2023 June | 150 | 18 | 168 |
| 2023 May | 175 | 27 | 202 |
| 2023 April | 122 | 16 | 138 |
| 2023 March | 215 | 27 | 242 |
| 2023 February | 156 | 23 | 179 |
| 2023 January | 139 | 26 | 165 |
| 2022 December | 156 | 20 | 176 |
| 2022 November | 206 | 28 | 234 |
| 2022 October | 221 | 47 | 268 |
| 2022 September | 182 | 36 | 218 |
| 2022 August | 188 | 47 | 235 |
| 2022 July | 182 | 40 | 222 |
| 2022 June | 185 | 42 | 227 |
| 2022 May | 167 | 31 | 198 |
| 2022 April | 189 | 27 | 216 |
| 2022 March | 231 | 44 | 275 |
| 2022 February | 194 | 22 | 216 |
| 2022 January | 191 | 30 | 221 |
| 2021 December | 159 | 23 | 182 |
| 2021 November | 167 | 49 | 216 |
| 2021 October | 193 | 50 | 243 |
| 2021 September | 185 | 28 | 213 |
| 2021 August | 140 | 35 | 175 |
| 2021 July | 152 | 22 | 174 |
| 2021 June | 130 | 29 | 159 |
| 2021 May | 145 | 37 | 182 |
| 2021 April | 340 | 39 | 379 |
| 2021 March | 234 | 21 | 255 |
| 2021 February | 145 | 26 | 171 |
| 2021 January | 161 | 16 | 177 |
| 2020 December | 167 | 13 | 180 |
| 2020 November | 181 | 14 | 195 |
| 2020 October | 156 | 16 | 172 |
| 2020 September | 219 | 19 | 238 |
| 2020 August | 233 | 10 | 243 |
| 2020 July | 237 | 13 | 250 |
| 2020 June | 147 | 6 | 153 |
| 2020 May | 225 | 19 | 244 |
| 2020 April | 176 | 10 | 186 |
| 2020 March | 174 | 13 | 187 |
| 2020 February | 214 | 10 | 224 |
| 2020 January | 152 | 7 | 159 |
| 2019 December | 120 | 15 | 135 |
| 2019 November | 65 | 10 | 75 |
| 2019 October | 37 | 8 | 45 |
| 2019 September | 73 | 16 | 89 |
| 2019 August | 16 | 9 | 25 |
Show all
