ABSTRACT
La brucelosis produce diversas manifestaciones clínicas muchas de las cuales son secundarias a alteraciones del sistema inmune desencadenadas por esta infección. Presentamos el caso de una paciente mujer de 71 años de edad que ingresó por un cuadro clínico de fiebre y púrpura, en quien se diagnosticó síndrome de crioglobulinemia mixta por infección brucellar. Este es el quinto caso que se reporta en el mundo. A pesar que la causa mas frecuente de púrpura por crioglobulinemia mixta es infección por VHC, se resalta que se debe sospechar de brucelosis especialmente cuando se presente con fiebre.(Rev Med Hered 2007;18:34-38).
Subject(s)
Humans , Female , Aged , Brucellosis/epidemiology , Brucellosis/pathology , Cryoglobulinemia/classification , Cryoglobulinemia/diagnosis , Cryoglobulinemia/pathology , Vasculitis/pathologyABSTRACT
Cryoglobulinemia is a systemic vasculitis that principally affects small and medium caliber vessels. It is thought that the inmunocomplex deposit made up of cryoglobulins that precipitate at temperatures under 38°C activate vessel wall complement, which in turn causes damage to the same. The cryoglobulins have been found in a wide spectrum of pathologies, though generally transitory and with no clinical importance. Monoclonal cryoglobulinemia is associated with hematologic diseases, while mixed cryoglobulinemias are found in infectious and systemic diseases. The association between the hepatitis C (VHC) virus and mixed cryoglobulinemias (MC) is more and more evident, and estimates show that 90 percent of cases include this infection. Clinical manifestations are varied and are due to the tissular ischemia caused by vessel occlusion, affecting the skin and visceral organs. Chronic VHC infection induces a persistent stimulation of the immune system, generating a constellation of autoimmune and neoplastic diseases.
Subject(s)
Humans , Cryoglobulinemia/classification , Cryoglobulinemia/diagnosis , Immune System Diseases/diagnosis , Vasculitis , Virus Diseases/diagnosis , Cryoglobulins/classification , Diagnosis, Differential , Patient Selection , Risk FactorsSubject(s)
Humans , Agglutinins , Blood Viscosity , Cryoglobulinemia/classification , Cryoglobulinemia/therapy , Immunoglobulin M/adverse effects , Lymphoproliferative Disorders , Waldenstrom Macroglobulinemia/blood , Paraproteinemias/therapy , Plasma Exchange , Renal Insufficiency , Hemolysis , Hypothermia, Induced , Multiple Myeloma/bloodABSTRACT
Relata-se caso de paciente portadora de hepatite crônica persistente, que após cinco meses do quadro da hepatite desenvolveu crioglobulinemia mista policlonal, na forma de síndrome de Meltzer. Concluiu-se que muitos casos de "crioglobulinemia mista essencial", na verdade, säo secundárias a doenças hepáticas preexistentes