ABSTRACT
Introduçäo: A Alopecia Areata (AA) é uma dermatopatia caracterizada por queda setorial ou difusa dos folículos pilosos, sendo os relatos na literatura médica sobre as manifestaçöes oculares desta doença controvertidos e, geralmente, restritos a casos isolados. O nosso objetivo é estudar as possíveis manifestaçöes oculares desta doença. Material e métodos: A nossa casuística é de 20 pacientes portadores de Alopecia Areata, e um segundo grupo de 20 pacientes isentos de doença ocular ou sistêmica servindo de controle. Todos foram submetidos a exame oftalmológico completo com inclusäo do teste de secreçäo básica de Jones para avaliaçäo do filme lacrimal. Resultados: Encontramos presença marcante de madarose (20 por cento), diminuiçäo do fluxo lacrimal (15 por cento) e opacidade do cristalino (25 por cento) nos pacientes portadores de Alopecia Areata a diferenciá-los do grupo controle. Näo encontramos quaisquer alteraçöes pigmentárias da retina, coróide ou íris, ao contrário do relatado na literatura. Conclusäo: Concluímos que nossos resultados diferem da literatura com relaçäo às alteraçöes pigmentárias do segmento posterior, e que a reduçäo do filme lacrimal na Alopecia Areata pode representar um novo achado desta patologia.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Alopecia Areata/complications , Eye Diseases/complications , Cataract , Control Groups , TearsABSTRACT
Introduction: Renal osteodystrophy includes the complete range of mineral metabolism disordes that affect the skeleton in patients with chronic renal failure. Patients and Methods: 200 patients with end-stage renal disease and on dialysis were investigated regarding the clinical, biochemical and histological findings of bone disease. Results: The spectrum of renal osteodystrophy consisted mainly of high turnover bone lesions (74.5 percent), including osteitis fibrosa in 57.5 percent. Patients with mild bone disease were on dialysis for shorter periods of time and were mostly asymptomatic. Patients with aluminum-related bone disease (16.5 percent) had the greatest aluminum exposure, either orally or parenterally, and together with patients with high turnover mixed disease, were the most symptomatic. Although on a non-regular basis, the vast majority of the patients (82.5 percent) had been receiving vitamin D. The incidence of adynamic bone disease was high (n=8) among parathyroidectomized patients (n=12). Significantly higher serum levels of alkaline phosphatase were observed in osteitis fibrosa. Conclusions: The use calcitriol and phosphate-binding agents on a non-regular basis seems to be the reason for the apparent reduced response to the treatment of secondary hyperparathyroidism. Alkaline phosphatase has been shown to be a fair marker for bone turnover in patients with osteitis fiborsa. The severity of the clinical manifestations of bone disease correlates with the histological features of bone lesion and to the time spent on dialysis.
Subject(s)
Humans , Adult , Child , Middle Aged , Adolescent , Male , Female , Chronic Kidney Disease-Mineral and Bone Disorder/etiology , Bone Diseases/etiology , Renal Dialysis/adverse effects , Kidney Failure, Chronic/therapy , Phosphorus/blood , Chronic Kidney Disease-Mineral and Bone Disorder/metabolism , Chronic Kidney Disease-Mineral and Bone Disorder/blood , Time Factors , Biopsy, Needle , Bone Diseases/diagnosis , Bone Diseases/pathology , Serum Albumin/analysis , Calcium/blood , Analysis of Variance , Alkaline Phosphatase/blood , Aluminum/metabolism , Aluminum/bloodABSTRACT
Fizemos este estudo com o objetivo de confirmar as manifestações oftalmológicas citadas em outros trabalhos em pacientes com alopécia areata, uma dermatopatia caracterizada por queda dos cabelos, uma vez que os relatos existentes na literatura mostram-se ainda controversos...Concluímos que nossos achados diferem dos da literatura em relação às alterações pgmentares, filme lacrimal e função do epetélio da retina, sendo necessário novos estudos para confirmação desses achados.