RESUMO
Acute pancreatitis may complicate viral hepatitis B, as well as the other causes of viral hepatitis. There have been reports of acute pancreatitis complicating acute exacerbations of chronic hepatitis B virus infection, most of which were related to immunosuppressive treatment or organ transplantation. However, acute pancreatitis complicating spontaneous acute exacerbation of chronic hepatitis B virus infection is rare. We report a case of acute pancreatitis that developed while a spontaneous acute exacerbation of chronic hepatitis B virus infection was underway in a healthy carrier.
Assuntos
Hepatite , Hepatite B , Hepatite B Crônica , Hepatite Crônica , Transplante de Órgãos , Pancreatite , Transplantes , VírusRESUMO
Hemarthrosis can occur in patients with a predisposition to hemorrhage such as hemophilia or anticoagulant therapy. A 72-year-old man presented with an acute painful swelling in the right knee. He was on anticoagulant therapy after a mechanical aortic valve replacement due to aortic valve insufficiency. There was no history of trauma and international normalized ratio (INR) was maintained at 3.76. On arthrocentesis of the knee, bloody synovial fluid was obtained. With the diagnosis of hemarthrosis, INR was maintained at 2. With immobilization, the knee pain gradually improved. Three weeks after discharge, right knee painful swelling was exacerbated, and arthrocentesis again revealed bloody synovial fluid. After magnetic resonance imaging (MRI) was performed, pseudoaneurysm of the right lateral superior genicular artery was diagnosed. The angiographic embolization was performed after which, he showed marked improvement. Knee MRI should be considered in hemarthrosis with atypical clinical progress, because it can detect lesions amenable to therapeutic intervention as in this case.
Assuntos
Idoso , Humanos , Dor Aguda , Falso Aneurisma , Valva Aórtica , Insuficiência da Valva Aórtica , Artérias , Diagnóstico , Embolização Terapêutica , Hemartrose , Hemofilia A , Hemorragia , Imobilização , Coeficiente Internacional Normatizado , Joelho , Imageamento por Ressonância Magnética , Líquido SinovialRESUMO
Human parvovirus B19 infection could be manifested as pure red cell aplasia or chronic anemia in immunocompromised host. The patient was 35-year-old female who had been diagnosed as non-Hodgkin lymphoma, peripheral T-cell unspecified type and had been performed chemotherapy. She complained headache and dizziness that was found to a marked drop in hemoglobin (3.2g/dL). A bone marrow aspiration revealed findings consistent with erythroid hypoplasia with maturation arrest. Serum parvovirus B19 PCR and anti parvovirus B19 IgM were positive. After immunoglobulin therapy, it was leading to a marked increase in reticulocyte count and corresponding rise in hemoglobin. To our knowledge, this is the first report to use immunoglobulin in an adult cancer patient with pure red-cell aplasia. Human parvovirus B19 infection should be considered in immunocompromised cancer patients with red cell aplasia and early use of immunoglobulins would be helpful in resolution of anemia and not to delay planned chemotherapy.
Assuntos
Adulto , Feminino , Humanos , Anemia , Medula Óssea , Tontura , Tratamento Farmacológico , Cefaleia , Imunização Passiva , Hospedeiro Imunocomprometido , Imunoglobulina M , Imunoglobulinas , Linfoma não Hodgkin , Parvovirus B19 Humano , Parvovirus , Reação em Cadeia da Polimerase , Aplasia Pura de Série Vermelha , Contagem de Reticulócitos , Linfócitos TRESUMO
The bronchus-asociated lymphoid tissue(BALT) lymphoma is a low-grade primary malignant lymphoma that originates from bronchus associated lymphoid tissue. A 67-year-old woman was admitted for evaluation of cough, sputum, rhinorrhea which had persisted for one month. Physical examination showed decreased breathing sound on the left upper lung field. High resolution chest computed tomography demonstrated consolidation which showed air-bronchogram and surrounding ground glass opacity in left upper lobe. These findings implicated inactive tuberculosis, organizing pneumonia, or bronchiolo-alveolar carcinoma. The histologic findings from percutaneous needle aspiration biopsy revealed aggregated atypical small lymphoid cells with lymphoepithelial lesions. With immunohistochemical staining, the atypical lymphoid cells reacted positively with CD 20 antibody and negatively with CD 3 antibody. Thus, we could diagnosed her as a patient with BALT lymphoma. After left upper lobectomy, she has been well without recurrence of the disease for 14 months. In this country of Republic of Korea, it was the 1st case of BALT lymphoma surgically treated when histological diagnosis had been done. Based on this case, we wanted to demonstrate the importance of early histological diagnosis and treatment of BALT lymphoma.
Assuntos
Idoso , Feminino , Humanos , Adenocarcinoma Bronquioloalveolar , Biópsia por Agulha , Brônquios , Tosse , Diagnóstico , Vidro , Pulmão , Linfócitos , Tecido Linfoide , Linfoma , Agulhas , Exame Físico , Pneumonia , Recidiva , República da Coreia , Sons Respiratórios , Escarro , Tórax , TuberculoseRESUMO
Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a benign, rare, self limitimg disease presenting with mainly cervical lymphadenopathy and fever unresponsive to antibiotics or medical treatment. A 28-year old man presented with fever and right lower quadrant abdominal pain. Physical examination showed abdominal tenderness and rebound tenderness mimicking acute appendicitis. Imaging studies showed normal appendix and other abdominal organs except enlarged multiple mesenteric lymph nodes. Symptoms persisted despite antimicrobial therapy. Multiple tender lymph nodes were palpable on bilateral cervical area at the 7th hospital day. The biopsy of the neck node showed large areas of patchy, irregular necrosis with prominent nuclear debris surrounded by T lymphocytes, histiocytes without neutrophils and granuloma, so he was diagnosed as Kikuchi-Fujimoto disease. With conservative management, clinical improvement was observed. We suggest that Kikuchi-Fujimoto disease with mesenteric lymphadenitis should be added to the differential diagnosis of acute abdomen mimicking acute appendicitis in young adults.
Assuntos
Adulto , Humanos , Adulto Jovem , Abdome Agudo , Dor Abdominal , Antibacterianos , Apendicite , Apêndice , Biópsia , Diagnóstico Diferencial , Febre , Granuloma , Histiócitos , Linfadenite Histiocítica Necrosante , Linfonodos , Doenças Linfáticas , Linfadenite Mesentérica , Pescoço , Necrose , Neutrófilos , Exame Físico , Linfócitos TRESUMO
Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a benign, rare, self limitimg disease presenting with mainly cervical lymphadenopathy and fever unresponsive to antibiotics or medical treatment. A 28-year old man presented with fever and right lower quadrant abdominal pain. Physical examination showed abdominal tenderness and rebound tenderness mimicking acute appendicitis. Imaging studies showed normal appendix and other abdominal organs except enlarged multiple mesenteric lymph nodes. Symptoms persisted despite antimicrobial therapy. Multiple tender lymph nodes were palpable on bilateral cervical area at the 7th hospital day. The biopsy of the neck node showed large areas of patchy, irregular necrosis with prominent nuclear debris surrounded by T lymphocytes, histiocytes without neutrophils and granuloma, so he was diagnosed as Kikuchi-Fujimoto disease. With conservative management, clinical improvement was observed. We suggest that Kikuchi-Fujimoto disease with mesenteric lymphadenitis should be added to the differential diagnosis of acute abdomen mimicking acute appendicitis in young adults.