RESUMO
Intravenous contrast medium (ICM) rarely induces anaphylactic reactions, including urticaria, hypotension and respiratory failure. Even the most modern ICM may cause such adverse events. Thrombocytopenia has been reported as an extreme rare consequence of ICM. Here we report on a case of a 72-year-old male patient with a self-limiting severe acute thrombocytopenia following administration of intravenous non-ionic low-osmolarity contrast medium. No such low platelet count has ever been reported. We also present a review of the literature.
Assuntos
Idoso , Humanos , Masculino , Comorbidade , Meios de Contraste/administração & dosagem , Diagnóstico Diferencial , Injeções Intravenosas , Nefropatias/diagnóstico por imagem , Concentração Osmolar , Trombocitopenia/induzido quimicamente , Tomografia Computadorizada por Raios X , Ácidos Tri-Iodobenzoicos/administração & dosagemRESUMO
The first clinical sign of chronic hepatitis C virus [HCV] infection can be one of the various extrahepatic manifestations. During antiviral treatment, symptoms of HCV-associated neuropathies usually improve, but can also worsen and lead to discontinuation of anti-HCV therapy. Recently, we have reported autonomic dysfunction in patients with HCV infection. In the present prospective study, we analyzed the changes of autonomic function during anti-HCV treatment. Cardiovagal autonomic function was assessed in 22 HCV RNA-positive, treatment-naive patients by determining heart rate variability [HRV] and baroreflex sensitivity [BRS], at the beginning of treatment and 12, 24 and 48 weeks of antiviral therapy. interferon alfa-2 and ribavirin were given according to the guidelines. Both HRV and BRS time and frequency domain indices decreased after 12 weeks of therapy compared to the pre-treatment values; then the mean +/- SD values increased significantly by week 24 and continued to improve by week 48 of therapy-253.0 +/- 156.1 ms before therapy vs 111.6 +/- 81.9 at week 12, and 183.4 +/- 169.6 at week 24 vs 211.6 +/- 149.1 ms at week 48 for low-frequency HRV index; p<0.05 for all comparisons]. These changes were independent from the presence of cryoglobulins and from virologic response. The first rise followed by reversible autonomic dysfunction during antiviral therapy may be caused by the immunomodulatory actions of interferon alfa-2