El papel de la vitamina D en la gestación y la preeclampsia: de la biología molecular a la clínica

Los niveles séricos de vitamina D bajos se han asociado con un riesgo elevado de preeclampsia, una de las principales causas de mortalidad materna en Colombia y el mundo. La asociación parte del papel de la vitamina D en la inflamación y de su relación con el eje renina-angiotensina-aldosterona. El Instituto de Salud de los Estados Unidos sugiere que la vitamina D debe suplementarse de forma rutinaria durante el control prenatal; sin embargo, la Organización Mundial de la Salud, respaldada en medicina basada en la evidencia, sugiere la no suplementación de rutina de esta vitamina. En Colombia, no se conoce la prevalencia de la deficiencia o insuficiencia de vitamina D y los puntos de corte de normalidad aún son objeto de discusión. El objetivo del presente artículo es el de presentar una revisión desde la bases de la biología molecular a la clínica, dilucidando el papel de la vitamina D en la gestación y en su relación con la preeclampsia, así como el de invitar al desarrollo de programas de investigación en temas relacionados con la vitamina D en el país. Abstract The low serum levels of vitamin D have been associated with the risk of preeclampsia, a leading cause of maternal mortality in Colombia. The biological plausibility of the association is the vitamin D role in inflammation and its relationship with the renin-angiotensin-aldosterone axis. The Institute of Medicine of the United States suggests that vitamin D should be supplemented routinely during antenatal care, however, the World Health Organization, supported by evidence-based medicine, suggests not supplement it. In Colombia, the prevalence of deficiency or insufficiency of vitamin D is not known and even normal break- points are discussed. The aim of this article is to review from the molecular biology to the clinic, elucidating the role of vitamin D during pregnancy and in the genesis of preeclampsia, and to encourage research in this field in the country

Extranodal marginal zone lymphoma: A case report

Non-Hodgkin lymphomas (NHLs) encompass a diverse range of lymphoproliferative neoplasms. Approximately 85%-90% of NHLs originate from mature B lymphocytes, with the remaining arising from T lymphocytes or natural killer (NK) cells. Notably, NHLs exhibit a pronounced extranodal predilection, with nearly 25% presenting in such locations. In developed countries, the most prevalent NHL subtypes are diffuse large B-cell lymphoma (accounting for 30%) and follicular lymphoma (representing 20%). All other NHL subtypes each constitute less than 10% of cases, including the rarer marginal zone lymphoma (MZL).We present a case involving a 70-year-old woman who experienced a palpable mass in the right hypochondrium. She displayed no peripheral adenopathies or systemic symptoms. Her diagnosis was established as MZL, posing a diagnostic challenge due to imaging findings that mimicked various infectious, benign, and malignant conditions

Serum 25-hydroxyvitamin D levels throughout pregnancy: a longitudinal study in healthy and preeclamptic pregnant women

Background: Worldwide there is a high prevalence of 25-hydroxyvitamin D (25OHD) deficiency and has been associated with adverse outcomes during pregnancy. Objective: This is a nested, case–control study in a longitudinal cohort to compare the serum 25OHD levels and other biomarkers throughout pregnancy in a group of 20 preeclamptic women and 61 healthy pregnant women. An additional group of 29 healthy non-pregnant women were also studied during the two phases of the menstrual cycle. Results: Mean 25OHD levels in non-pregnant women were 31.9 ng/mL and 34.9 ng/mL during follicular and luteal phase, respectively (P < 0.01). Mean serum 25OHD levels in healthy pregnant women were 26.5, 30.1 and 31.9 ng/mL, at first, second and third trimester, respectively (P < 0.001). The first trimester levels of 25OHD were lower than those of healthy non-pregnant women (P < 0.001), showing a significant recovery at third trimester. In the group of healthy pregnant women, the 25OHD levels were 25.7 ng/mL and 27.2 ng/mL at 3 and 6 months postpartum, respectively; both values were lower than those observed in the non-pregnant women (P < 0.001). In preeclamptic women, 25OHD serum levels were similar to those of healthy pregnant women; nevertheless, they remained almost unchanged throughout pregnancy. Conclusion: There were no significant differences between healthy and preeclamptic pregnant women in terms of 25OHD levels throughout the pregnancy. Serum 25OHD levels in non-pregnant women were higher during luteal phase compared with follicular phase. The 25OHD levels of non-pregnant women tended to be higher than those of pregnant women