RESUMO
Four patients of rheumatoid arthritis (RA) with biopsy confirmed AA amyloidosis were treated with chlorambucil. All had established but uncontrolled RA with a persistently raised ESR. Moderate (> 1 gm, < 3.5 gm/d) to nephrotic range (> 3.5 gm/d) proteinuria and a relatively well preserved renal function was noted in three patients. One patient had deranged renal function and required dialysis. On chlorambucil, there was complete recovery, partial improvement and no improvement in one patient each. The fourth patient required haemodialysis, did not tolerate chlorambucil and succumbed to the illness. Therapy with chlorambucil can benefit some patients of RA with AA amyloidosis. Leucopenia is the most important dose limiting side effect.
Assuntos
Adulto , Amiloidose/tratamento farmacológico , Antineoplásicos Alquilantes/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Clorambucila/uso terapêutico , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Biópsia por Agulha , Colite Ulcerativa/tratamento farmacológico , Hipersensibilidade a Drogas/diagnóstico , Seguimentos , Humanos , Rim/efeitos dos fármacos , Masculino , Mesalamina/administração & dosagem , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Medição de Risco , Índice de Gravidade de Doença , Pele/efeitos dos fármacosRESUMO
A 60 year old diabetic was admitted with the history of low grade fever and weight loss of six weeks duration. After investigations, he was detected to have bilateral adrenal masses which on biopsy proved to be due to histoplasmosis. He was treated with itraconazole and made complete recovery.