Nocardiosis is caused by a branched Gram-positive bacillus that affects mostly immunosuppressed patients. The clinical manifestations can be localized or disseminated, and the treatment depends on the affected organs, th...Nocardiosis is caused by a branched Gram-positive bacillus that affects mostly immunosuppressed patients. The clinical manifestations can be localized or disseminated, and the treatment depends on the affected organs, the severity of the disease, and the susceptibility profile. Nocardiosis should be considered in the differential diagnosis of localized or disseminated abscesses in immunosuppressed patients. Early clinical suspicion would allow the start of empirical treatment, prompt microbiological research, and may positively impact survival. We present a case series of 14 patients with infection by Nocardia spp. who attended different health institutions in Bogotá between January 2008 and November 2023. The clinical microbiology laboratory provided information on demographic, clinical, and laboratory variables. Fourteen patients were analyzed, with an average age of 49.8 years (30 to 72 years); 10 were men, and nine had a diagnosis involving immunosuppression: six had cancer and three had other underlying immunosuppression. Diabetes and hypertension were the most common comorbidities. The infection was chronic in 10 patients; the organs involved were the brain and lungs in 7 cases. Nocardia species’ was identified in five subjects; one of the patients presented infection with Cryptococcus spp. Nocardiosis treatment was prolonged and included trimethoprim-sulfamethoxazole in 12 cases; four patients died. Infection by Nocardia spp. is primarily opportunistic, presents unique clinical and microbiological aspects, and is a differential diagnosis of localized or systemic abscesses in immunosuppressed patients. Clinical suspicion allows a careful approach in terms of diagnosis, and initiation of empiric antibiotic treatment can positively impact survival.
This case is about a previously healthy five-year-old girl who presented with hand, foot, and mouth disease, and subsequently developed onychomadesis one month later, with detachment of the nail plates on both fingers an...This case is about a previously healthy five-year-old girl who presented with hand, foot, and mouth disease, and subsequently developed onychomadesis one month later, with detachment of the nail plates on both fingers and toes. However, the condition resolved spontaneously. After hand, foot, and mouth disease, she exhibited nail bed elevation at the proximal región of the nails on the second and third fingers of both hands. This elevation was painless, without bleeding, and later involved all toes. The condition resolved spontaneously over the following three months, with new, healthy nail growth. In Latin America, onychomadesis is a rare complication of hand, foot, and mouth disease in our region and is associated with atypical forms of the disease, indicating altered host response to common infections with coxsackie viruses. Reporting such cases is essential to understand these benign and self-limited variations, prevent misdiagnoses, and inform parents appropriately.
Malaria is a tropical disease that is rarely reported in liver transplant recipients. However, some cases have been documented around the world and here we report two. Case 1. A 54-year-old male attended the emergency ro...Malaria is a tropical disease that is rarely reported in liver transplant recipients. However, some cases have been documented around the world and here we report two. Case 1. A 54-year-old male attended the emergency room 30 days after liver transplantation due to malaise, fever, chills, thrombocytopenia, and anemia. Plasmodium vivax was detected in the blood smear, and the patient was treated with artemether/lumefantrine, achieving resolution of the parasitemia. Neither chloroquine nor primaquine were prescribed because they were unavailable in the country. Two months later, the patient returned to the emergency room with the same symptoms and was diagnosed with a relapse of malaria caused by P. vivax. The patient received successful treatment with chloroquine and primaquine, which were already available. Given that the liver donor came from a malaria-endemic area, the infection was probably of donor origin, likely by hypnozoites present in the allograft. Case 2. A 58-year-old woman living in a malaria-endemic region attended the emergency service with fever, malaise, arthralgia, cytopenias, and hypertransaminasemia six months after undergoing a liver transplant. P. vivax was detected in the blood smear, so treatment with chloroquine and primaquine was started. After treatment, the blood smear was negative, and the patient was discharged.
The Dyke-Davidoff-Masson syndrome is characterized by the presence of cerebral hemiatrophy, craneal vault thickening, epileptic seizures, hemiparesis, and cognitive impairment. It is typically diagnosed in childhood and...The Dyke-Davidoff-Masson syndrome is characterized by the presence of cerebral hemiatrophy, craneal vault thickening, epileptic seizures, hemiparesis, and cognitive impairment. It is typically diagnosed in childhood and requires specific diagnostic tools for accurate assessment. This report describes the case of a 19-year-old woman who presented with epileptic seizures and regression in neurodevelopment. She was admitted to the emergency department due to high ictal frequency. During her hospitalization, imaging and electroencephalographic findings were consistent with Dyke-Davidoff-Masson syndrome. Additionally, neuropsychological tests revealed global cognitive impairment. After ten days of hospitalization and five days without epileptic seizures, the patient was discharged. Dyke-Davidoff-Masson syndrome is a rare and often unrecognized condition with high morbidity. Clinicians has the responsibility to identify the key characteristics of the syndrome and perform an adequate differential diagnosis.
Introduction. Candida species are the main etiological agent of fungal infections in the pediatric population, especially in neonates and in intensive care unit patients. Invasive candidiasis is associated with unfavorab...Introduction. Candida species are the main etiological agent of fungal infections in the pediatric population, especially in neonates and in intensive care unit patients. Invasive candidiasis is associated with unfavorable clinical outcomes, such as prolonged hospitalization time, and mortality. Objective. To describe demographic, clinical and microbiological characteristics of pediatric patients (older than one month and younger than 18 years) hospitalized in a pediatric intensive care unit with a diagnosis of invasive candidiasis between 2012 and 2020. Materials and methods. A retrospective, observational, cohort study was conducted at a high-complexity center in southwestern Colombia. Results. We included 100 pediatric patients diagnosed with invasive candidiasis, 51% female with a median age of 6.5 years (IQR = 2-11.5). We obtained 114 isolates of Candida spp. The median hospital stay was 51 days (IQR = 29-77), with a pediatric intensive care unit stay of 27 days (IQR = 16-58). Tachycardia was present in 85% of the patients 24 hours before Candida spp. isolation. Nearly half of the isolates were found in bloodstream samples (49.1%), respiratory samples (21.9%), and peritoneal fluid (20.2%). The most frequently isolated species were C. albicans (36.8%), followed by non-albicans species, such as C. parapsilosis (22.8%), and C. tropicalis (21.1%). The overall mortality rate at discharge was 36%. Conclusions. In pediatric intensive care units, invasive candidiasis is a common condition representing a significant threat due to its high morbidity, prolonged hospital stay, and considerable mortality rate. While C. albicans remains as the predominant species, non-albicans Candida species exhibit a growing trend, posing new diagnostic and therapeutic challenges.
INTRODUCTION: In the Colombian context, research on victims of armed conflict has demonstrated that exposure to violence impacts different aspects of their lives and represents a challenge for their support workers. OBJE...INTRODUCTION: In the Colombian context, research on victims of armed conflict has demonstrated that exposure to violence impacts different aspects of their lives and represents a challenge for their support workers. OBJECTIVE: To explore perceptions, beliefs, and knowledge about mental health and support sources among victims of forced migration -due to the internal armed conflict- and their support workers in Soacha, Colombia. MATERIALS AND METHODS: We conducted a qualitative exploratory study. Data were collected from December 2018 to March 2019 using separate focus groups of victims and workers. Thematic content analysis established five deductive categories: perceptions of mental health; the impact of forced displacement and its relationship with mental health; knowledge or perception of institutional support; community networks; and knowledge or perception of the state measures concerning care, assistance, and reparation. We also included some inductive categories that emerged from the analysis. RESULTS: Victims demonstrated deteriorated mental health, expressed by emotional, cognitive, and behavioural disturbances. Many of these conducts were exacerbated by the traumatic stress of displacement and exposure to other forms of violence, in addition to social and material deprivation. Emotional avoidance and active search for self-improvement emerged as coping mechanisms used by the victims. Workers experienced high levels of stress assisting trauma victims, and they also needed support for their mental health. CONCLUSIONS: The findings showed complex and mainly negative impacts on mental health in both groups. Interventions should aim to address poor mental health and strengthen cultural identity and support networks for victims.
INTRODUCTION: Entomological surveillance of adult Aedes aegypti mosquitoes provides better risk indicators than in immature stages. OBJECTIVE: To determine the usefulness of MosquiTRAP™ traps for Ae. aegypti surveillance...INTRODUCTION: Entomological surveillance of adult Aedes aegypti mosquitoes provides better risk indicators than in immature stages. OBJECTIVE: To determine the usefulness of MosquiTRAP™ traps for Ae. aegypti surveillance, targeted vector control, and the design of dengue prevention measures in Sincelejo, Colombia. MATERIALS AND METHODS: Forty-nine MosquiTRAP™ traps were deployed over six months to capture gravid Ae. aegypti females in two neighborhoods with historical reports of dengue cases. Entomological indices were calculated to monitor mosquito population dynamics, and the infection frequency of the captured mosquitoes with dengue, zika, and chikungunya virus were assessed. The rates of trap approval and adherence were evaluated, and risk maps were developed based on mosquito abundance. These maps facilitated the identification of specific areas for targeted vector control interventions. RESULTS: A total of 1,475 mosquitoes were captured, of which 99.1% were identified as A. aegypti. The trap positivity index ranged from 85.7 to 42.9% per inspection, with a mean female Aedes index of two to three mosquitoes per house. Evidence of Ae. aegypti infestation was observed in both neighborhoods, although specific hotspots of high mosquito abundance were identified. No viral infection was detected in the captured mosquitoes. CONCLUSIONS: MosquiTRAP™ traps are useful for Ae. aegypti surveillance as a potential tool to guide vector control and prevention measures for diseases transmitted by this mosquito species.
Franco L, Gallego N, Velarde C
… +14 more, Valencia D, Pérez-Bedoya JP, Betancur K, Marisancen K, Parra P, Carvalho S, Parra L, Jiménez E, Martínez C, Saldarriaga C, Arango JC, González-Jaramillo N, García J, Valencia A
INTRODUCTION: Multiple genetic and environmental factors interact with the development of acute coronary syndrome. Smoking is one of the environmental factors that might alter the metabolic pathways shared by genes assoc...INTRODUCTION: Multiple genetic and environmental factors interact with the development of acute coronary syndrome. Smoking is one of the environmental factors that might alter the metabolic pathways shared by genes associated with this condition. OBJECTIVE: To investigate the association of acute coronary syndrome with genetic variants related to inflammation, lipid metabolism, and platelet aggregation among subjects from the northeastern region of Colombia. The effects of interactions between polymorphisms and smoking were also evaluated. MATERIALS AND METHODS: We analyzed data from 330 acute coronary syndrome cases and 430 controls. Associations between 20 polymorphisms and acute coronary syndrome were evaluated using logistic regression, adjusting for confounders. Gene and smoking interaction terms were calculated, and variants were analyzed separately in smokers and non-smokers for their association with acute coronary syndrome. RESULTS: Two variants were associated with acute coronary syndrome, rs10455872 in the LPA gene (OR = 2.69; 95% CI: 1.61-4.49) and rs429358 in the APOE gene (OR = 1.93; 95% CI: 1.30-2.87). We identified smoking interactions with the variants rs6511720 in the LDLR gene (p = 0.04) and rs2227631 in the SERPINE1 gene (p = 0.02), with significant effects in non-smokers (rs6511720: OR = 0.40; 95% CI: 0.19-0.88; and rs2227631: OR = 0.69; 95% CI: 0.48-1.00), but not in smokers (rs6511720: OR = 1.28; 95% CI: 0.66-2.46; and rs2227631: OR = 1.30; 95% CI: 0.91-1.87). CONCLUSIONS: Variants in the candidate genes LPA and APOE are associated with an increased risk of acute coronary syndrome in a population from northeastern Colombia. The effects of rs6511720 in LDLR and rs2227631 in SERPINE1 differ according to smoking habits and are significant in non-smokers. These results are helpful for early risk screening of acute coronary syndrome, mainly in individuals without defined conventional risk factors.
INTRODUCTION: In a previous study, we identified an inverse relationship between adverse perinatal outcomes and iron status during late pregnancy of women recruited from a maternal hospital in Cartagena, Colombia. Some o...INTRODUCTION: In a previous study, we identified an inverse relationship between adverse perinatal outcomes and iron status during late pregnancy of women recruited from a maternal hospital in Cartagena, Colombia. Some of these outcomes have also been linked to maternal inflammatory states. However, there is currently no clarity regarding the relationship between iron levels and proinflammatory markers during this period. OBJECTIVE: To estimate the relationship between inflammatory markers and serum ferritin in third-trimester pregnancies. MATERIALS AND METHODS: Serum ferritin, hemoglobin, and proinflammatory cytokine levels were determined in women in Cartagena in their third trimester of pregnancy. We analyzed the relationship between ferritin levels and proinflammatory cytokines, as well as the relationship between serum ferritin, hemoglobin, and inflammatory cytokine levels with adverse perinatal outcomes. RESULTS: The levels of IL-6 were significantly associated with serum ferritin levels (β = 0.42, SE = 0.21, p = 0.04) but not with maternal age. Maternal serum ferritin had a positive weak correlation with the absolute number of lymphocytes and monocytes. Hemoglobin and maternal serum ferritin were weakly and inversely associated with birth weight. Serum ferritin but not IL-6 or IL-8 was associated with preterm birth. CONCLUSIONS: We observed direct and mild associations of serum iron markers (serum ferritin, hemoglobin, and hematocrit) with lymphocyte counts. The inflammation marker, IL-6, was mildly associated with serum ferritin levels in late pregnancy. Women with elevated white blood cell counts and serum ferritin levels tended to have infants with lower birth weights. This fact suggests a potential involvement of iron in inflammatory processes during pregnancy, and conditions associated with inflammation in the final trimester may have adverse effects on perinatal outcomes.
INTRODUCTION: Sjögren’s syndrome is a systemic autoimmune disease. The usefulness of immunohistochemistry in minor salivary gland biopsies has been described to be helpful in indirectly characterizing the lymphocyte phen...INTRODUCTION: Sjögren’s syndrome is a systemic autoimmune disease. The usefulness of immunohistochemistry in minor salivary gland biopsies has been described to be helpful in indirectly characterizing the lymphocyte phenotype in difficult diagnosis cases. OBJECTIVE: To describe sociodemographic, clinical, serological, histopathological, and immunohistochemical variables in patients with sicca syndrome and a minor salivary gland biopsy focus score greater than or equal to one. MATERIALS AND METHODS: We conducted an observational, retrospective study that included patients under study for potential sicca syndrome whose minor salivary gland biopsy was available and had obtained a focus score greater than or equal to one. Immunohistochemistry was performed on the minor salivary gland biopsy with chromogen red staining for CD8 T lymphocytes and brown staining for CD4 T lymphocytes. Expression ratio of CD20:CD3 and CD4:CD8 markers was determined with the MoticEasyScan Pro 6™ (MOTIC) device and the QuPath™ software. Qualitative variables were analyzed using the chi-square or Fisher’s exact test, and quantitative variables were analyzed according to their assumption of normality. RESULTS: Twenty-eight patients were analyzed: 16 patients had Sjögren’s syndrome, and 8 of them had polyautoimmunity. An association was found between atrophy in the minor salivary gland biopsy and development of polyautoimmunity (OR = 11.1; 95% CI: 1.12-112; p value = 0.033). The CD20:CD3 and CD4:CD8 ratios were normal, with no statistically significant differences between patients with and without Sjögren’s syndrome. In the subgroup of patients with Sjögren’s syndrome, CD4 T lymphocytes were predominant, with 15 cases out of 16 with CD4:CD8 ratios equal to or greater than 2:1. CONCLUSIONS: Glandular atrophy was associated with the development of polyautoimmunity and a predominance of CD4 T lymphocytes in patients with Sjögren’s syndrome. This finding highlights the potential value of immunohistochemistry of minor salivary gland biopsies in this group.
Introduction. Previous reports have described a relationship between teamwork and burnout in health workers, involving variables associated with patients’ safety. Objective. To determine and describe the relationship bet...Introduction. Previous reports have described a relationship between teamwork and burnout in health workers, involving variables associated with patients’ safety. Objective. To determine and describe the relationship between teamwork and burnout perceived by health workers from a tertiary-level hospital in Colombia. Materials and methods. We conducted a cross-sectional, observational, analytical study with a convenience sample of 510 participants. We applied the TeamSTEPPS Teamwork Perceptions Questionnaire and the Copenhagen Burnout Inventory to assess burnout. An additional survey was conducted to collect demographic and employment data. Data was collected digitally. Descriptive analyses were carried out to compare teamwork and burnout across units, by occupation, and according to the average number of hours worked per week. Finally, correlation matrices were calculated with the scores from both tests. Results. Teamwork levels were moderate to high, and 31.4% of workers reported moderate or high levels of burnout. No significant differences were found based on sex or work unit. Results from the TeamSTEPPS Teamwork Perceptions Questionnaire and the Copenhagen Burnout Inventory were correlated with a low and moderate strength of association, showing an inverse relationship between them. Conclusion. Teamwork and burnout may have an inverse relationship, where better teamwork results in a lower perception of burnout among healthcare workers. However, the results of this study should be interpreted with caution due to potential biases.
Introduction. Spending on drugs to treat cancer will increase by 9-12% annually until 2025. For health systems in high and middle-income countries –such as Colombia– and with an increasing trend of new cancer cases, clin...Introduction. Spending on drugs to treat cancer will increase by 9-12% annually until 2025. For health systems in high and middle-income countries –such as Colombia– and with an increasing trend of new cancer cases, clinical research can contribute to the efficient use of the system resources available without undermining the timeliness and quality of healthcare. Objective. To calculate the savings generated to the Colombian health system by the implementation of externally funded clinical trials for cancer. Materials and methods. We conducted an observational, longitudinal, descriptive, and retrospective study analyzing participant’s medical records of clinical trials between 2016 and 2022 at the Clínica IMAT Oncomédica Auna, Colombia. Results. The total savings to the health system for external financing of oncology drugs was USD $1,526,320, and the monthly weighted average savings per patient was USD $3,257. The participation of breast cancer patients in randomized controlled clinical trials (n = 138) accounted for 24% (USD $369,363) of the total savings. Participants with clinical stage IV and III accounted for 41.7% (USD $636,475) and 31.06% (USD $473,159), respectively, of the total savings to the general social security health system in Colombia from external financing of oncological drugs. Conclusion. The participation of cancer patients in clinical trials mitigated costs to the Colombian health system, especially in women with breast cancer and in those patients with clinical stage IV of the disease.
INTRODUCTION: Psychological resilience and self-compassion are qualities that nurses should have when helping people with health problems. OBJECTIVE: To determine the effect of resilience on self-handicapping and self-co...INTRODUCTION: Psychological resilience and self-compassion are qualities that nurses should have when helping people with health problems. OBJECTIVE: To determine the effect of resilience on self-handicapping and self-compassion in nursing students. MATERIALS AND METHODS: This research has a correlational design. The study sample included nursing students who met the inclusion criteria (n = 369). Data were collected using the Connor-Davidson Resilience Scale, Self-Handicapping Scale, and Self-Compassion Scale questionnaires. RESULTS: The questionnaire scores of the nursing students were above the average, with 63.91 ± 14.54 for the Connor-Davidson Resilience Scale and 82.68 ± 11.32 for the Self-Handicapping Scale; their self-compassion level was high, with a mean of 13.92 ± 2.87 points on the Self-Compassion Scale. We found a significant negative correlation between the mean scores of the Connor-Davidson Resilience Scale (r = -0.409; p = 0.000) and the Self-Compassion Scale (r = -0.524; p = 0.000) with the Self-Handicapping Scale. We also obtained a positive and significant correlation between the mean scores of the Connor-Davidson Resilience Scale and the Self-Compassion Scale (r = 0.486; p = 0.000). According to the regression analysis, the effect of these two scales on the Self-Compassion Scale was 30.2%. CONCLUSIONS: Considering the study results, we can argue that as the students' resilience and self-compassion increase, their tendency to self-handicap decreases. For health professionals and patients' safety, it is very important to determine the levels of resilience, self-handicapping, and self-compassion because these factors may increase anxiety and stress in nursing students, affecting the proper care of patients during the work period.
The growing scientific and biotechnological interest in biobanks highlights the need to establish guidelines that allow for important scientific advances and guarantee the rights of the donors of biological samples and t...The growing scientific and biotechnological interest in biobanks highlights the need to establish guidelines that allow for important scientific advances and guarantee the rights of the donors of biological samples and their associated data. In line with this need, on January 13, 2023, the Congress of Colombia enacted Law 2287 on biobanks, beginning a path that other countries have followed for almost 25 years. As a result, new questions Will arise that are beyond the scope of this regulation and transcend bioethical conflicts. This manuscript aims to summarize key aspects of the mentioned law and reflects on its scope from bioethics, the ethics of biomedical research, and other bioethical currents or theories.
Paragonimiasis is caused by the trematode Paragonimus spp. and is considered a foodborne trematodiasis; it is classified as a neglected tropical disease by the World Health Organization, primarily transmitted through the...Paragonimiasis is caused by the trematode Paragonimus spp. and is considered a foodborne trematodiasis; it is classified as a neglected tropical disease by the World Health Organization, primarily transmitted through the consumption of infected and undercooked freshwater crustaceans. In Ecuador, it predominantly affects tropical regions such as the Coast and the Amazon. We present the case of a ten-year-old Kichwa boy from a rural Amazonian community, diagnosed at the Hospital Pediátrico de Quito. The child presented persistent cough and rusty sputum for four years, with a history of eating crabs. Computed tomography indicated pulmonary parenchymal alterations. The diagnosis of pulmonary paragonimiasis was confirmed via microscopic identification of operculated Paragonimus spp. eggs in the sputum. Treatment with triclabendazole for two days resulted in subsequent negative sputum findings during follow-up examinations. We discuss the possibility of diagnosis in non-endemic regions and the lack of clinical suspicion and laboratory diagnosis in endemic areas. Furthermore, we highlight the shortage of the drugs of choice, triclabendazole, and praziquantel, in Ecuador.
Methemoglobinemia results from an increased concentration of methemoglobin in the blood, impairing oxygen delivery to tissues. It is considered a rare condition that requires a high diagnostic suspicion. We report the ca...Methemoglobinemia results from an increased concentration of methemoglobin in the blood, impairing oxygen delivery to tissues. It is considered a rare condition that requires a high diagnostic suspicion. We report the case of a pediatric patient with malaria who presented with cyanosis and hypoxemia as manifestations of methemoglobinemia induced by primaquine treatment. The patient responded adequately after antimalarial drug suspension and ascorbic acid administration.
INTRODUCTION: Predominant antibody deficiency is the most frequent group of innate immunity errors, but information about patients’ nutritional status is scarce. OBJECTIVES: To characterize the nutritional status of Colo...INTRODUCTION: Predominant antibody deficiency is the most frequent group of innate immunity errors, but information about patients’ nutritional status is scarce. OBJECTIVES: To characterize the nutritional status of Colombian patients with predominant antibody deficiencies. MATERIAL AND METHODS: Material and methods. We analyzed medical charts of patients with predominant antibody deficiency in a pediatric hospital in Bogotá. RESULTS: We analyzed 55 medical charts. The most frequent diagnoses were specific deficiencies of polysaccharide antibodies and immunoglobulin A, common variable immunodeficiency, and agammaglobulinemia. More than 70% of the patients had sinopulmonary infections, with pneumonia being the most frequent, followed by otitis and sinusitis. In children under five years, 45% had adequate weight for their height, 18% had a risk of malnutrition, and 18% had moderate acute malnutrition. Four-point-five percent had obesity, 4.5% showed overweight, and 9% had a risk of being overweight. Of those older than five years, 54% had an adequate body mass index, 22.5% showed overweight, 9.6% were at risk of thinness, and 9.6% were thin. We found that the risk of short stature and short stature per se were more frequent than the expected height in these patients. The percentages of patients with short stature were higher than those reported nationally. CONCLUSIONS: Due to the epidemic of childhood obesity, it will be more frequent to find overweight or obesity in children above five years. Therefore, finding short stature could be a more sensitive alarm sign for predominant antibody deficiency.
INTRODUCTION: Graft-versus-host disease is a serious complication after hematopoietic stem cell transplantation and is a major cause of death post-transplantation. Approximately 50% of acute graft-versus-host disease pat...INTRODUCTION: Graft-versus-host disease is a serious complication after hematopoietic stem cell transplantation and is a major cause of death post-transplantation. Approximately 50% of acute graft-versus-host disease patients do not respond to systemic steroids and their prognosis is poor regardless of the treatment. This study describes our experience with pediatric patients diagnosed with steroid-refractory graft-versus-host disease who received intra-mesenteric steroid treatment. OBJECTIVE: To determine the outcomes of intra-mesenteric steroid use in the management of pediatric patients diagnosed with refractory graft-versus-host disease. MATERIALS AND METHODS: The study included patients under 18 years old with allogeneic hematopoietic stem cell transplantation who underwent intra-mesenteric steroid injection for resistant gastrointestinal graft-versus-host disease between January, 2016, and December, 2021. Methylprednisolone was administered via intra-arterial injection through the celiac trunk and the superior and inferior mesenteric arteries. RESULTS: We collected data on 21 patients: nine (90%) responded with a subjective decrease in fecal output and a reduction in bilirubin and transaminases. Seven patients required a second intra-mesenteric injection and presented a complete response in 85% of the cases. Only one patient experienced local complications after the procedure. Twelve patients (57%) died with one death due to acute graft-versus-host disease. CONCLUSION: Reports in the adult population have shown an approximately 50% response rate with few complications, making it a second-line management standard. As far as we know, this is the largest pediatric cohort reported in Latin America. Our findings suggest that intra-mesenteric steroid administration for managing hepatic and gastrointestinal graftversus-host disease may be considered an early adjuvant treatment in patients with steroidrefractory graft-versus-host disease.