Coronary arteritis as a cause of sudden cardiac death in a young girl

A case of probable coronary arteritis in a young girl who died suddenly and unexpectedly is presented. The histologic presentation of the disorder is discussed, especially the differential diagnosis of arteritis of the coronary arteries with an emphasis on tuberculosis (TB). TB myocarditis with or without concomitant lung involvement is rare, and tubercular coronary arteritis without underlying pulmonary Koch's disease is all the rarer. We herein describe a case where the cause of death was ascertained on post-mortem examination.

Arteritis de celulas gigantes: clásicos y novedades que vale la pena recordar / Giant cells arteritis: classics and innovations for remember

La Arteritis de Células Gigantes (ACG) es una vasculitis frecuente que ocurre en personas mayores y que afecta principalmente vasos craneanos. Generalmente se acompaña de síntomas sistémicos, claudicación mandibular y alteraciones visuales. La Polimialgia Reumática (PMR) se caracteriza por dolor y rigidez de cintura escapular y pelviana que presenta síntomas constitucionales y reacciones sistémicas. En los últimos años, ha aparecido evidencia que relaciona ambas entidades como componentes de una misma enfermedad. En este artículo se revisan aspectos nuevos en diagnóstico, terapia y etiopatogenia de la ACG y sus relaciones con PMR.

The Giant cell arteritis (GCA) is a common vasculitic syndrome occurring in older persons and it preferentially affects cranial arteries. Generally accompanied by constitutional symptoms and typical findings like jaw claudication and vision disorder.Polymyalgia Rheumatica (PMR) is caracterized by pain and stiffness involving shoulder and pelvic girdless with constitutional symptoms and findings of a systemic reaction. In recents years, evidence linking both conditions as components of asingle disease process has been accumulated. In the present article, we review new aspects of the diagnosis, therapy and pathogenesis of the GCA, and their relationship.

Aortoarteritis with systemic lupus erythematosus and secondary antiphospholipid antibody syndrome: a rare association.

A 41-year-old woman diagnosed with aortoarteritis since 1988 was admitted with unstable angina. She also had anemia, thrombocytopenia, aortic regurgitation and pulmonary artery hypertension. She gave a history of recurrent fetal loss and myocardial infarction, following which angioplasty to the left anterior descending artery had been done. After investigation, a diagnosis of aortoarteritis with systemic lupus erythematosus and associated antiphospholipid antibody syndrome was made. Aortoarteritis may coexist with systemic lupus erythematosus and associated antiphospholipid antibody syndrome.

Non-atherosclerotic aorto-arterial thrombosis: A study of 30 cases at autopsy.

BACKGROUND: Aorto-arterial thrombosis is very often associated with atherosclerotic and/or aneurysmal changes. Thrombosis, unrelated to these changes is infrequent. AIMS: To evaluate the clinical presentation and aetiopathogenesis of aorto-arterial thrombosis, unrelated to atherosclerosis and aneurysms. SUBJECTS AND METHODS: A retrospective study of 30 autopsied cases of non-atherosclerotic and non-aneurysmal aorto-arterial thrombosis collected over a period of 14 years was carried out. RESULTS: There were 23 males and seven females and majority presented in the third to fourth decades of life with clinical features of acute abdomen or lower limb gangrene. Abdominal aorta as the site of thrombosis was observed in 46.5% cases. The causes were attributed to hypercoagulable states and changes in the aortic wall. No aetiology could be identified in 5 patients (16.6%. Associated tuberculosis was seen in six cases. CONCLUSIONS: Non-atherosclerotic aortic thrombosis is a heterogeneous group of disorders. Young and even elderly patients with symptoms related to abdominal ischaemia or peripheral vascular disease should be investigated thoroughly for hypercoagulable states and aortic pathology.

Insuficiência renal aguda anúrica causada por obstruçäo bilateral das artérias renais / Anuric kidney failure by renal arteries bilateral obstruction

Descrevemos um caso de insuficiência renal aguda anúrica associada à obstruçäo bilateral e arterite granulomatosa e necrotizante de artérias renais em paciente portador de síndrome mielodisplásica. Säo discutidos os métodos diagnosticos, as principais patologias causadoras de artérias renais e as opçöes terapêuticas. Apesar de ser causa rara de insuficiência renal aguda, a possibilidade de obstruçäo de artéria renal deve ser lembrada em casos de anúria, pois o seu diagnóstico precoce implica em maior chance de sucesso terapêutico.

Infarto do miocárdio fatal em jovem causado por arterite coronária / Fatal myocardial infarction in a young patient due to coronary arteritis

A 34 year-old male patient suffered an acute anterior wall infarction at age 32. Myocardial ischemia was demonstrated later by stress testing and thallium myocardial scintigraphy. Coronary arteriography revealed a proximal 90 per cent obstruction of the left anterior descending artery. The patient was submitted to percutaneous transluminal coronary angioplasty. The procedure was unsuccessful as the catheter could not progress through the obstruction. On follow-up, there was less than ideal adherence to medical treatment and the patient complained of occasional atypical non-effort related chest pain. Two years later the patient suffered a large fatal myocardial infarction. Necropsy disclosed that the cause of myocardial infarction was severe coronary arteritis of left circumflex artery with giant cell granulomas

Thalamic haemorrhage due to tuberculous arteritis.

A young adult presenting as subarachnoid haemorrhage, which was proved to be a thalamic haemorrhage on CT scan, with evidence of tuberculous arteritis, is reported.

Apendicitis secundaria a vasculitis en el lupus eritematoso sistémico (LES) / Apendicitis secondary to vasculitis in systemic lupus erithematosus

Se reporta el caso de un paciente con LES que en el curso de actividad de su enfermedad desarrollo un episodio de abdomen agudo por lo que fue laparotomizado; el estudio histológico del apéndice mostró signos de vasculitis. Se discuten los hallazgos con lo descrito en la literatura

Panarteritis precipitating extensive circumferential acute myocardial infarction: a case report

Sabe-se que, além da trombose coronária, outras causas podem precipitar infarto agudo do miocárdio em presença de aterosclerose coronária. Um paciente com 48 anos de idade foi internado devido a insuficiência coronária aguda. O eletrocardiograma mostrou necrose ântero-lateral e isquemia lateral. A despeito da medicaçäo o angina persistiu e o paciente faleceu imediatamente após a angiografia coronária. A necrópsia, observou-se necrose de coagulaçäo estabelecida na metade interna e no subendocárdio das paredes lateral e posterior do ventrículo esquerdo, e necrose de coagulaçäo recente nas paredes anterior, posterior e septal. Em todas as artérias coronárias principais havia lesöes ateroscleróticas severas. Observou-se também panarterite difusa, envolvendo rams coronários extra e intramiocárdicos, consistindo de células mononucleares e edema acentuado. Um mecanismo misto pode ser invocado para explicar a extensa necrose miocárdica: infiltrados panarteriais, edema extenso e espasmo coronário induzido por fatores humorais

Arterite coronária de causa näo esclarecida em um menino de 10 anos. Relato de caso / Coronary arteritis of unknown origin in a 10-year-old boy. Report of a case

Menino de 10 anos desenvolveu quadro de infarto do miocárdio por atrite coronária. As causas mais comuns deste evento na infância säo analisadas e a inespecificidade do processo inflamatório do caso é discutida. Näo foi possível estabelecer a natureza da doença. A importância da valorizaçäo de dor precordial em crianças por doença coronária é sublinhada