Colitis Ulcerosa

Epidemiología y Fisiopatología

Epidemiología

• Incidencia: distribución bimodal
  • 15–35 años (media ligeramente superior a la de la enfermedad de Crohn)
  • El pico más pequeño se produce entre los LOS Neisseria 50 y los LOS Neisseria 70 años de edad
• Hombres > mujeres
• El riesgo de enfermedad es menor en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria fumadores.
• Más común entre los LOS Neisseria blancos y los LOS Neisseria judíos de Europa del Este (asquenazíes)
• Incidencia: 9–20 casos por cada 100 000 personas al AL Amyloidosis año

Factores de riesgo

Un mayor riesgo de desarrollar colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa puede estar asociado a lo siguiente

• Genética: HLA-B27 (codifica los LOS Neisseria genes Genes A category of nucleic acid sequences that function as units of heredity and which code for the basic instructions for the development, reproduction, and maintenance of organisms. DNA Types and Structure del complejo mayor de histocompatibilidad [CMH])
• Antecedentes familiares de enfermedad inflamatoria intestinal
  • La tasa de concordancia entre gemelos es del 10%–15%.
  • Los LOS Neisseria familiares de primer grado tienen un riesgo 4 veces mayor de desarrollar la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa.
• Aumento de la ingesta de grasa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la dieta
• Uso de antiinflamatorios no esteroideos (AINE)
• El estrés psicológico y las infecciones intestinales pueden desencadenar la aparición de la enfermedad.

Fisiopatología

Se desconoce la fisiopatología exacta, pero es probable que esté asociada a una combinación de desregulación del epitelio intestinal y del sistema inmunitario.

1. Los LOS Neisseria defectos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la lámina propia y la barrera epitelial del tracto gastrointestinal permiten que penetren más patógenos → reclutamiento y activación de células citotóxicas
2. Además, se cree que los LOS Neisseria pANCA (anticuerpos citoplasmáticos antineutrófilos perinucleares) reconocen a las bacterias no patógenas y a las células epiteliales como patógenos.
3. Liberación excesiva de citoquinas proinflamatorias, especialmente de las células Th2 Th2 A subset of helper-inducer T-lymphocytes which synthesize and secrete the interleukins il-4; il-5; il-6; and il-10. These cytokines influence b-cell development and antibody production as well as augmenting humoral responses. T cells: Types and Functions, que parecen dirigirse a las células epiteliales → inflamación intestinal
4. Causa daños en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el epitelio intestinal, incluyendo ulceraciones, erosiones y necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage

La inflamación afecta invariablemente el recto y puede extenderse proximalmente por el colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy de forma continua.

• No se observan lesiones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum parches.
• El intestino delgado no se ve VE Ventilation: Mechanics of Breathing afectado, excepto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria casos graves de pancolitis.
• Pancolitis: afecta a todo el colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy
• Proctitis Proctitis Inflammation of the mucous membrane of the rectum, the distal end of the large intestine. Chronic Granulomatous Disease ulcerosa o proctosigmoiditis ulcerosa: efectos limitados al AL Amyloidosis recto o al AL Amyloidosis rectosigmoide

Presentación Clínica

La presentación típica de la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa es un trastorno recidivante que incluye lo siguiente:

• Manifestaciones gastrointestinales:
  • Diarrea sanguinolenta que dura de semanas a meses (con o sin mucosidad)
  • Urgencia y/o incontinencia fecal
  • Tenesmo
  • Dolor Dolor Inflammation abdominal bajo con cólicos que se alivia temporalmente con la defecación
• Manifestaciones generales:
  • Signos de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types: fatiga, palidez, disnea, palpitaciones
  • Pérdida de peso
  • Fiebre de bajo grado
• Manifestaciones extraintestinales ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum general, menos frecuentes que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la enfermedad de Crohn):
  • Colangitis esclerosante primaria (mucho más frecuente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la enfermedad de Crohn)
  • Pioderma gangrenoso: pápulas rojas y dolorosas rápidamente progresivas → pústulas → úlceras profundas con necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage central
  • Eritema nodoso: nódulos rojos y dolorosos que suelen aparecer en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la cara anterior de las piernas
  • Inflamación ocular (epiescleritis, uveítis)
  • Ulceraciones orales (estomatitis aftosa)
  • Artritis periférica, espondilitis anquilosante u osteoporosis Osteoporosis Osteoporosis refers to a decrease in bone mass and density leading to an increased number of fractures. There are 2 forms of osteoporosis: primary, which is commonly postmenopausal or senile; and secondary, which is a manifestation of immobilization, underlying medical disorders, or long-term use of certain medications. Osteoporosis
  • Úlceras aftosas
  • Trombosis venosa profunda y/o embolia pulmonar

Diagnóstico

Estudios de laboratorio:

• El hemograma mostrará anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types, leucocitosis y trombocitosis (ocasionalmente).
• Panel metabólico completo para comprobar si la diarrea crónica ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia causado un desequilibrio electrolítico
• ↑ VES

Estudios de heces: pueden utilizarse para excluir otras causas de diarrea inflamatoria (e.g., infección)

Imágenes abdominales:

• Radiografía, tomografía computarizada (TC) y/o resonancia magnética (RM):
  • Hallazgos inespecíficos: pared intestinal engrosada, dilatación del colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy
  • Enema de bario: microulceraciones, pérdida de haustra Haustra Colon, Cecum, and Appendix: Anatomy con aspecto de “tubo de plomo” y mucosa granular
• Colonoscopia con biopsia:
  • Ayuda a determinar la extensión de la enfermedad
  • Contraindicado durante una exacerbación aguda debido al AL Amyloidosis riesgo de perforación intestinal
  • Hallazgos macroscópicos:
    • Inflamación difusa y continua de la mucosa que siempre involucra al AL Amyloidosis recto
    • Infiltración de neutrófilos limitada a la mucosa y submucosa
    • Mucosa friable
    • Pérdida de haustras, dando al AL Amyloidosis tracto gastrointestinal una apariencia de “tubo de plomo”.
    • Pseudopólipos: áreas elevadas causadas por la ulceración recurrente, la curación y la cicatrización de la mucosa
  • Hallazgos microscópicos:
    • Abscesos de la cripta
    • Úlceras de base amplia que no penetran en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la muscularis propria
    • No hay formación de granulomas Granulomas A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Sarcoidosis
    • Hemorragia digestiva
    • Metaplasia Metaplasia A condition in which there is a change of one adult cell type to another similar adult cell type. Cellular Adaptation epitelial
    • Fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans de la submucosa y atrofia de la mucosa

Tratamiento

Las terapias médicas para la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa dependen de la gravedad de la enfermedad. Los LOS Neisseria dos objetivos terapéuticos principales son:

1. Terminar un ataque agudo y sintomático
2. Prevención de los LOS Neisseria ataques recurrentes

Medidas terapéuticas generales

• Atención preventiva: colonoscopia para detectar el cáncer colorrectal (mayor riesgo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa)
  • 8–10 años después del diagnóstico inicial
  • A partir de entonces, cada 1–2 años
• Terapia médica dirigida:
  • Corticosteroides
    • Para los LOS Neisseria brotes agudos de la enfermedad
    • La duración es limitada debido a las complicaciones del uso a largo plazo
  • Ácido 5-aminosalicílico (5-ASA) (mesalamina tópica u oral, sulfasalazina)
  • Inmunomoduladores (6-mercaptopurina)
  • Terapias anti factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral (anti-TNF) ( infliximab Infliximab A chimeric monoclonal antibody to tnf-alpha that is used in the treatment of rheumatoid arthritis; ankylosing spondylitis; psoriatic arthritis and Crohn’s disease. Disease-Modifying Antirheumatic Drugs (DMARDs), adalimumab Adalimumab A humanized monoclonal antibody that binds specifically to tnf-alpha and blocks its interaction with endogenous tnf receptors to modulate inflammation. It is used in the treatment of rheumatoid arthritis; psoriatic arthritis; Crohn’s disease and ulcerative colitis. Disease-Modifying Antirheumatic Drugs (DMARDs))
  • Agentes antidiarreicos
• Intervención quirúrgica:
  • Colectomía
    • Se considera curativo
    • Reservado para enfermedades graves, terapia médica ineficaz, megacolon Megacolon Megacolon is a severe, abnormal dilatation of the colon, and is classified as acute or chronic. There are many etiologies of megacolon, including neuropathic and dysmotility conditions, severe infections, ischemia, and inflammatory bowel disease. Megacolon tóxico refractario o malignidad probada por biopsia
  • Necesario en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum caso de complicaciones

Tratamiento según gravedad

• Enfermedad leve a moderada:
  • Mesalamina tópica (mediante supositorio o enema) para los LOS Neisseria brotes agudos
  • Si no hay respuesta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 4 semanas, considere la posibilidad de añadir un corticosteroide tópico/oral o un agente oral de ácido 5-aminosalicílico (5-ASA)
• Enfermedad de moderada a severa:
  • Corticosteroides orales y ácido 5-aminosalicílico (5-ASA) para los LOS Neisseria brotes agudos
  • Si no hay respuesta, considerar la adición de terapias anti-TNF
  • Los LOS Neisseria pacientes que alcanzan la remisión se mantienen con mesalamina oral +/- un agente anti-TNF.
• Enfermedad severa-fulminante o refractaria:
  • Mantener nada por la boca durante 24–48 horas, administrar líquidos intravenosos, controlar los LOS Neisseria electrolitos y hacer una transfusión para la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types, según sea necesario.
  • Corticosteroides intravenosos
  • Para los LOS Neisseria pacientes que no responden a los LOS Neisseria corticosteroides en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 4–7 días, el tratamiento posterior incluye infliximab Infliximab A chimeric monoclonal antibody to tnf-alpha that is used in the treatment of rheumatoid arthritis; ankylosing spondylitis; psoriatic arthritis and Crohn’s disease. Disease-Modifying Antirheumatic Drugs (DMARDs)/ciclosporina.
  • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el caso del megacolon Megacolon Megacolon is a severe, abnormal dilatation of the colon, and is classified as acute or chronic. There are many etiologies of megacolon, including neuropathic and dysmotility conditions, severe infections, ischemia, and inflammatory bowel disease. Megacolon tóxico, se pueden añadir antibióticos de amplio espectro para reducir las complicaciones sépticas.

Complicaciones

• Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis fulminante
  • Causada por la inflamación de la mucosa del colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy
  • Presenta > 10 deposiciones con sangre al AL Amyloidosis día, dolor Dolor Inflammation y distensión abdominal y síntomas sistémicos de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock
  • Aumenta el riesgo de desarrollar megacolon Megacolon Megacolon is a severe, abnormal dilatation of the colon, and is classified as acute or chronic. There are many etiologies of megacolon, including neuropathic and dysmotility conditions, severe infections, ischemia, and inflammatory bowel disease. Megacolon tóxico
• Megacolon Megacolon Megacolon is a severe, abnormal dilatation of the colon, and is classified as acute or chronic. There are many etiologies of megacolon, including neuropathic and dysmotility conditions, severe infections, ischemia, and inflammatory bowel disease. Megacolon tóxico
  • Implica una inflamación que se extiende más allá de las capas de la mucosa hasta las capas musculares del colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy
  • Se caracteriza por:
    • Dilatación colónica de > 6 cm en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la placa simple
    • Signos de toxicidad grave
  • El tratamiento consiste en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la succión nasogástrica, el estado de nada por boca, los LOS Neisseria antibióticos y los LOS Neisseria corticosteroides.
• Hemorragia digestiva:
  • Puede ocurrir de forma aguda durante un brote o de forma crónica
  • Puede provocar anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types
• Perforación intestinal: generalmente causada por la realización de una colonoscopia durante un brote agudo
• Obstrucción del intestino grueso: debido a la estenosis colónica producida por episodios recurrentes de ulceración, curación y cicatrización de la mucosa
• Mayor riesgo de cáncer colorrectal

Diagnóstico Diferencial

Las siguientes afecciones son diagnósticos diferenciales de la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa:

• Síndrome del intestino irritable: se presenta con dolor Dolor Inflammation abdominal recurrente; sin embargo, el síndrome del intestino irritable requiere 2 o más de las siguientes características: dolor Dolor Inflammation abdominal que mejora con la defecación, cambio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la frecuencia de las heces o cambio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la consistencia de las heces (con predominio de diarrea, con predominio de estreñimiento o mixto). El diagnóstico es clínico y la enfermedad no está asociada a anomalías estructurales.
• Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis infecciosa: se presenta con fiebre de inicio agudo y diarrea. Los LOS Neisseria patógenos entéricos causantes más comunes son Shigella Shigella Shigella is a genus of gram-negative, non-lactose-fermenting facultative intracellular bacilli. Infection spreads most commonly via person-to-person contact or through contaminated food and water. Humans are the only known reservoir. Shigella, Salmonella Salmonella Salmonellae are gram-negative bacilli of the family Enterobacteriaceae. Salmonellae are flagellated, non-lactose-fermenting, and hydrogen sulfide-producing microbes. Salmonella enterica, the most common disease-causing species in humans, is further classified based on serotype as typhoidal (S. typhi and paratyphi) and nontyphoidal (S. enteritidis and typhimurium). Salmonella, Campylobacter Campylobacter Campylobacter (“curved bacteria”) is a genus of thermophilic, S-shaped, gram-negative bacilli. There are many species of Campylobacter, with C. jejuni and C. coli most commonly implicated in human disease. Campylobacter, E. coli O157:H7, Yersinia Yersinia Yersinia is a genus of bacteria characterized as gram-negative bacilli that are facultative anaerobic with bipolar staining. There are 2 enteropathogenic species that cause yersiniosis, Y. enterocolitica and Y. pseudotuberculosis. Infections are manifested as pseudoappendicitis or mesenteric lymphadenitis, and enterocolitis. Yersinia spp./Yersiniosis y Clostridioides difficile. Estas infecciones pueden ser autolimitadas o requerir tratamiento antibiótico y pueden confirmarse con cultivos de heces y reacción en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cadena de la polimerasa ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)).
• Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis por radiación: también se presenta con diarrea sanguinolenta, pero suele ir precedida de una irradiación pélvica ( hace HACE Altitude Sickness meses/años). Los LOS Neisseria hallazgos histológicos que sugieren una colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis por radiación incluyen infiltrados por eosinófilos, que puede ayudar a diferenciarla de la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa.
• Enfermedad diverticular: también se presenta con hemorragia por el recto, pero puede diferenciarse de la enfermedad inflamatoria intestinal por la presencia de divertículos característicos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la colonoscopia.
• Enfermedad de Crohn: se presenta con dolor Dolor Inflammation abdominal intermitente y cólico, y diarrea no sanguinolenta. Esta enfermedad provoca una inflamación transmural en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de parches que puede afectar a cualquier zona del tracto gastrointestinal; sin embargo, el íleon terminal y el colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy proximal son los LOS Neisseria más afectados. La biopsia intestinal muestra granulomas Granulomas A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Sarcoidosis no caseificantes.
  Una de las formas más eficaces de conocer la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa es compararla y contrastarla con la enfermedad de Crohn, la otra forma de enfermedad inflamatoria intestinal. El siguiente cuadro ofrece una comparación: