ABSTRACT
BACKGROUND: We report an unusual localization of a hydatid cyst: the septum interventriculare. CASE REPORT: A 60-year-old algerian man with hypertension was treated for cardiac insufficiency with hypereosinophilia. Cardiac echography showed a round tumor in the septum interventriculare. Serologic tests for hydatidosis were positive. Computed tomography and magnetic resonance imaging were consistent with the diagnostic of hydatid cyst. Surgical treatment was rejected because of severe underlying hypertensive cardiopathy. DISCUSSION: Cardiac hydatidosis is uncommon, but may be revealed by cyst rupture. Treatment requires surgery and associated medical management with albendazole requires further evaluation.
Subject(s)
Cardiomyopathies/parasitology , Echinococcosis/diagnosis , Cardiomyopathies/surgery , Echinococcosis/surgery , Humans , Male , Middle AgedABSTRACT
Medical treatment of systemic idiopathic fibrosis is first based on steroid therapy, of which efficacy is well known for nearly 75% of cases of retroperitoneal fibrosis, but les certain for the other localisations of the disease. Studies on the immuno-pathological mechanism of systemic fibrosis have led to immunosuppressive drug use, such as azathioprin, cyclophosphamide and methotrexate. Tamoxifen has been tried because of its efficacy on desmoid tumors and seems to be of great interest. Attention is focused on fibrosing cervicitis which may also be treated with immunosuppressive drugs.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Estrogen Antagonists/therapeutic use , Immunosuppressive Agents/therapeutic use , Retroperitoneal Fibrosis/drug therapy , Fibrosis , Humans , NeckSubject(s)
Anemia, Hemolytic, Autoimmune/complications , Pancreatitis/etiology , Acute Disease , Aged , Humans , MaleABSTRACT
Simultaneous elevation of thyreostimulin and thyroid hormones values, when associated with clinical hyperthyroidism, raises a dual problem of diagnosis and treatment. We report a case of hyperthyroidism with elevated thyreostimulin in a young adult man. The values of free triiodothyronin and free thyroxin were elevated and the thyroxin binding globulin was normal. A normal pituitary tomodensitometry, the normal values of the alpha sub-unit of thyreostimulin and the dynamic tests of thyreostimulin secretion allowed us to rule out the hypothesis of a pituitary adenoma. Non-tumoral inappropriate secretions of thyreostimulin are at present regarded as syndromes of resistance to thyroid hormones. Their biological translation is a simultaneous elevation of thyreostimulin and thyroid hormones. Peripheral resistance, which is rarely complete, finds its expression in clinical hyperthyroidism or in normal clinical condition, whereas pituitary resistance, which causes the lack of feedback on the secretion of thyreostimulin expresses itself by clinical hyperthyroidism, sometimes with goitre owing to the trophic action of thyreostimulin on the thyroid. Generalized syndromes of resistance are the most common. Our patient had a selective pituitary resistance to thyroid hormones and less than thirty cases are reported in the literature. Treatment with a beta-blocker remains indicated when facing clinical evidence for hyperthyroidism and oral triiodothyronin seems to be able to slow down the inappropriate secretion of thyreostimulin. Regarding our patient who experienced a clinical and biological relapse after the stopping of the treatment, we join many authors who recommend a prolonged treatment.
