Revista medica del Instituto Mexicano del Seguro Social最新文献

{"title":"[Clinical activity and validation of the disability disc in inflammatory bowel disease].","authors":"Rogelio Plomozo-Román, Iván Lozano-García, Héctor Martínez-Torres, Blanca Miriam Torres-Mendoza, Raúl Maldonado-Rodríguez, José Francisco Aguayo-Villaseñor, Christian Jaramillo-Buendía, Juan Ernesto Gutiérrez-Sevilla","doi":"10.5281/zenodo.19099666","DOIUrl":"10.5281/zenodo.19099666","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic immune-mediated pathology that causes disability and can be assessed by the simplified IBD-Disk tool, which could be conditioned by clinical activity.</p><p><strong>Objective: </strong>Associate disability with clinical activity using the IBD-DISK tool validated in patients with IBD.</p><p><strong>Material and methods: </strong>Analytical cross-sectional study in 101 outpatients and inpatients diagnosed with IBD. After obtaining informed consent, the IBD-Disk tool for disability was validated and administered, as well as its correlation with the IBD-DI. Clinical activity was assessed with the Mayo score for chronic nonspecific ulcerative colitis (CUCI) and the Harvey-Bradshaw score for Crohn's disease (CD). The association between disability and clinical activity was performed with a regression model.</p><p><strong>Results: </strong>The reliability of the IBD-Disk was > 0.900. Patients with CUCI and moderate or severe clinical activity are 8.2 times more likely to have an IBD-Disk score > 40 compared to those in remission or with mild activity. Patients with Crohn´s disease the association was OR = 2.4 (95%CI: 0.19 - 31.52). The regression model shows that clinical activity (Mayo and Harvey-Bradshaw) is the factor that most influences the disability scales (B = 4.400).</p><p><strong>Conclusions: </strong>IBD-Disk is a reliable instrument for measuring disability in CUCI and CD. Although disability does not differ significantly between CUCI and CD, clinical activity is associated with disability (IBD-Disk).</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 Suppl 1","pages":"e6689"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical profile of patients with secondary immunodeficiency on immunoglobulin replacement therapy].","authors":"Alicia Méndez-Gómez, Noemí Gómez-Hernández, Margarita Ortega-Cisneros, Bricia Melissa Gutiérrez-Zepeda, Antonio de Jesús Quintero-Rodríguez, Luis Alberto Duran-Marín, Marya Lizzeth Rosaldo-Solís, Antonio Quintero-Ramos","doi":"10.5281/zenodo.19099403","DOIUrl":"10.5281/zenodo.19099403","url":null,"abstract":"<p><strong>Background: </strong>Secondary immunodeficiency (SID) is a disorder in which the immune system is compromised by external or acquired factors, reducing the quantity or function of immunoglobulins. This condition increases the need for specialist consultation, follow-up, and replacement therapy, which in turn raises healthcare costs. To date, few studies have clinically characterized patients with SID; therefore, understanding their profile will enable improved management and treatment.</p><p><strong>Objective: </strong>To describe the clinical profile of patients with SID receiving human immunoglobulin replacement therapy (IgG-RT).</p><p><strong>Material and methods: </strong>A retrospective observational study was conducted through the review of 40 medical records of patients with SID undergoing IgG-RT. Risk factors and the benefits of replacement therapy were analyzed.</p><p><strong>Results: </strong>The mean age was 48 years, with a predominance of women (62.5%). The most frequent conditions were rheumatologic diseases (38%), followed by hematologic disorders (31%) and protein-losing diseases (27%). All patients had received corticosteroids in combination with another immunosuppressant, and 77.5% had also been treated with rituximab. Infections were recorded in 50% of cases; however, only 35% received prophylaxis. Relapse was documented in 22.5% of patients, and mortality was 2.5%.</p><p><strong>Conclusions: </strong>The use of corticosteroids and immunosuppressants, specifically rituximab, was the main cause of SID, predominantly associated with rheumatologic and hematologic diseases.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 Suppl 1","pages":"e6671"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Visual field index and pituitary tumors resected by microsurgical transsphenoidal approach].","authors":"Leticia Guadalupe Segura-Campillo, Erika Dalila Ascencio-Gil, Luz Ma Adriana Balderas-Peña, Abraham Reynoso-Topete","doi":"10.5281/zenodo.19099678","DOIUrl":"10.5281/zenodo.19099678","url":null,"abstract":"<p><strong>Background: </strong>Pituitary adenomas are the third most common intracranial tumor. Due to their growth, they may cause endocrine disturbances, compression, and visual deficits, particularly visual field defects. The Visual Field Index (VFI) is an objective parameter that accurately quantifies visual improvement or deterioration. Transsphenoidal resection is the first-line treatment; therefore, pre- and postoperative visual assessment is essential for follow-up and prognosis.</p><p><strong>Objective: </strong>To correlate pre- and postoperative VFI in patients with pituitary adenomas who underwent microscopic transsphenoidal surgery at the Centro Médico Nacional de Occidente.</p><p><strong>Materials and methods: </strong>A retrospective study of patients operated on between January 2020 and January 2024 was conducted, including those with pre- and postoperative automated perimetry. Both sexes and all ages were included, provided they had complete medical records, magnetic resonance imaging, and visual field testing. VFI values were compared using descriptive and correlational analyses.</p><p><strong>Results: </strong>Thirty-two patients were analyzed (mean age 54 years); 29 had comorbidities, with hypothyroidism being the most common (56%). The most frequent visual deficit was bitemporal hemianopia (60%). In the right eye, the mean VFI increased from 50.1% to 56.1% (p = 0.002); the median increased from 55% to 68.5% (p = 0.001). In the left eye, the mean changed from 54.6% to 56.7% (p = 0.472); the median from 55.5% to 64.5% (p = 0.537). A greater proportion of improvement was observed in the right eye. In diabetic patients, a reduction in left-eye VFI was noted.</p><p><strong>Conclusions: </strong>Postoperative VFI showed an overall increase following microscopic transsphenoidal resection, supporting its usefulness as a practical and objective parameter for evaluating visual function.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 Suppl 1","pages":"e6692"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical and obstetric characteristics in women with multiple sclerosis during pregnancy].","authors":"Erick René Nava-Escobar, Mario Alberto Mireles-Ramírez, Blanca Miriam Torres-Mendoza, Martha Rocío Hernández-Preciado, Nayeli Alejandra Sánchez-Rosales, Jazmin Márquez-Pedroza","doi":"10.5281/zenodo.19099672","DOIUrl":"10.5281/zenodo.19099672","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is an inflammatory demyelinating disease that affects the central nervous system. It is the second leading cause of disability in young adults, with a higher prevalence in women, and 70% to 75% of these women are of reproductive age.</p><p><strong>Objective: </strong>To identify the clinical characteristics of pregnant patients with multiple sclerosis.</p><p><strong>Material and methods: </strong>Retrospective cohort. Medical records from the Neurology Department of the Specialty Hospital, CMNO of the Mexican Social Security Institute were reviewed from January 2001 to December 2022. Women diagnosed with MS who had previously been pregnant were identified.</p><p><strong>Results: </strong>Twenty-two patients who had been pregnant after their MS diagnosis were recruited. The age at diagnosis was 25.50 ± 6.7 years, and the age at pregnancy was 31.94 ± 5.54 years. No significant changes (p = 0.636) were observed on the Expanded Disability Status Scale (EDSS) during pregnancy. The most used medication was glatiramer acetate. 77.8% of patients did not experience disease relapses during pregnancy.</p><p><strong>Conclusions: </strong>Pregnant women with multiple sclerosis treated at the National Western Medical Center showed clinical stability according to the EDSS before, during, and after pregnancy (p = 0.636). Most patients did not experience disease relapses during pregnancy, nor did they report complications during the immediate postpartum period.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 Suppl 1","pages":"e6691"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Histopathological findings associated with complete clinical remission in patients with lupus nephritis].","authors":"Elsa Angélica Fuentes-López, José Ignacio Cerrillos-Gutiérrez, Miguel Medina-Pérez, Claudia Alejandra Mendoza-Cerpa, Alfonso Martín Cueto-Manzano","doi":"10.5281/zenodo.19099411","DOIUrl":"10.5281/zenodo.19099411","url":null,"abstract":"<p><strong>Background: </strong>Lupus nephritis (LN) is a serious manifestation of systemic lupus erythematosus. Patients who do not achieve remission have a 10-year renal survival rate of 19%.</p><p><strong>Objective: </strong>To evaluate the histopathological findings of LN associated with complete remission > 12 months after kidney biopsy.</p><p><strong>Material and methods: </strong>Retrospective cohort of adults with lupus (2019 EULAR/ACR criteria) who underwent kidney biopsy between January 2017 and December 2021. Clinical, biochemical, and histopathological data were collected at the time of biopsy; renal function (serum creatinine, estimated glomerular filtration rate [eGFR], and proteinuria/day) was measured throughout the study (end of follow-up in June 2023).</p><p><strong>Results: </strong>Thirty-eight patients were included. When comparing the non-remission group (n = 13) with the complete remission group (n = 18), only the degree of interstitial fibrosis and tubular atrophy (IFTA) (grade 2: 46% vs. 11%, respectively) and the chronicity index [5.0 (4.0-6.5) vs. 3.0 (1.0-5.0)] showed significant differences (p < 0.05). At the end of the study, the non-remission group, compared with the complete remission group, had lower eGFR [57 (10-100) vs. 104 (87-123) mL/min/1.73 m², p < 0.05] and higher proteinuria [4.00 (1.82-8.00) vs. 0.25 (0.16-0.39) g/day, p < 0.05]. In the logistic regression analysis, only proteinuria [OR 0.72 (95%CI 0.54-0.98), p = 0.03] predicted remission.</p><p><strong>Conclusions: </strong>The histopathological findings associated with complete LN remission > 12 months were lower IFTA and a lower chronicity index. In the multivariate analysis, the only significant variable predicting remission was baseline proteinuria.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 Suppl 1","pages":"e6673"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[First cohort: Robotic radical prostatectomy at the Mexican Institute for Social Security].","authors":"Seiichi Fuziwara-Ruíz, Narciso Hernández-Toriz, Juan Carlos Huerta-Gómez, Joel Quintero-Becerra, Andrés Martínez-Cornelio, Juan Carlos Zapot-Martínez, Arturo Delgado-Herrera, Cristobal Castro-Chávez, Oscar Pérez-Ramírez","doi":"10.5281/zenodo.18715375","DOIUrl":"10.5281/zenodo.18715375","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is the most common cancer in men and the leading cause of malignancy-related mortality in Mexico. The Mexican Institute for Social Security (IMSS for its initialism in Spanish) introduced its first robotic system at the Oncology Hospital of the 21st Century National Medical Center in Mexico City.</p><p><strong>Objective: </strong>To evaluate the accumulated experience, perioperative, oncologic and functional outcomes of the first 200 robot-assisted radical prostatectomy (RARP) cases.</p><p><strong>Material and methods: </strong>A retrospective analysis of 200 patients undergoing RARP for localized prostate cancer was conducted. Perioperative and postoperative variables, pathology results, complications, and one-year continence rates were considered.</p><p><strong>Results: </strong>Mean surgical time was 242.1 minutes (90-600), with a console time of 197.6 minutes (68-495). Mean blood loss was 327.7 cc (10-1800). Positive surgical margins were observed in 34.5% of cases. Complications occurred in 22 patients (11%). No conversions to open surgery or mortality were reported. Mean hospital stay was 2.54 days (2-14). Postoperative antigen was undetectable in 88.5% of patients. The continence rate was 95.7%.</p><p><strong>Conclusions: </strong>The first 200 RARP cases at our institution demonstrate the accumulated experience with the procedure, showing low complication rates. These results are consistent with those of high-volume centers, which require additional long-term functional follow-up.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 3","pages":"e6880"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Solitary fibrous tumor of the prostate mimicking a tumor of the vesicoprostatic junction. Case report].","authors":"Huber Díaz-Fuentes, Juan Carlos Zapot-Martínez, Norma Alejandra Cabrera-Mora, Eduardo Ramos-Arceo, Juana Sonia Tavares-García","doi":"10.5281/zenodo.18715470","DOIUrl":"10.5281/zenodo.18715470","url":null,"abstract":"<p><strong>Background: </strong>Differentiating among the various neoplasms of the urinary and reproductive system in adult patients is essential for establishing an accurate diagnosis and determining the appropriate therapeutic strategy.</p><p><strong>Clinical case: </strong>71-year-old man with a history of Gleason 10 (5+5) prostate adenocarcinoma who developed a suspicious lesion at the vesicoprostatic junction, initially considered a urothelial carcinoma based on cystoscopy findings and immunohistochemistry. Following a multidisciplinary evaluation, a radical cystoprostatectomy with lymphadenectomy was performed, which subsequently revealed a solitary fibrous tumor of the prostate, a rare entity with benign behavior. Immunohistochemical analysis was key to the final diagnosis, differentiating this benign lesion from the initially suspected urothelial origin.</p><p><strong>Conclusions: </strong>This case underscores the importance of a comprehensive and meticulous approach in the evaluation of atypical prostate lesions, as misdiagnoses can lead to overtreatment. The experience reported here highlights the need to consider solitary fibrous tumors in the differential diagnosis of prostatic stromal tumors.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 3","pages":"e6779"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical update and comprehensive approach to menopausal symptoms for healthcare professionals].","authors":"Jorgelina Barrios-De Tomasi, María Verónica de Los Ángeles Pacheco-Chan","doi":"10.5281/zenodo.18715388","DOIUrl":"10.5281/zenodo.18715388","url":null,"abstract":"<p><p>Menopause is a physiological stage in a woman's life characterized by the permanent cessation of menstruation and decreased ovarian function, which leads to hormonal changes responsible for vasomotor, genitourinary, psychological, cognitive, and sexual symptoms. Given the increasing life expectancy in Mexico, women spend a substantial period in the postmenopausal state, posing clinical and public health challenges for reproductive health professionals. This review provides a clinical update on the pathophysiology and symptomatology of menopause, as well as a comprehensive approach that includes therapeutic and psychosocial support strategies. Emphasis is placed on the importance of individualized assessment, patient education, and the integration of pharmacological and non pharmacological interventions, with the aim of improving quality of life and well being for women during this stage. The article offers practical tools and evidence-based recommendations for health professionals, promoting multidisciplinary, patient centered care.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 3","pages":"e6818"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevalence of hearing loss in a high-specialty medical unit].","authors":"Brenda Gabriela Baca-Sigler, Jorge Moreno-Palacios, Salomón Waizel-Haiat","doi":"10.5281/zenodo.18715318","DOIUrl":"10.5281/zenodo.18715318","url":null,"abstract":"<p><strong>Background: </strong>Hearing impairment constitutes the fourth leading cause of disability on a global scale, predominantly affecting geriatric patients. In 2023, deafness was identified in the Hospital de Especialidades (Specialties Hospital) \"Dr. Bernardo Sepúlveda\" as the main reason for consultation in the Otorhinolaryngology Department, accounting for a total of 1755 cases, while it occupied second place in the Audiology Department with 1723 cases.</p><p><strong>Objective: </strong>To identify the prevalence of hearing loss in the Mexican population attended as beneficiaries in a high specialty medical unit in Mexico City in 2023.</p><p><strong>Material and methods: </strong>An observational, cross-sectional, retrospective, and descriptive study was carried out based on the records of patients who attended the Audiology Department from January 1 to December 31, 2023. Data were collected from the Electronic Medical Record, including age, gender, symptoms, diagnosis, type, severity and laterality of hearing loss.</p><p><strong>Results: </strong>A total of 3396 patients with hearing impairment were obtained. The prevalence of hearing loss in 2023 in the Audiology Department was 68.6%, predominantly in female patients, with a superficial degree, sensorineural type and over 60 years of age.</p><p><strong>Conclusions: </strong>In the Hospital de Especialidades \"Dr. Bernardo Sepúlveda\", 2 out of 3 patients who come to the Audiology Department present some degree of hearing impairment, mainly due to a sensorineural condition.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 3","pages":"e6674"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Early preeclampsia associated with hydatidiform mole and pulmonary metastasis: A case report].","authors":"Daniel Anuar Rivera-Hernández, Lenyn Daniel Montes-Sevilla, Dennis Ximena Murcia-Acero, Ana Lilia Castillo Medina","doi":"10.5281/zenodo.18715459","DOIUrl":"10.5281/zenodo.18715459","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia before 20 weeks of gestation is an unusual clinical entity that suggests an underlying etiology, such as gestational trophoblastic disease (GTD). Among its forms, complete hydatidiform mole may evolve into gestational trophoblastic neoplasia with metastatic potential. The objective was to present the case of an adolescent patient with early-onset preeclampsia as the initial manifestation of a complete hydatidiform mole with pulmonary metastasis.</p><p><strong>Clinical case: </strong>A 15-year-old patient without prenatal care was admitted due to vaginal bleeding, persistent nausea, and clinical signs of preeclampsia. A complete hydatidiform mole associated with grade IV hypovolemic shock was diagnosed. Patient underwent urgent uterine evacuation, intensive care for uterine atony, and received EMA-CO chemotherapy after pulmonary metastases were identified. 3 months after completing treatment, a viable intrauterine pregnancy was confirmed, with no evidence of tumor recurrence.</p><p><strong>Conclusions: </strong>The onset of preeclampsia before 20 weeks should raise suspicion of GTD. Timely, multidisciplinary management can achieve full disease resolution, preserve fertility, and avoid long-term sequelae, even in advanced clinical scenarios.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":"64 3","pages":"e6752"},"PeriodicalIF":0.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}