RESUMO
Although, with regard to diagnosis, history, physical examination, laboratory data, and electrocardiogram (ECG) are helpful, it can be difficult to distinguish between pericarditis, myopericarditis, and myocardial infarction. Typically, the ECG pattern evolves similarly in acute pericarditis and myopericarditis and includes diffuse ST elevation and PR depression, and then diffuse T wave inversion. Nevertheless, atypical ECG features are seen occasionally in both, especially in myopericarditis. They are characterized by localized ST elevation (inferolateral or anterolateral) and T wave inversion before ST segment normalization. This makes it difficult to distinguish acute myopericarditis from acute myocardial infarction. We report the case of a 27-year-old man with acute myopericarditis with localized ST elevation mimicking acute myocardial infarction.
Assuntos
Adulto , Humanos , Depressão , Eletrocardiografia , Infarto do Miocárdio , Miocardite , Pericardite , Exame FísicoRESUMO
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is an inflammatory arthropathy that is defined by the deposition of CPPD crystals in articular and periarticular structures. CPPD crystal deposition disease has various clinical manifestation patterns ranging from an absence of symptoms to a severely destructive arthropathy. CPPD crystal deposition disease very rare with rheumatoid arthritis or systemic sclerosis. We report a case of CPPD crystal deposition disease combined in a patient with rheumatoid arthritis and systemic sclerosis.
Assuntos
Humanos , Artrite Reumatoide , Pirofosfato de Cálcio , Difosfatos , Escleroderma SistêmicoRESUMO
Human immunodeficiency virus infection is associated with a variety of rheumatic manifestations. The pathogenic mechanisms are not well defined, but evidences suggests multiple mechanisms, including direct or indirect human immunodeficiency virus involvement with a genetic, immunological, and environmental basis. Rheumatic manifestations can occur during the course of human immunodeficiency virus infection, and their presence is associated with an overall poor prognosis for the underlying human immunodeficiency virus infection. We report a case of a 37-year-old male who had ankylosing spondylitis with a human immunodeficiency virus infection.
Assuntos
Adulto , Humanos , Masculino , HIV , Prognóstico , Doenças Reumáticas , Espondilite AnquilosanteRESUMO
Microscopic polyangiitis (MPA) is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. The kidney is the most often affected organ in the majority of patients with MPA, and renal manifestations are usually the first symptoms. Glomerular capillaries are affected most often, resulting in necrotizing glomerulonephritis, usually in a crescent formation, with no or few immune deposits able to be demonstrated at the sites of vasculitis and glomerulonephritis. We report a case of microscopic polyangiitis in both legs with pitting edema in a 50-year-old female. Laboratory findings showed hematuria, proteinuria, and a positive peripheral antineutrophil cytoplasmic antibody. A renal biopsy revealed pauci-immune splitting and necrotizing capillary loop walls necrotizing vasculitis and membranoproliferative glomerulonephritis (MPGN). With a diagnosis of MPA, she has been managed with high dose steroid and cyclophosphamide. To our knowledge, this is the first reported case of MPA with MPGN.