[Medium-term management of protein-losing enteropathy of cardiac origin unresponsive to medical therapy in a patient awaiting heart transplantation]

Protein-losing enteropathy is characterized by excessive leaking of serum proteins into the gastrointestinal tract, as a result of disease progression in several diseases. We report the case of a 17-year-old-woman with hypoproteinemia, generalized edema and serosal effusions diagnosed as protein-losing enteropathy due to right ventricular failure secondary to previous surgical damage. All previously described therapies were ineffective in curing or relieving the disease or its symptoms, and the patient was listed for heart transplantation. During the 7-month period on the waiting list, the patient was managed as an outpatient, with fortnightly albumin infusions and intravenous furosemide administration, which allowed her a better quality of life during that period, avoiding further admissions.

[Fungal liver abscesses in a patient with primary sclerosing cholangitis and Crohn's disease]

Liver abscesses are a relatively infrequent complication of inflammatory bowel disease. These abscesses are usually multiple and of polymicrobial origin. The development of primary sclerosing cholangitis in inflammatory bowel disease, although provoking alterations in biliary morphology and a higher incidence of infections, does not predispose patients to the development of liver abscesses. We describe a new case of primary sclerosing cholangitis and Crohn's disease with multiple fungal liver abscesses caused by Candida albicans. The patient had developed a duodenal-biliary fistula. Antibiotic therapy produced clinical response and surgery was performed to repair the fistula.