RESUMO
Common variable immunodeficiency [CVID] is a primary immunodeficiency disease characterized by hypogammaglobulinemia and recurrent bacterial infections especially in respiratory and gastrointestinal systems. We present here 2 cases of CVID with gastrointestinal complications. Case 1 is a 25-year-old man with a history of chronic diarrhoea from childhood. Ultrasonography revealed ascites, with liver size smaller than normal. Liver biopsy showed non-specific hepatitis. Lymphoid proliferation and Histiocytosis were reported in his ascites cytology. Moreover friability in colonoscopy due to moderate active chronic colitis was detected. Case 2 is a 26-year-old man with chronic diarrhoea since 8 years. Abdominal sonography revealed increased liver echogenicity, increased liver size, and some enlarged lymph nodes beside pancreas. Colonoscopy revealed friability and decreased vascularity while biopsy showed moderate active chronic colitis. Lymph node biopsy showed unusual immunologic reaction. Moreover, small bowel transition test showed nodularity. CVID should be considered in any patient with gastrointestinal manifestations especially chronic diarrhoea in association with recurrent bacterial infections in other organs. Diagnostic delay results in more morbidity and complications in untreated patients
RESUMO
Background: the essence of parathyroid surgery is finding the diseased gland or glands. Even experienced surgeons have a small miss rate despite numerous paraclinical localizing techniques. The surgeons' information about location of glands is the most important factor in finding them. The goal of anatomical research is to determine the location of glands and help improve surgeons' information
Methods and Cases: to find ectopic cases of parathyroid glands this descriptive study which took 1.5 years was done on 100 cadavers which had been dissected for legal purposes. Obtained samples were dissected by classical method, and 871 tissue samples which were considered as parathyroid tissue were sent for pathological evaluation
Results: four hundred-eleven tissue samples were diagnosed as parathyroid tissue. Forty-seven [11.5%] were ectopic. Seventeen ectopic glands were found in the postrosuperior part of the thyroid gland, 15 mediastinum and thymus, 8 in the posterior part of the esophagus and pharynx, and 7 in thyroid tissue. Seventeen percent of ectopic cases were in upper glands and 30% of ectopic glands were in lower glands [P = 0.002]
Conclusion: possibility of existence of ectopic cases of parathyroid glands in thyroid and mediastinum should be considered during thyroid surgery