ABSTRACT
Thrombotic thrombocytopenic purpura presents as a multisystemic disease with thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological and renal involvement. We report a 24 years-old male presenting with purpura and a generalized seizure. His blood tests showed an hemolytic anemia, unconjungated hyperbilirubinemia, increased lactated dehydrogenase, thrombocytopenia and impairment of renal function. He was initially treated with daily plasmapheresis and steroids without improvement. Due to persistence of the disease, he was treated with two doses of intravenous vincristine in four days, with clinical and laboratory improvement. He was discharged 40 days after the last dose of vincristine, in good conditions.
Subject(s)
Adult , Humans , Male , Fibrinolytic Agents/therapeutic use , Purpura, Thrombotic Thrombocytopenic/drug therapy , Vincristine/therapeutic use , Plasmapheresis , Platelet Count , Purpura, Thrombotic Thrombocytopenic/blood , Purpura, Thrombotic Thrombocytopenic/diagnosisABSTRACT
Thrombotic thrombocytopenic purpura presents as a multisystemic disease with thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological and renal involvement. We report a 24 years-old male presenting with purpura and a generalized seizure. His blood tests showed an hemolytic anemia, unconjugated hyperbilirubinemia, increased lactated dehydrogenase, thrombocytopenia and impairment of renal function. He was initially treated with daily plasmapheresis and steroids without improvement. Due to persistence of the disease, he was treated with two doses of intravenous vincristine in four days, with clinical and laboratory improvement. He was discharged 40 days after the last dose of vincristine, in good conditions.
Subject(s)
Fibrinolytic Agents/therapeutic use , Purpura, Thrombotic Thrombocytopenic/drug therapy , Vincristine/therapeutic use , Adult , Humans , Male , Plasmapheresis , Platelet Count , Purpura, Thrombotic Thrombocytopenic/blood , Purpura, Thrombotic Thrombocytopenic/diagnosisSubject(s)
Rabbits , Animals , Male , Epoprostenol/analogs & derivatives , Epoprostenol/pharmacology , Fatty Acids, Nonesterified/pharmacology , Leukotrienes/physiology , Lung/physiology , Thromboxane A2/pharmacology , Epoprostenol/administration & dosage , Hemodynamics/drug effects , Infusions, Intravenous , Lung/drug effectsABSTRACT
La infusión intravenosa de ácidos grasos libres (AGL) en conejos producem edema pulmonar por aumento de la permeabilidad, reacción inflamatoria y aumento del surfactante alveolar. Con el objetivo de definir el rol del anión super-óxido (O2-) en el daño pulmonar difuso producido por EGL, se evaluó el efecto de la superóxido dismutasa (SOD). Se estudiaron 4 series de conejos que recibieron: a) AGL (n = 6): 10 mg AGL/Kg/min.i.v. durante 15 minutos. b) Vehículo de AGL (n=5)i.v. durante 15 y 25 minutos AGL + SOD (mg/Kg i.v. durante 15 y 25 minutos respectivamente (n = 6); d) Vehículo + SOD durante 15 y 25 minutos respectivamente (n = 7). Al cabo de 96 horas los conejos fueron sacrificados, determinándose en el lavado bronquioalveolar: proteínas, fosfatidilcolina disaturada (DPPC) y el recuento celular. Hubo un aumento significativo de DPPC del recuento de células en todas las seires en comparación a la serie vehículo (b). SOD no modificó las alteraciones inducidas por AGL, aunque "per se" aumentó la DPPC y el recuento de células en el LBA. La histología pulmonar mostró edema perivascular e intra-alveolar en los animales inyectados con AGL. Estas alteraciones fueron francamente disminuidas por la SOD. Estos resultados sugieren que el O2- tendria un rol sólo secundario en el daño pulmonar difuso por AGL, ya que SOD protegió solo parcialmente al pulmón de este daño
