Estadísticas

 array:21 [
  "pii" => "X0211699514054197"
  "issn" => "02116995"
  "doi" => "10.3265/Nefrologia.pre2014.May.12474"
  "estado" => "S300"
  "fechaPublicacion" => "2014-07-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia. 2014;34:540-2"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 6135
    "formatos" => array:3 [
      "EPUB" => 356
      "HTML" => 5005
      "PDF" => 774
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:17 [
      "pii" => "X2013251414054194"
      "issn" => "20132514"
      "doi" => "10.3265/Nefrologia.pre2014.May.12474"
      "estado" => "S300"
      "fechaPublicacion" => "2014-07-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia (English Version). 2014;34:540-2"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 5071
        "formatos" => array:3 [
          "EPUB" => 314
          "HTML" => 4111
          "PDF" => 646
        ]
      ]
      "en" => array:9 [
        "idiomaDefecto" => true
        "titulo" => "An uncommon cause of linfadenopathy in a kidney transplant patient: Cat-scratch disease"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "540"
            "paginaFinal" => "542"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Fig. 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier España"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "12474_16025_58474_en_f112474.jpg"
                "Alto" => 654
                "Ancho" => 649
                "Tamanyo" => 412771
              ]
            ]
            "descripcion" => array:1 [
              "en" => "Ganglion biopsy – Focus of necrosis, some surrounded by granulomatous inflammation in cortical region (H&E, original magnification x40)."
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Cláudia Bento, La Salete Martins, André Coelho, Manuela Almeida, Sofia Pedroso, Leonídeo Dias, Ramon Vizcaíno, António Castro-Henriques, António Cabrita"
            "autores" => array:9 [
              0 => array:2 [
                "nombre" => "Cláudia"
                "apellidos" => "Bento"
              ]
              1 => array:2 [
                "nombre" => "La Salete"
                "apellidos" => "Martins"
              ]
              2 => array:2 [
                "nombre" => "André"
                "apellidos" => "Coelho"
              ]
              3 => array:2 [
                "nombre" => "Manuela"
                "apellidos" => "Almeida"
              ]
              4 => array:2 [
                "nombre" => "Sofia"
                "apellidos" => "Pedroso"
              ]
              5 => array:2 [
                "nombre" => "Leonídeo"
                "apellidos" => "Dias"
              ]
              6 => array:2 [
                "nombre" => "Ramon"
                "apellidos" => "Vizcaíno"
              ]
              7 => array:2 [
                "nombre" => "António"
                "apellidos" => "Castro-Henriques"
              ]
              8 => array:2 [
                "nombre" => "António"
                "apellidos" => "Cabrita"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X0211699514054197"
          "doi" => "10.3265/Nefrologia.pre2014.May.12474"
          "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/X0211699514054197?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251414054194?idApp=UINPBA000064"
      "url" => "/20132514/0000003400000004/v0_201502091609/X2013251414054194/v0_201502091609/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X0211699514054416"
    "issn" => "02116995"
    "doi" => "10.3265/Nefrologia.pre2014.Mar.12383"
    "estado" => "S300"
    "fechaPublicacion" => "2014-07-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia. 2014;34:542-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 7583
      "formatos" => array:3 [
        "EPUB" => 336
        "HTML" => 6422
        "PDF" => 825
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Hipocalcemia e hiperparatiroidismo extremos tras denosumab. ¿Es seguro este fármaco en la enfermedad renal crónica?"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "542"
          "paginaFinal" => "544"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Extreme hypocalcaemia and hyperparathyroidism following denosumab. Is this drug safe in chronic kidney disease?"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Fig. 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "12383_19904_53908_es_12383_f1.jpg"
              "Alto" => 424
              "Ancho" => 571
              "Tamanyo" => 123918
            ]
          ]
          "descripcion" => array:1 [
            "es" => "Evolución de los parámetros bioquímicos."
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana E. Sirvent, Ricardo Enríquez, María Sánchez, César González, Isabel Millán, Francisco Amorós"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Ana E."
              "apellidos" => "Sirvent"
            ]
            1 => array:2 [
              "nombre" => "Ricardo"
              "apellidos" => "Enríquez"
            ]
            2 => array:2 [
              "nombre" => "María"
              "apellidos" => "Sánchez"
            ]
            3 => array:2 [
              "nombre" => "César"
              "apellidos" => "González"
            ]
            4 => array:2 [
              "nombre" => "Isabel"
              "apellidos" => "Millán"
            ]
            5 => array:2 [
              "nombre" => "Francisco"
              "apellidos" => "Amorós"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "X2013251414054413"
        "doi" => "10.3265/Nefrologia.pre2014.Mar.12383"
        "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/X2013251414054413?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699514054416?idApp=UINPBA000064"
    "url" => "/02116995/0000003400000004/v0_201502091342/X0211699514054416/v0_201502091343/es/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X0211699514054201"
    "issn" => "02116995"
    "doi" => "10.3265/Nefrologia.pre2014.May.12058"
    "estado" => "S300"
    "fechaPublicacion" => "2014-07-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia. 2014;34:539-40"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 8187
      "formatos" => array:3 [
        "EPUB" => 360
        "HTML" => 6988
        "PDF" => 839
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Aciduria metilmalónica con homocistinuria. Una causa muy poco frecuente de fallo renal en el período neonatal"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "539"
          "paginaFinal" => "540"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Methylmalonic acidemia with homocystinuria. A very rare cause of kidney failure in the neonatal period"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Tab.  1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "12058_19904_44999_es_12058_t1.jpg"
              "Alto" => 196
              "Ancho" => 691
              "Tamanyo" => 97390
            ]
          ]
          "descripcion" => array:1 [
            "es" => "Datos bioquímicos y genéticos"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Orlando Mesa-Medina, Mónica Ruiz-Pons, Víctor García-Nieto, José León-González, Santiago López-Mendoza, Carlos Solís-Reyes"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Orlando"
              "apellidos" => "Mesa-Medina"
            ]
            1 => array:2 [
              "nombre" => "Mónica"
              "apellidos" => "Ruiz-Pons"
            ]
            2 => array:2 [
              "nombre" => "Víctor"
              "apellidos" => "García-Nieto"
            ]
            3 => array:2 [
              "nombre" => "José"
              "apellidos" => "León-González"
            ]
            4 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "López-Mendoza"
            ]
            5 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Solís-Reyes"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "X2013251414054209"
        "doi" => "10.3265/Nefrologia.pre2014.May.12058"
        "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/X2013251414054209?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699514054201?idApp=UINPBA000064"
    "url" => "/02116995/0000003400000004/v0_201502091342/X0211699514054201/v0_201502091343/es/main.assets"
  ]
  "en" => array:9 [
    "idiomaDefecto" => true
    "titulo" => "An uncommon cause of linfadenopathy in a kidney transplant patient: Cat-scratch disease"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "540"
        "paginaFinal" => "542"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Cláudia Bento, La Salete Martins, André Coelho, Manuela Almeida, Sofia Pedroso, Leonídeo Dias, Ramon Vizcaíno, António Castro-Henriques, António Cabrita"
        "autores" => array:9 [
          0 => array:3 [
            "nombre" => "Cláudia"
            "apellidos" => "Bento"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "La Salete"
            "apellidos" => "Martins"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Andr&#233;"
            "apellidos" => "Coelho"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Manuela"
            "apellidos" => "Almeida"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Sofia"
            "apellidos" => "Pedroso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Leon&#237;deo"
            "apellidos" => "Dias"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Ramon"
            "apellidos" => "Vizca&#237;no"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Ant&#243;nio"
            "apellidos" => "Castro-Henriques"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Ant&#243;nio"
            "apellidos" => "Cabrita"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real,  Portugal, "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Department of Nephrology, Hospital Geral de Santo António, Porto,  Portugal, "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Department of Clinical Pathology, Hospital Geral de Santo António, Porto,  Portugal, "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Dear Editor&#44;</span></p><p class="elsevierStylePara">Cat scratch disease &#40;CSD&#41; is an infectious disease that usually presents as a self-limiting illness characterized by regional lymphadenopathy&#44; fever and constitutional symptoms in association with a cat scratch or bite&#46;<span class="elsevierStyleSup">1-4</span> In most cases&#44; Bartonella henselae is the etiologic agent and cats are important reservoirs&#46;<span class="elsevierStyleSup">2-5</span></p><p class="elsevierStylePara">We report a case of CSD in a 38-year-old Caucasian female recipient of a deceased kidney transplant since 2006 due to chronic renal failure of unknown etiology&#46; Her maintenance immunosuppressive treatment was mycophenolate mofetil and cyclosporine&#46; She was also medicated with calcium carbonate&#44; vitamin D&#44; atenolol&#44; folic acid&#44; fluoxetine&#44; omeprazole&#44; ferrous sulfate&#46;</p><p class="elsevierStylePara">Six years post transplantation the patient was admitted to the hospital with a 4-week history of asthenia&#44; low fever&#44; loss of weight and multiple painful cervical ganglions&#46; There was no previous history of tuberculosis&#46; She had close contact at home with cats&#46; On physical examination&#44; the patient had a temperature of 37&#44;3&#186;C&#44; pulse rate of 84&#47;min&#44; blood pressure of 134&#47;88mmHg&#44; respiratory rate of 16&#47;min and pulse oximetry of 100&#37; in ambient air&#46; She had multiple bilateral painful ganglions only in cervical region &#40;node size &#8804;4cm&#41;&#46; There was no rash&#46; Examination of the lungs&#44; heart and abdomen revealed no abnormalities including hepatosplenomegaly&#46; The graft was painless&#46; Laboratory tests revealed a white blood cell count 11&#44;81&#215;10<span class="elsevierStyleSup">&#94;3</span>&#47;L &#40;neutrophils 65&#44;8&#37;&#44; lymphocytes 23&#44;6&#37;&#44; monocytes 10&#37;&#44; eosinophils 0&#44;1&#37;&#41;&#44; normochromic-normocytic anemia &#40;Hgb 9&#44;6g&#47;dL&#41;&#59; creatinine 1&#44;2mg&#47;dL &#40;basal value&#41;&#44; blood urea nitrogen 39mg&#47;dL&#59; protein C reactive 143mg&#47;L&#59; LDH&#44; SGOT&#44; SGPT&#44; total bilirubin and alkaline phosphate without alterations&#46; Ultrasound cervical ecography demonstrated multiple ganglion formations&#46;</p><p class="elsevierStylePara">She was observed on admission by an otorhinolaryngologist who prescribed metronidazole plus amoxicillin and clavulanate for a nasopharynx&#180;s infection&#46; Serologies for Epstein-Barr virus&#44; herpes virus&#44; cytomegalovirus&#44; toxoplasmosis&#44; brucella&#44; leishmania&#44; and HIV infection were negative&#46; Blood culture was sterile&#46; Chest and abdominal CT scan without changes&#46; Quantiferon test for tuberculosis was indeterminate&#46; Peripheral blood cytometry and cytometry of ganglion did not showed immunophenotypic alterations compatible with lymphoma&#46; An ganglion biopsy was performed and histological examination revealed reactive lymphadenitis with central necrosis &#40;Ziehl neelsen was negative&#41; alterations compatible with CSD &#40;Figure 1 and Figure 2&#41;&#46; She stopped the initial antibiotherapy on the 6th of internment &#40;without improvement of complains&#41; and began azithromycin 500mg on day one&#44; followed by 250mg for four days&#46; There has been a good clinic improvement with involution of ganglion swelling and resolution of the pain and fever&#46; One month later the patient was asymptomatic&#44; without any signs of recurrence&#46;</p><p class="elsevierStylePara">This case report intends to illustrate that the investigation of an immunocompromised kidney transplant patient presenting with lymphadenopathy may constitute a challenge given the wide differential diagnosis possible&#46; The presence of enlarged lymph nodes in those patients should lead to post-transplant lymphoproliferative disorders &#40;PTLD&#41; as a first hypothesis&#59; however more benign and unsuspected causes must be the cause&#46;</p><p class="elsevierStylePara">The risk of PTLD is associated with the degree of immunosupression&#44; time post transplant and the presence of Epstein-Barr virus&#46;<span class="elsevierStyleSup">6-9</span> Their incidence is approximately 30 to 50 times greater than in the general population and comprises a wide histological spectrum from hyperplastic appearing lesions&#44; non-Hodgkin lymphoma or multiple myeloma histology&#46;<span class="elsevierStyleSup">6&#44;8</span></p><p class="elsevierStylePara">Regional lymphadenopathy is the hallmark of CSD in association with mild constitutional symptoms and a previous history of cat scratch or bite&#46;<span class="elsevierStyleSup">1-3</span> In our case the investigation was wide and extensive once this disease can mimic the more common PTLD disease or others infectious causes&#46;<span class="elsevierStyleSup">2-4</span> In addition to serological tests a lymph node biopsy was performed to exclude lymphoma or other malignant causes&#46; It has been proposed that at least three of four criteria must be present to establish the diagnosis of CSD&#58; a&#41; cat or flea contact&#59; b&#41; negative serology for other causes of adenopathy or sterile pus aspirated from a node or a positive Bartonella PCR assay or liver or spleen lesions on CT scan&#59; c&#41; positive serology for Bartonella henselae &#40;EIA or IFA&#8805;1&#58;64&#41;&#59; d&#41; biopsy showing granulomatous inflammation consistent with CSD or a positive Warthin-Starry silver stain&#46;<span class="elsevierStyleSup">2&#44;3&#44;10</span> The diagnosis of CSD in our patient was based on the presence of a cat contact history&#44; negative serology for other causes and a ganglion biopsy compatible with CSD &#40;Figure 1 and Figure 2&#41;&#46; Serologic methods for detection of Bartonella henselae were not available in our hospital and it was not possible to isolate this agent by culture&#46; The treatment of this entity is recommended in immunocompromised patients due to high risk for disseminated and recurrent CSD&#46;<span class="elsevierStyleSup">2&#44;3</span></p><p class="elsevierStylePara">Although CSD had rarely been reported in kidney transplant patients it should be considered in the differential diagnosis of patients with lymphadenopathy and a history of cat exposure&#46;<span class="elsevierStyleSup">5</span> The absence of easy complementary tests&#44; the difficulty in isolating the bacteria and the need of tissue biopsy makes a difficult diagnosis&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflict of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article&#46;</p><p class="elsevierStylePara"><a href="grande&#47;12474&#95;16025&#95;58474&#95;en&#95;f112474&#46;jpg" class="elsevierStyleCrossRefs"><img src="12474_16025_58474_en_f112474.jpg" alt="Ganglion biopsy ¿ Focus of necrosis&#44; some surrounded by granulomatous inflammation in cortical region &#40;H&#38;E&#44; original magnification x40&#41;&#46;"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Ganglion biopsy ¿ Focus of necrosis&#44; some surrounded by granulomatous inflammation in cortical region &#40;H&#38;E&#44; original magnification x40&#41;&#46;</p><p class="elsevierStylePara"><a href="grande&#47;12474&#95;16025&#95;58475&#95;en&#95;f212474&#46;jpg" class="elsevierStyleCrossRefs"><img src="12474_16025_58475_en_f212474.jpg" alt="Ganglion biopsy ¿ Focus of stellate aspect necrosis with epithelioid macrophages in the periphery &#40;H&#38;E&#44; original magnification x100&#41;&#46;"></img></a></p><p class="elsevierStylePara">Figure 2&#46; Ganglion biopsy ¿ Focus of stellate aspect necrosis with epithelioid macrophages in the periphery &#40;H&#38;E&#44; original magnification x100&#41;&#46;</p>"
    "pdfFichero" => "P1-E572-S4647-A12474.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Spach D, Kaplan S. Treatment of cat scratch disease. Available at: www.uptodate.com (accessed in 01/10/2013)."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Spach D, Kaplan S. Microbiology, epidemiology, clinical manifestations, and diagnosis of cat scratch disease. Available at: www.uptodate.com (accessed in 01/10/2013)."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Lamps L, Scott M. Cat-scratch disease. Historic, clinical, and pathologic perspectives. Am J Clin Pathol 2004;121 Suppl:S71-80."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Goral S, Scott M, Dummer S, Miller G, Antony S, Helderman J. Cat-scratch disease in a patient undergoing haemodialysis. Nephrol Dial Transplant 1997;12:811-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9141021" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Rheault MN, van Burik, Mauer M, Ingulli E, Ferrieri P, Jessurun J, et al. Cat-scratch disease relapse in a kidney transplant recipient. Pediatr Transplant 2007;11(1):105-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17239132" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:1 [
                        "itemHostRev" => array:3 [
                          "pii" => "S0168851012002254"
                          "estado" => "S300"
                          "issn" => "01688510"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Newstead C. Lymphoproliferative disease post-renal transplantation. Nephrol Dial Transplant 2000;15:1913-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11096131" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Quinlan S, Pleiffer R, Morton L, Engels E. Risk factors for early-onset and late-onset post-transplant lymphoproliferative disorder in U.S. kidney recipients. Am J Hematol 2011;86(2):206-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21264909" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Friedberg J, Aster J. Epidemiology, clinical manifestations, and diagnosis of post-transplant lymphoproliferative disorders. Available at: www.uptodate.com (accessed in 01/10/2013)."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Caillard S, Dharnidharka V, Agodoa L, Bohen E, Abbott K. Posttransplant lymphoproliferative disorders after renal transplantation in the United States in era of modern immunosuppression. Transplantation 2005;80:1233-43. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16314791" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:1 [
                        "itemHostRev" => array:3 [
                          "pii" => "S0168851012000802"
                          "estado" => "S300"
                          "issn" => "01688510"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Souza G. Cat scratch disease: case report. Rev Med Minas Gerais 2011;21(1):75-8."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02116995/0000003400000004/v0_201502091342/X0211699514054197/v0_201502091343/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35346"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas al Director - Casos clínicos breves"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02116995/0000003400000004/v0_201502091342/X0211699514054197/v0_201502091343/en/P1-E572-S4647-A12474.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699514054197?idApp=UINPBA000064"
]