ABSTRACT
Se describe los casos de tres pacientes a quien se les realiza diagnóstico de colestasis intrahepática del embarazo (CIE) de aparición temprana. En dos de ellos el diagnóstico se relacionó con infección por el virus de la hepatitis C (VHC). Reconocer que esta enfermedad puede presentarse de manera temprana en el embarazo y su relación con la infección por el VHC es fundamental para hacer un diagnóstico oportuno de ambas enfermedades y tomar las conductas terapéuticas adecuadas, mejorando así el pronóstico materno y fetal.
It is of great importance to acknowledge that this disease can occur early in pregnancy and that its relationship with HCV infection is a key point for a prompt diagnosis, allowing taking timely appropriate therapeutic decisions, aimed at improving the fetal prognosis.
Descrevemos os casos de três pacientes com diagnóstico de colestase intra-hepática da gravidez de início precoce. Em dois deles o diagnóstico estava relacionado à infecção pelo vírus da hepatite C (VHC). Reconhecer que esta doença pode se manifestar precocemente na gravidez e sua relação com a infecção pelo VHC é fundamental para fazer um diagnóstico oportuno de ambas as doenças e assumir condutas terapêuticas adequadas, melhorando assim o prognóstico materno e fetal.
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications, Infectious/diagnosis , Pruritus , Cholestasis, Intrahepatic/diagnosis , Cholestasis, Intrahepatic/etiology , Hepatitis C/complications , Pregnancy Trimester, Second , Pregnancy Trimester, First , Ursodeoxycholic Acid/therapeutic use , Chlorpheniramine/therapeutic use , Cholestasis, Intrahepatic/drug therapy , Hepatitis C/diagnosis , Early DiagnosisABSTRACT
Resumen La infección por Strongyloides stercoralis es una parasitosis frecuente en las regiones tropicales y subtropicales, incluyendo la Amazonía peruana. En pacientes con inmunocompromiso, las manifestaciones clínicas son variadas y es frecuente la diseminación sistémica de la enfermedad, con compromiso de diversos órganos. Las manifestaciones cutáneas son infrecuentes y se describen en pacientes con algún grado de inmunosupresión. Se presenta el caso de un paciente inmunocompetente que desarrolló una púrpura reactiva por una infección por Strongyloides stercoralis crónica. Ante ello, es posible el compromiso cutáneo en pacientes inmunocompetentes con reagudización sistémica por este parásito.
Infection with Strongyloides stercoralis is a common parasitic infection in tropical and subtropical regions, including the Peruvian Amazon. The clinical manifestations are varied in patients with immunocompromised disease, and the systemic spread of the disease is frequent, compromising different organs and systems. Cutaneous manifestations are infrequent, being described in patients with some degree of immunosuppression. We present the case of an immunocompetent patient who developed a reactive purpura due to chronic Strongyloides stercoralis infection. Thus, skin involvement is possible in immunocompetent patients with systemic exacerbation due to this parasite.
Subject(s)
Humans , Animals , Male , Adult , Young Adult , Purpura/etiology , Purpura/immunology , Strongyloidiasis/complications , Strongyloidiasis/immunology , Purpura/drug therapy , Ivermectin/therapeutic use , Chlorpheniramine/therapeutic use , Immunocompromised Host , Strongyloides stercoralis/isolation & purification , Antiparasitic Agents/classification , Antiparasitic Agents/therapeutic use , Antipruritics/therapeutic useSubject(s)
Animals , Male , Mice , Anxiety/drug therapy , Chlorpheniramine/therapeutic use , Maze Learning/drug effects , Memory/drug effects , Motor ActivityABSTRACT
La embarazada es susceptible a cambios en la piel y fanéreos que pueden ser fisiológicos como patológicos. El reconocimiento de estas entidades es fundamental para un correcto manejo. La clasificación y nomenclatura de las dermatosis del embarazo ha sido controversial y confusa, principalmente dado el pobre conocimiento que se tiene sobre el origen de estas entidades. El objetivo de esta revisión es informar sobre el conocimiento actual del penfigoide gestacional a partir de un caso clínico, centrándose en su diagnóstico y tratamiento como patología multidiscilpinaria.
The pregnant woman is susceptible to both physiologic and pathologic changes of the skin and appendages. Recognition of these entities is important for appropriate management. The classification and nomenclature have been controversial and confusing, mainly because of the poor knowledge that we have regarding the origin of this entities. The purpose of this review is to contribute to the current knowledge of pemphigoid gestationis, based on a case-report its diagnosis and treatment as a multidisciplinary pathology.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Pemphigoid Gestationis/diagnosis , Pemphigoid Gestationis/drug therapy , Clobetasol/therapeutic use , Prednisone/therapeutic use , Chlorpheniramine/therapeutic useABSTRACT
En el departamento de ultrasonido diagnóstico fue atendida una paciente, de tres años de edad, que presentaba inflamación de ambas glándulas parótidas y que había presentado varios episodios de dolor, tumefacción unilateral o bilateral y fiebre. Había sido valorada en varias ocasiones por pediatría y había recibido múltiples tratamientos con antibióticos. Se le indicó ultrasonido de partes blandas y se valoró por inmunología. Se encontró un retardo en la fagocitosis y una disminución de la inmunidad celular. Se puso tratamiento con inmunomoduladores y antihistamínicos.
A 3-year-old female patient with swelling of both parotid glands that had presented various episodes of pain, unilateral or bilateral tumefaction and fever was seen at the diagnostic ultrasound department. She had been evaluated on several occasions by the pediatric department and had received multiple treatments with antibiotics. An ultrasound of soft tissues was indicated and she was assessed at the immunology service. A phagocytosis retardation and a reduction of cellular immunity were found. A treatment with immunomodulators and antihistamines was applied.
Subject(s)
Humans , Female , Child, Preschool , Chlorpheniramine/therapeutic use , Levamisole/therapeutic use , Parotitis/drug therapy , Parotitis , Thiamine/therapeutic use , /therapeutic useABSTRACT
A ocorrência uma dermatite pápulo-pruriginosa em toda a tripulação de um navio comercial filipino em Salvador, BA, foi associada ao contato com mariposas do gênero Hylesia. Esta enfermidade insólita é causada por cerdas corporais das mariposas (flechettes). O relato dos casos serve como alerta para possíveis situações semelhantes.
An occurrence of pruritic papular dermatitis among the whole crew of a Filipino commercial ship in Salvador, State of Bahia, was associated with contact with Hylesia moths. This unusual type of dermatitis is caused by the bristles (flechettes) on the moths' bodies. Reporting on such cases serves to warn about possible similar situations.
Subject(s)
Animals , Humans , Disease Outbreaks , Dermatitis, Contact/etiology , Moths , Brazil/epidemiology , Chlorpheniramine/therapeutic use , Dermatitis, Contact/drug therapy , Dermatitis, Contact/epidemiology , Histamine H1 Antagonists/therapeutic use , Severity of Illness IndexABSTRACT
Presentamos un caso de liquen simple crónico vulvar izquierdo, en una paciente con diagnóstico psiquiátrico de trastorno bipolar, tratado repetidamente como micosis. Se realizó biopsia que confirmó el diagnóstico y se trató exitosamente con antihistamínicos orales y corticoides tópicos.
Subject(s)
Female , Adult , Humans , Neurodermatitis/diagnosis , Neurodermatitis/drug therapy , Vulva/pathology , Chronic Disease , Chlorpheniramine/therapeutic use , Neurodermatitis/pathology , PregnadienediolsABSTRACT
Herbal medicine is a growing alternative for established medicine. Many plants and herbs are currently in use for a myriad of diseases and symptoms. However, there are many reports in the literature of life-threatening adverse effects of these drugs. We report a 39 years old male, that consulted for pain in the nostrils and severe nasal obstruction, that appeared two hours after instilling Ecballium elaterirum in the nostrils. On physical examination, uvular edema was observed. The patient was successfully managed with intravenous betametasone and chlorphenamine.
Subject(s)
Humans , Male , Adult , Angioedema , Mouth Diseases/chemically induced , Phytotherapy/adverse effects , Uvula , Angioedema , Anti-Inflammatory Agents , Antipruritics/therapeutic use , Self Medication , Betamethasone/therapeutic use , Chlorpheniramine/therapeutic use , Mouth Diseases/drug therapySubject(s)
Humans , Child , Spider Bites/diagnosis , Spider Venoms/poisoning , Antidotes/administration & dosage , Antidotes/adverse effects , Chlorpheniramine/therapeutic use , Clinical Laboratory Techniques , Edema/etiology , Erythema/etiology , Spider Bites/complications , Spider Bites/drug therapyABSTRACT
La pustulosis exantémica aguda generalizada (PEAG) es una entidad poco frecuente, caracterizada por un exantema pustular superficial no folicular que se considera una forma de reacción cutánea frente a diferentes agentes, fundamentalmente fármacos, infecciones víricas y contacto con mercurio. Presentamos una serie de cinco casos de PEAG, tres de ellos probablemente causados por drogas, aunque no se pudo descartar un proceso infeccioso concomitante. Un caso ocurrió tras vacunación BCG y en el otro no se encontró agente causal
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Exanthema/diagnosis , Acetaminophen/adverse effects , BCG Vaccine/adverse effects , Chlorpheniramine/therapeutic use , Dipyrone/adverse effects , Exanthema/chemically induced , Exanthema/drug therapy , Hydrocortisone/therapeutic use , Penicillins/adverse effectsABSTRACT
Loxoscelism in the clinical condition produced by the venom of spiders belonging to the genus loxosceles, human cases of loxoscelism have been observed in diverse countries of different continents in temperate and tropical regions. In Chile loxoscelism is caused by loxosceles laeta, spider with domestic habits. Loxoscelism can be observed into two well definited clinical variants: cutaneous loxoscelism (CL) and systemic or viscerocutaneous loxoscelism (VCL) which occur in around 83,3 and 16,7 percent cases respectively. Within the universe of CL patients a clinical modality in which necrotic lesion is not present or is insignificant, but presenting a remarkable edema, particularly when the bite is on the face, which as received the name of CL with an edematous predominance (CLEP). In this paper the individual description and the assambled analysis of 10 cases, four males and six females, age ranging from 6 to 68 years, of CLEP are presented. Nine cases occurred in warm periods spring through fall and one in winter. In six cases the accident causing spider was seen and two of these were identified as L. laeta adult females. In all cases the patients went or were transported to emergency medical services 4-24 h after the bite. The predominant initial symptom was a burning stinging sensation at the site of the bite, followed by intensive pain which expanded the neighbour areas concomitantly with the emerging and progressive edema. In four of the nine patients in who the bite was on the face, the edema envolved all of it, closed both eyelids and expanded to the neck and upper part of the thorax. In three cases the enormous edema was the only signicant clinical manifestation, whereas in the remaining seven conjunctly with the edema, a small violaceous plaque or a blister of serous content gave place to a little livedoid plaque (diameter 0,3-0,8 cm) which evolved to desquamation without leaving any scarring. The edema was characterized by its brilliant rose color, painful and hard which is not accompanied by regional adenopathy. Treatment of the 10 patients depended on the moment in they were seen by us. It consisted on parenteral administration, according to age and weight, of 5-10 mg of chloroprofenpyridamine maleate every 8 hours for be continued every 12-24 hours until the patient was discharged. Parenteral route was preferred in order that it was going to be adequately absorbed
Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Edema/etiology , Spider Bites/complications , Spiders/classification , Chlorpheniramine/therapeutic use , Diagnosis, Differential , Signs and Symptoms , Spider Bites/diagnosis , Spider Bites/drug therapy , Spider Bites/etiology , Spider Venoms/poisoningABSTRACT
Neste estudo retrospectivo, relatam-se as características clínicas do edema cerebral crônico (ECCr) em 34 pacientes com neurocisticercose (NCC), que apresentavam edema cerebral difuso, à tomografia computadorizada (TC), como característica comum. Todos foram tratados com dextroclorofeniramina e, 32 deles, com albendazol. O ECCr predominou no sexo feminino (73,5 por cento) na faixa etária dos 11 - 40 anos (92,3 por cento). A cefaléia ocorreu em 94,1 por cento dos pacientes, násuseas/vômitos em 47,1 por cento, crises epilépticas em 41,1 por cento e distúrbios psíquicos em 38,2 por cento. A hiperrreflexia ocorreu em 82,3 por cento e o papiledema em 58,8 por cento e o exame neurológico normal em 11,8 por cento. Na TC, o edema esteve associado a calcificaçoes em 61,8 por cento dos casos. As pressoes liquóricas foram mais elevadas (p<0,05) antes do tratamento. Atualmente, estao assintomáticos, ou com melhora clínica 79,4 por cento dos pacientes (57,1 por cento deles sem medicaçao). Discute-se a possibilidade do ECCr, na NCC, ser uma manifestaçao antigênica, sem a presença concomitante de cistos parasitários, e poder representar mais uma condiçao clínica associada à hipertensao intracraniana benigna.
Subject(s)
Adult , Female , Humans , Middle Aged , Albendazole/therapeutic use , Anthelmintics/therapeutic use , Brain Edema/etiology , Chlorpheniramine/therapeutic use , Histamine H1 Antagonists/therapeutic use , Neurocysticercosis/complications , Brain Edema , Chronic Disease , Neurocysticercosis , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Some reports suggest that addition of an H2 antagonist increases the efficacy of H1 antagonist but the influence on the side effect profile of antihistamines are largely unknown. The effects of ranitidine, chlorpheniramine, their combination and placebo on histamine induced wheal and flare, psychomotor performance and subjective symptoms were studied in 6 healthy male volunteers in a double blind randomized and cross-over (Latin square) study. Ranitidine significantly reduced the histamine induced wheal at 4 hrs (P < 0.05). Chlorpheniramine and the combination significantly reduced both histamine induced wheal and flare at 2 hrs and at 4 hrs (P < 0.05). Addition of ranitidine reduced the feeling of sleepiness produced by chlorpheniramine, though other subjective symptoms were not affected. None of the treatment schedules produced any consistent change in the psychomotor performance of the volunteers.
Subject(s)
Adult , Chlorpheniramine/therapeutic use , Dermatitis, Allergic Contact/immunology , Double-Blind Method , Drug Therapy, Combination , Histamine/immunology , Humans , Male , Psychomotor Performance/drug effects , Ranitidine/therapeutic use , Skin TestsABSTRACT
En el presente estudio se evaluó de manera comparativa la eficacia y seguridad del bromuro de ipratropio en aerosol y la clorfenamina por vía i.v. en el tratamiento de la picadura por alacrán de grado moderado a grave. Los resultados fueron: 1. Ambos tratamientos evitaron la evolución del cuadro a intensidad más grave. 2. Los síntomas de sialorrea y lengua reptante desaparecieron más rápidamente con el bromuro de ipratropio. 3. Los efectos colaterales fueron menores con el bromuro de ipratropio. 4. Aunque se produce somnolencia en ambos grupos, el bromuro de ipratropio no ocasiona confusión mental. 5. La aplicación en aerosol del bromuro de ipratropio es más fácil y menos costosa.
Subject(s)
Humans , Animals , Male , Female , Child, Preschool , Adolescent , Adult , Middle Aged , Bites and Stings/drug therapy , Ipratropium/therapeutic use , Chlorpheniramine/therapeutic use , Mexico , Scorpions , Spider Bites/drug therapyABSTRACT
En el presente estudio sobre repigmentacion de vitiligo y otras leucodermias mediante el empleo de antihistaminicos H1, sobre un total de 56 pacientes de ambos sexos con edades que oscilaron entre 2 y 69 anos, se obtuvo repigmentacion en 42 (75%de respuestas positivas). Requirio el tratamiento una duracion promedio de 15,4 meses para adquirir una repigmentacion igual o mayor a 50%del area afectada. Asimismo, repigmentaron 3 pacientes con nevos halo y 2 pacientes de sexo femenino repigmentadas con monobencileter de hidroquinona. De entre los antihistaminicos ensayados se observo mayor respuesta con terfenadina (60-240 mg/dia) e hidroxicina (5-50 mg/dia). Se propone un posible mecanismo de accion, que podria involucrar a los receptores H1 de los linfocitos T supresores