ABSTRACT
La Macroglobulinemia de Waldenström (MW) es una neoplasia hematológica infrecuente, caracterizada por presentar gammapatía monoclonal de IgM e infiltración linfoplasmocítica en la médula ósea. Representa cerca del 1-2% de las neoplasias malignas hematológicas y es importante diferenciarla de otros procesos linfoproliferativos como la gammapatía monoclonal de significado incierto (MGUS) y de otros trastornos asociados a IgM.Suele debutar con síntomas inespecíficos, o ser un hallazgo de laboratorio, pudiendo presentar malestar general, astenia, baja de peso, o bien un cuadro poco frecuente producido por el aumento de la concentración de IgM sérica, denominado síndrome de hiperviscosidad. Éste corresponde a una urgencia hematológica que debe ser tratada precozmente ya que conlleva consecuencias graves para el paciente. Reportamos el caso de una mujer de 64 años con antecedente de MGUS IgM que progresa a Macroglobulinemia de Waldenström con síndrome de hiperviscosidad, presentado manifestaciones clínicas inespecíficas que al inicio minimiza, pero que conlleva a lesiones retinianas extensas. Dado la gravedad del cuadro, requiere manejo con plasmaféresis en unidad de paciente crítico.
Waldenström's macroglobulinemia is an infrequent hematological neoplasm characterized by Ig M monoclonal gammopathy and lymphoplasmacytic infiltration of the bone marrow. It accounts for 1-2% of malignant hematological neoplasms and it is important to distinguish it from other lymphoproliferative disorders such as monoclonal gammopathy of undetermined significance and other disorders involving IgM. It usually presents with non-specific symptoms, or is a laboratory finding, and may present as general malaise, weakness, weight loss or, rarely, hyperviscosity syndrome caused by a rise in the levels of circulating IgM. This is a hematological emergency which must be treated at once as it can have serious consequences for the patient. We report a case of a 64 year old woman with previously diagnosed monoclonal gammopathy of undetermined significance who progressed to Waldenström´s macroglobulinemia with hyperviscosity syndrome and minimal non-specific clinical signs which led to extensive retinal lesions. Given the seriousness of her condition she was treated with plasmapheresis in Intensive Care.
ABSTRACT
La nefrostomía es una técnica urológica que permite la derivación temporal de la vía urinaria buscando con esto preservar la función renal, aliviar el dolor y/o drenar la orina infectada. En el servicio de urología del Hospital Van Buren se implementó una técnica de nefrostomía percutánea ecoguiada con catéter Arrow 14 que ha permitido tratar precozmente a pacientes con patología urinaria obstructiva, con complicaciones menores y bajo costo...
Nephrostomy is an urologic technique that allows the temporary derivation of the urinary tract allowing with this to preserve the renal function, to alleviate the pain, to drain tinkles it infected. ln the Service of Urology of the Hospital Van Buren a percutaneous technique of nefrostomy has been ¡implemented guided by echography that has allowed treats to tens about patients with obstructive urinary pathology in precocious form, with smaller complications and low cost...
Subject(s)
Humans , Male , Female , Middle Aged , Catheterization/methods , Urologic Diseases/surgery , Urologic Diseases , Nephrostomy, Percutaneous/methods , Retrospective Studies , Time Factors , Nephrostomy, Percutaneous/adverse effectsABSTRACT
Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperítoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deteríoration of hemodynamic parameters. The CT sean showed a left renal injury associated to an expansive retroperítoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outcome.
Subject(s)
Adult , Humans , Male , Angiomyolipoma/complications , Kidney Neoplasms/complications , Low Back Pain/etiology , Angiomyolipoma/diagnosis , Hematoma/etiology , Kidney Neoplasms/diagnosis , Retroperitoneal Space , Rupture, Spontaneous , Tomography, X-Ray ComputedABSTRACT
Se presenta la experiencia del Servicio de Urología del Hospital Carlos Van Büren en el uso de malla de polipropileno intralbugínea como prótesis testicular, contemporánea a la orquiectomía subalbugínea bilateral por cáncer de próstata. Nuestra serie es de 30 pacientes, con un total de 60 testículos, correspondientes al período comprendido entre noviembre de 2001 y septiembre de 2002. Los resultados iniciales son alentadores.