Subject(s)
Humans , Female , Middle Aged , Pulmonary Eosinophilia/complications , Pulmonary Eosinophilia/diagnosis , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/diagnosis , Adrenal Cortex Hormones/therapeutic use , Bronchodilator Agents/therapeutic use , Pulmonary Eosinophilia/physiopathology , Pulmonary Eosinophilia , Arthritis, Rheumatoid/physiopathology , Retrospective Studies , SpirometrySubject(s)
Arthritis, Rheumatoid/etiology , Female , Humans , Middle Aged , Pulmonary Eosinophilia/etiologyABSTRACT
El síndrome de Löfgren es una entidad definida por lapresencia de eritema nudoso, adenopatías hiliares bilaterales,poliartralgias, fiebre y, ocasionalmente, iritis. Se trata deuna forma habitual de presentación aguda de la sarcoidosis,enfermedad sistémica de etiología desconocida caracterizadapor la presencia de granulomas no caseificantes en los órganosafectados. Clásicamente se ha descrito su apariciónpreferente en primavera e invierno. Aunque para el diagnósticode sarcoidosis se requiere, además de un cuadro clínicoy una evolución compatibles, la presencia de granulomas nocaseificantes en uno o más de los órganos afectos, y la exclusiónde otras enfermedades granulomatosas, infecciosas ono, para el síndrome de Löfgren se acepta el diagnóstico sinconfirmación histológica, habida cuenta de su buen pronósticoy su presentación clínica peculiar.Presentamos tres casos de síndrome de Löfgren de aparicióncoincidente en el tiempo, y con buena evolución sintratamiento específico, a pesar de que una de las pacientesmostraba una afectación leve de la función pulmonar conafectación radiológica pulmonar (AU)
Löfgrens syndrome is characterized by the presence oferythema nodosum, bilateral hilar adenopathy, polyarthralgias,fever and, occasionally, iritis. It is usually an acute formof sarcoidosis, which is a systemic disease of unknown etiology,characterized by the presence of non-caseificant granulomatasin the affected organs. It classically appears inspring and winter. The presence of non-caseificant granulomatason one or more of the affected organs, and the exclusionof any other granulomatous diseases (infectious or not)is necessary to diagnose sarcoidosis in addition to a compatibleclinical picture and course, However, in regards toLöfgrens syndrome, the diagnosis can be accepted withouthistological confirmation because of its good prognosis andits characteristic clinical presentation.We present three cases of Löfgrens syndrome which hadappeared at the same time and with good progress withoutspecific treatment even though one of the patients had aslight impairment of the pulmonary function with pulmonaryradiological involvement (AU)
Subject(s)
Humans , Male , Female , Adult , Erythema Nodosum/complications , Erythema Nodosum/diagnosis , Erythema Nodosum/therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Prednisone/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Sarcoidosis/complications , Sarcoidosis/diagnosis , Granulomatous Disease, Chronic/classification , Bronchoalveolar Lavage/methodsABSTRACT
We studied retrospectively 107 cases of extrapulmonary tuberculosis diagnosed during a period lasting from 1988 to 1992 in a General Hospital (asistencial area of 185,000 population). These cases represent 35.7% from the overall tuberculosis diagnosed in the same period of time and same attendance centre, with an mean rate of 11.5 cases/100,000 population. 62.6% were males and 37.4% were females. Mean age was 40.7 +/- 22 years old (range 2-84). The most frequently age group was 20-30 years old and 56% were persons less than 50 years of age. Smoking and alcohol (53.6% and 36.5% respectively) were the greatest factors risk; only two persons had been infected by the HIV. The most common forms of disease were tuberculosis pleural effusions (29%), genito-urinary (22%) and lymph node disease (20.5%). The diagnosis was performed by consistent pathological findings in 64% and in 53% microbiologic procedures were found positives. 74% patients received treatment by recommended 9-month regimen (three drugs) and 24% 6-month regimen (four drugs) with the same efficacy. Relevant adverse reactions were not found except a case of neurotoxicity.
Subject(s)
Tuberculosis/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
We studied the seric activity of the angiotensin converting enzyme (ACE) in 19 patients with sarcoidosis, 14 tuberculosis, 16 silicosis and 15 workers of coal mining without silicosis and other concomitant diseases, in order to assess its usefulness as orientative parameter for the differential diagnosis of these processes. We found significantly increased values with respect to the control group in all of them: control group (40.84 +/- 13.06 U/l), sarcoidosis (57.77 +/- 16.47 U/l), tuberculosis (46.85 +/- 10.25 U/l), silicosis (61.50 +/- 21.40 U/l), miners (71.50 +/- 12.48 U/l). We did not detect any statistically significant differences between the several diagnostic groups except for miners and tuberculosis (p = 0.04). We conclude that this parameter is hot very useful for the diagnostic orientation of these processes.
Subject(s)
Coal Mining , Occupational Diseases/enzymology , Peptidyl-Dipeptidase A/blood , Sarcoidosis, Pulmonary/enzymology , Silicosis/enzymology , Tuberculosis, Pulmonary/enzymology , Adult , Aged , Case-Control Studies , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Occupational Diseases/diagnosis , Sarcoidosis, Pulmonary/diagnosis , Silicosis/diagnosis , Tuberculosis, Pulmonary/diagnosisABSTRACT
OBJECTIVE: A clinical evaluation of Sarcoidosis in our environment. DESIGN: A retrospective and descriptive analysis of 14 cases encountered between 1988 and 1990. SITE. In-hospital patients studied within a catchment area of 200,000 people. PATIENTS AND OTHERS PARTICIPANTS: 13 women and 1 man ranging in age from 24 to 63 (X = 37. DS 13). All of them were confirmed histologically. MAIN MEASUREMENTS AND RESULTS: Six patients received V.O. steroid treatment. 28.5% started as Nodose Erythema, 28.5% as Respiratory Syndrome, 21% as general Toxic Syndrome. 35% were without clinical symptoms; 25% Arthralgias, 21% cough. Thoracic X-ray with bilateral hiliar adenopathies 78%; interstitial pattern 28.5%. Analytically, Monocitosis was presented in 43%; Anaemia, Hypergammaglobulinemia, rise in Transaminases in 35%; a normal ACE in 50% and raised ACE in 35%. There was a positive pulmonary Cammagraphy (Galio) in 50%. Diagnostic confirmation was made by means of transbronchial B (28%), Mediastinoscopy (14%), open Pulmonary B. (14%), Hepatic B (14%), osseous B. and Daniels (14%) and peripheric adenopathy B (14%). Pulmonary circulatory capacity (DLCO-KCO) was decreased in 3 cases. Statistic 1, 71%; 11, 14%, 111, 14%. CONCLUSIONS: Sarcoidosis is not so rare in our environment as had been thought. Factors such as a Northerly geographical situation, low temperatures, the long duration of the disease, improvement in diagnostic methods and a high level of awareness have all influenced this high number of cases found in an area of 200,000 inhabitants. The disease's clinical behaviour in our environment does not differ from that described by other spanish and foreign authors.
