ABSTRACT
El presente estudio se ha realizado con el objeto de determinar si existe variación en las cuentas totales de la fórmula leucocitaria, en 37 pacientes que presentaron el diagnóstico definitivo de tuberculosis extrapulmonar incluidos en el Programa de Control de la Tuberculosis del Hospital Regional Honorio Delgado y Hospital Goyeneche de Arequipa, durante los años 1992-1995, en relación a valores considerados como normales; asímismo determinar la relación que existe entre las variables independientes del estudio y las alteraciones producidas en la serie blanca. La mayoría de pacientes (64.9 por ciento) fueron mujeres, el promedio de edad encontrado fue de 34.2 años y el tiempo de enfermedad promedio de 23.3 semanas; la localización de la enfermedad más frecuente fue la enteroperitoneal, seguida de la forma generalizada. El 89.1 por ciento de pacientes presentaron de regular a mal estado de nutrición; 9 pacientes refirieron ingesta de bebidas alcoholicas y solo 6 consumo de tabaco. Solo 6 pacientes presentaron leucocitosis, 24 tuvieron números aumentados de neutrófilos segmentados. En cuanto la disminución de las series, 16 pacientes tuvieron números disminuidos de neutrófilos abastonados, 19 de eosinófilos, 18 de linfocitos y 27 de monocitos. Las cuentas celulares en sangre periférica de todas las localizaciones consideradas no tuvieron diferencias estadísticamente significativas, sin embargo en comparación con los valores normales, los leucocitos totales y neutrófilos segmentados estuvieron más elevados en los pacientes con tuberculosis meníngea, los neutrófilos abastonados en los pacientes con tuberculosis generalizada y los eosinófilos en la localización renal; no hubieron casos de linfocitosis ni monocitosis. En cuanto a la disminución en la cuentas celulares, la localización generalizada presento mayor leucopenia, eosinopenia, linfopenia y monocitopenia con respecto a las otras localizaciones, la localización renal y osteoarticular presentaron los menores números de neutrófilos abastonados y la enteroperitoneal de neutrófilos segmentados. No se encontró correlación entre la edad, sexo, tiempo de enfermedad, estado de nutrición, consumo de tabaco y alcohol ni localización de la enfermedad con la cuenta total de leucocitos y sus cuentas celulares.
Subject(s)
Schilling TestABSTRACT
We present a case of pernicious anemia without history of operation in 52 year old female. She suffered from oral ulcer, gum bleeding, nausea, vomiting, and beefy tongue. She had dysesthesia on the both arm and foot, and hypesthesia of global and stocking type by neurologic examination. Laboratory findings were as follows: serum cobalamin 9.1 pg/mL (normal range: 180-710pg/mL), anti intrinsic factor antibody (strong positive), antiparietal cell Antibody 1:10 (positive), first stage of Schilling test (1.4%). The findings of peripheral blood and bone marrow were compatible with megaloblastic anemia. We report a case of pemicious anemia with positive anti intrinsic factor antibody and antiparietal cell antibody.
Subject(s)
Female , Humans , Middle Aged , Anemia , Anemia, Megaloblastic , Anemia, Pernicious , Arm , Bone Marrow , Foot , Gingiva , Hemorrhage , Hypesthesia , Intrinsic Factor , Nausea , Neurologic Examination , Oral Ulcer , Paresthesia , Schilling Test , Tongue , Vitamin B 12 , VomitingABSTRACT
Pernicious anemia is understood as an autoimmune disease and associated with various other autoimmune diseases, such as Graves` disease, primary hypothyroidism, thyroiditis and vitiligo. We report a case of pernicious anemia associated with autoimmune thyroiditis. A 40-year-old man was admitted to the Sanggye Paik Hospital due to general weakness, dyspnea on exertion and sore throat for 2 months. Eight years before admission, he had been treated with hyperthyroidism in other hospital. Examination revealed anemic conjunctivae, exophthalmos and smooth and beefy tongue. Laboratory tests showed 6.2g/dL of hemoglobin, 16.7% of hematocrit, 7,970/microliter of WBC, 152,000/microliter of platelets and 116.3fL of MCV. Reticulocyte index was 0.3%. Peripheral blood smear showed macrocytic red blood cells and hypersegmented neutrophils. The level of vitamin B12 was 139.2pg/mL and folic acid was in normal range. The result of schilling test was abnormal. Anti-parietal cell antibody was positive. The results of thyroid function tests were compatible with hypothyroidism and anti-microsomal antibody was positive. TBII was 9.8U/L. Treatment with vitamin B12 and thyroid hormone was started. Three months after treatment, he has been completely free of symptoms. Now he has been treated with thyroxine 0.2mg per day and adenosylcobalamine 1,000microgram per 2 month.
Subject(s)
Adult , Humans , Anemia, Pernicious , Autoimmune Diseases , Conjunctiva , Dyspnea , Erythrocytes , Exophthalmos , Folic Acid , Hematocrit , Hyperthyroidism , Hypothyroidism , Neutrophils , Pharyngitis , Reference Values , Reticulocytes , Schilling Test , Thyroid Diseases , Thyroid Function Tests , Thyroid Gland , Thyroiditis , Thyroiditis, Autoimmune , Thyroxine , Tongue , Vitamin B 12 , VitiligoABSTRACT
Se evalúan los resultados de la citología, colposcopia, test de Schiller y biopsia de cuello uterino como métodos auxiliares en el diagnóstico de los procesos patológicos en el Hospital Materno Infantil de Caricuao, "Dr. Pastor Oropeza" durante los años 1983-1993. Donde observamos que la colposcopia es un método útil y sencillo para el diagnóstico precoz de las lesiones precancerosas y por lo tanto debe ser incluido en el estudio de la paciente para su seguridad diagnóstica
Subject(s)
Humans , Female , Adult , Adolescent , Middle Aged , Biopsy , Cell Biology/instrumentation , Colposcopy/statistics & numerical data , Schilling Test , Schilling Test/classification , Uterine Cervical Dysplasia/diagnosisABSTRACT
Foram estudados retrospectivamente os prontuários de 20 pacientes idosos internados no Hospital das Clínicas da FMUSP, durante o período de 1974 a 1984, com diagnóstico de anemia megaloblástica. Dez doentes eram do sexo masculino e dez do feminino, com idades variando de 62 a 84 anos (média: 70,4 anos). Em todos os casos as manifestaçöes foram múltiplas e acentuadas, predominando as hematológicas, cardiocirculatórias, neurológicas, digestivas e o grave comprometimento do estado geral. Anemia com volume corpuscular médio elevado, aumento do índice de segmentaçäo dos neutrófilos, leucopenia, plaquetopenia e hemólise foram os achados hematológicos mais freqüentes, ocorrendo muitas vezes associadamente. Em todos os casos em que foi realizado o estudo endoscópico e a biópsia gástrica, encontraram-se alteraçöes. Näo houve diferença quanto às manifestaçöes entre os portadores de deficiência de vitamina B12 ou de ácido fólico. A resposta à terapêutica foi observada em 18 pacientes (90,0%) sendo, em geral, brilhante e rápida; porém, certas manifestaçöes neurológicas podem persistir. Por outro lado, os casos näo tratados podem até evoluir para óbito, em decorrência principalmente de complicaçöes cardiocirculatórias, hemorrágicas e infecciosas
Subject(s)
Humans , Middle Aged , Male , Female , Vitamin B 12 Deficiency/complications , Anemia, Megaloblastic/etiology , Folic Acid Deficiency/complications , Schilling Test , Aged, 80 and over , Retrospective Studies , Anemia, Megaloblastic/blood , Anemia, Megaloblastic/diagnosisABSTRACT
This is a case report of pernicious anemia with neurologic deficits. The patient is a 69 years old male with generalized tingling sense. On examination, slight pale conjunctiva and beefy red tongue are noted. Laboratory stud show megaloblastic anemia with low serum vitamin B12 level, positive Schilling test, gastric achlorhydria and mild gastric atrophy. Neurologic examination reveals cerebral, spinal and peripheral involovement and EEG and EMG study support those things. On parenteral vitamin B12, the hematologic and neurological abnormalities are improved dramatically.
Subject(s)
Aged , Humans , Male , Achlorhydria , Anemia, Megaloblastic , Anemia, Pernicious , Atrophy , Conjunctiva , Electroencephalography , Neurologic Examination , Neurologic Manifestations , Schilling Test , Tongue , Vitamin B 12ABSTRACT
Vitamin B-12 absorption of 12 healthy young male subjects was determined by using labelled vitamin B-12 by Schilling's test and whole body retention test. The whole body retention test was performed first using low energy Co57 isotope and a week later, Schilling's test was performed. Whole body retention showed a mean absorption of 56.5% while Schilling's test showed mean absorption of 16.9% in the same subjects. Data supports the whole body retention test being more accurate.