ABSTRACT
Abstract: Psoriasis is a chronic disease, characterized by erythematous scaly lesions, presented in eight different forms: plaques, guttate, pustular, erythrodermic, inverse, nail and scalp psoriasis, and psoriatic arthritis. Its development depends on genetic factors, external stimulus and immune response alteration.1 Proinflammatory cytokines such as TNF-alpha, IL-12 and 23 may also be involved. In the worst cases, systemic complications linked to endothelial alterations may occur. A literature review was conducted for a better understanding of what roles VEGF (vascular endothelial growth factor) and ICAM-1 (intercellular adhesion molecule) have, among other cytokines, in systemic capillary leak syndrome, involved in erythrodermic and pustular psoriasis, the most unstable forms of the disease.
Subject(s)
Humans , Psoriasis/complications , Psoriasis/pathology , Intercellular Adhesion Molecule-1/analysis , Capillary Leak Syndrome/etiology , Capillary Leak Syndrome/pathology , Vascular Endothelial Growth Factor A/analysis , Psoriasis/physiopathology , Cytokines/analysis , Capillary Leak Syndrome/physiopathologyABSTRACT
Os autores apresentam um caso raro de choque em doente sem antecedentes pessoais significativos, admitido na unidade de terapia intensiva por suspeita de choque séptico. Inicialmente, foi tratado com fluidoterapia sem melhoria, tendo sido aventada a hipótese de síndrome de hiperpermeabilidade capilar, após confirmação de hipoalbulinemia paradoxal grave, hipotensão e hemoconcentração exuberante - tríade característica da doença. Os autores discutiram o diagnóstico diferencial e ainda realizaram uma revisão do diagnóstico e do tratamento da doença.
The authors report a rare case of shock in a patient without significant clinical history, admitted to the intensive care unit for suspected septic shock. The patient was initially treated with fluid therapy without improvement. A hypothesis of systemic capillary leak syndrome was postulated following the confirmation of severe hypoalbuminemia, hypotension, and hemoconcentration - a combination of three symptoms typical of the disease. The authors discussed the differential diagnosis and also conducted a review of the diagnosis and treatment of the disease.
Subject(s)
Female , Humans , Middle Aged , Capillary Leak Syndrome/diagnosis , Shock, Septic/diagnosis , Capillary Leak Syndrome/physiopathology , Capillary Leak Syndrome/therapy , Diagnosis, Differential , Fluid Therapy/methodsABSTRACT
Introducción: se proponen dos parámetros para estimar la fuga capilar que se presenta en pacientes con preeclampsia grave y eclampsia, cuando se alteran las fuerzas de Starling.Objetivo: reportar los valores de la PCOc y el IB en mujeres con preeclampsia grave y eclampsia, asimismo compararlo con embarazo normal.Pacientes y método: se estudiaron prospectivamente los valores de la PCOc y el IB en 87 pacientes con preeclampsia grave y eclampsia (grupo A); comparandolo con 50 pacientes con embarazo normal (grupo B). La PCOc se calculó de acuerdo con la fórmula de Landis-Pappenheimer y el IB se obtuvo de dividir el resultado entre la PCOc y la PAM.Resultados: la PCOc fue de 15.3 ñ 4.5; el IB de 0.11 ñ 0.03 en el grupo A, 24.0 ñ 4.4 y 0.27 ñ 0.03 en el grupo B, (p < 0.005 y p = 0.300 respectivamente).Conclusiones: la PCOc y el IB disminuyen significativamente en la preeclampsia-eclampsia y se propone su utilización como índices cuantitativos de fuga capilar.