RESUMO
Chronic recurrent multifocal osteomyelitis (CRMO) is a non-infectious inflammatory bone disease that occurs mainly in children and adolescents. The clinical presentation shows imprecise bone pain, while radiologic findings and histologic exam are similar to those of infectious osteomyelitis. It is a rare disease, which is difficult to distinguish from other diseases, therefore it could be misdiagnosed. We report on a case of CRMO on the distal tibia and fibula in an 11-year-old boy.
Assuntos
Adolescente , Criança , Humanos , Masculino , Doenças Ósseas , Fíbula , Osteomielite , Doenças Raras , TíbiaRESUMO
Gastric carcinoid tumor is a rare neoplasm and it accounts for only 0.3% of all the gastric neoplasms. Gastric carcinoid tumor has high incidence in patients who are aged between 50 and 70 years, and it usually develops over a long period of time. Type I gastric carcinoid tumors are associated with autoimmune atrophic gastritis and pernicious anemia, and there are a few cases of gastric carcinoids in patients with other autoimmune diseases like Sjogren's syndrome and autoimmune thyroiditis. Here, we report on a case of recurrent type I gastric carcinoid tumors in a 42-years old woman who suffered with systemic lupus erythematosus.
Assuntos
Idoso , Feminino , Humanos , Anemia Perniciosa , Doenças Autoimunes , Tumor Carcinoide , Gastrite Atrófica , Incidência , Lúpus Eritematoso Sistêmico , Síndrome de Sjogren , Neoplasias Gástricas , Tireoidite AutoimuneRESUMO
Urticarial vasculitis is characterized clinically by urticarial skin lesions and histologically by leukocytoclastic vasculitis. Hypocomplementemic urticarial vasculitis is associated with connective tissue diseases such as systemic lupus erythematosus (SLE). We report a case of urticarial vasculitis that preceded manifestations of SLE.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Diagnóstico Diferencial , Lúpus Eritematoso Sistêmico/diagnóstico , Recidiva , Pele/patologia , Urticária/complicações , Vasculite Leucocitoclástica Cutânea/complicaçõesRESUMO
Neurologic manifestations rarely occur as presenting feature of systemic lupus erythematosus (SLE). We describe two women who presented with several episodes of neurologic symptoms mimicking multiple sclerosis. Several years after disease onset, clinical and laboratory finding were compatible with SLE. These cases show that demyelinating syndrome resembling multiple sclerosis may present as a first manifestation of SLE.
Assuntos
Feminino , Humanos , Lúpus Eritematoso Sistêmico , Esclerose Múltipla , Manifestações NeurológicasRESUMO
The conventional approach to treatment of patients with ankylosing spondylitis (AS) have been rather limited in the last decades. Evidence is accumulating that tumor necrosis factor (TNF) blocker is highly effective in AS. This article reviews the most recent and the most pertinent advances in the treatment in AS. TNF blocker have been evaluated in a number of randomized controlled trials in AS and have been demonstrated to be effective in disease activity, function, and quality of life in these patients. TNF blocker is emerging as the best therapeutic option available for patients with AS.
Assuntos
Humanos , Qualidade de Vida , Espondilite Anquilosante , Fator de Necrose Tumoral alfaRESUMO
OBJECTIVE: It has been suggested that overproduction of interleukin -18 (IL-18) may contribute to the pathogenesis of adult onset Still's disease (AOSD). Recently, positive association between a polymorphism in the IL-18 gene and different diseases like diabetes, sarcoidosis and asthma has been reported. The aim of the present study was to investigate the potential association of two single-nucleotide polymorphisms (SNPs) at position -137 (G/C) and -607 (C/A) in the promoter region of the IL-18 gene with susceptibility and clinical feature of AOSD in the Korean population. METHODS: We examined two SNPs of IL-18 in 70 patients with AOSD and 204 healthy control individuals. The genotyping were performed using sequence specific PCR. Haplotypes were analyzed by the estimated haplotype program. The patients with AOSD were subdivided into groups according to disease course: monocyclic systemic, polycyclic systemic, and chronic articular type. RESULTS: As for the -607 genotypes, 13 of the 69 patients had CC genotype (18.8%), 36 the CA type (52.2%) and 20 the AA type (29.0%). AOSD patients had higher frequency of A allele at -607 when compared to controls (OR 1.48, 95% CI 1.00~2.18, p=0.048). AOSD patients had significantly higher frequency of AA genotypes at -607 when compared to controls (AA vs CA& CC, OR 1.90, 95% CI 1.01~3.58, p=0.044). As for the -137 genotypes, of the 68 patients, 57 had GG genotype (83.8%), 9 the GC type (13.2%) and 2 (2.9%) had the CC type. No differences were found in allele and genotype frequencies between two groups. The haplotype frequencies of the IL-18 polymorphism were not significantly different between patients with AOSD and controls. The frequency of -137 GG genotype was significantly increased in chronic articular type compared to healthy control and systemic type of AOSD. CONCLUSION: In IL-18 gene polymorphisms, the A allele and AA genotye at position -607 might be genetic risk factors for the development of AOSD in Korean population. Further investigation in larger groups is required to provide more conclusive evidence regarding the role of the IL-18 gene polymorphism in AOSD.
Assuntos
Adulto , Humanos , Alelos , Asma , Genótipo , Haplótipos , Interleucina-18 , Interleucinas , Coreia (Geográfico) , Reação em Cadeia da Polimerase , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Fatores de Risco , Sarcoidose , Doença de Still de Início TardioRESUMO
Diverticuli may be either congenital or acquired and may affect either the small or large intestines. Recently, the incidence of colonic diverticular disease is increasing in Korea but that of the small bowel, especially ileum, is very rare. We experienced a case of ileal diverticulitis causing small bowel stenosis. A 62-year-old woman was referred to our hospital because of diffuse abdominal pain for several months. Abdominal CT and small bowel series showed thickening of mucosal folds in the distal ileum. Colonoscopic findings revealed edema, mucosal thickening, blood clots, irregular dimpling, and stenosis in the distal ileum. The lesion was resected surgically and diagnosed as diverticulitis with microperforation.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Dor Abdominal , Colo , Constrição Patológica , Diverticulite , Edema , Íleo , Incidência , Intestinos , Coreia (Geográfico) , Tomografia Computadorizada por Raios XRESUMO
Neuroleptic malignant syndrome is a rare, idiosyncratic and potentially lethal side effect that occurs patients receiving neuroleptic drugs. Characteristic sings and symtoms include muscle rigidity, fever, altered consciousness, and autonomic dysfuction. The most common serious complication is rhabdomyolysis, which produces acute myoglobiuric renal failure. We present a case of 32-year-old man in whom had NMS and acute renal failure after he had received a combination of chloropromazine and haloperidol. The patients recorvered after treatment by immediate hydration, diuretics and other conservative measure.
Assuntos
Adulto , Humanos , Injúria Renal Aguda , Antipsicóticos , Estado de Consciência , Diuréticos , Febre , Haloperidol , Rigidez Muscular , Síndrome Maligna Neuroléptica , Insuficiência Renal , RabdomióliseRESUMO
Primary cardiac tumors in infancy and childhood are rare, with fibromas being the second most common tumor after rhabdomyomas. Although cardiac fibromas are characteristically benign intramural tumors, they may exhibit expansile growth resulting in obstruction, valvular dysfunction, as well as other problems so early diagnosis and successful surgical excision are important. We experienced a case of cardiac fibroma in right ventricle that diagnosed by transthoracic echocardiography, chest CT, open heart tissue biopsy etc.