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1.
Sao Paulo Med J ; 133(5): 445-9, 2015.
Article in English | MEDLINE | ID: mdl-26648435

ABSTRACT

CONTEXT: Tumor-like inflammatory demyelinating disease (TIDD) usually occurs in the brain and rarely occurs in the spinal cord. TIDD appears to be very similar to tumors such as gliomas on imaging, which may lead to incorrect or delayed diagnosis and treatment. CASE REPORT: Because of headache and incoherent speech, a 24-year-old Chinese male presented to our hospital with a two-week history of respiratory infections. After dexamethasone treatment, his symptoms still got worse and surgery was performed for diagnostic purposes. Histological examination revealed that the lesion was inflammatory. Further lesions appeared in the spine (T3 and T4 levels) after two months and in the right occipital lobe after three months. After intravenous immunoglobulin (IVIG) and methylprednisolone treatment, his symptoms improved. CONCLUSION: Progressive lesions may damage the brain and spinal cord, and long-term prednisolone and IVIG therapy are beneficial in TIDD patients.


Subject(s)
Demyelinating Diseases/pathology , Encephalitis/pathology , Myelitis/pathology , Anti-Inflammatory Agents/therapeutic use , Biopsy , Demyelinating Diseases/therapy , Diagnosis, Differential , Encephalitis/therapy , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Magnetic Resonance Imaging , Male , Methylprednisolone/therapeutic use , Myelitis/therapy , Young Adult
2.
São Paulo med. j ; São Paulo med. j;133(5): 445-449, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-767127

ABSTRACT

CONTEXT: Tumor-like inflammatory demyelinating disease (TIDD) usually occurs in the brain and rarely occurs in the spinal cord. TIDD appears to be very similar to tumors such as gliomas on imaging, which may lead to incorrect or delayed diagnosis and treatment. CASE REPORT: Because of headache and incoherent speech, a 24-year-old Chinese male presented to our hospital with a two-week history of respiratory infections. After dexamethasone treatment, his symptoms still got worse and surgery was performed for diagnostic purposes. Histological examination revealed that the lesion was inflammatory. Further lesions appeared in the spine (T3 and T4 levels) after two months and in the right occipital lobe after three months. After intravenous immunoglobulin (IVIG) and methylprednisolone treatment, his symptoms improved. CONCLUSION: Progressive lesions may damage the brain and spinal cord, and long-term prednisolone and IVIG therapy are beneficial in TIDD patients.


CONTEXTO: A doença desmielinizante inflamatória tumoral (DDIT) geralmente ocorre no cérebro e raramente na medula espinhal. A DDIT é muito semelhante a tumores tais como gliomas em exames de imagem, o que pode conduzir a diagnóstico e tratamento tardios e incorretos. RELATO DO CASO: Por causa de dor de cabeça e discurso incoerente, um homem chinês de 24 anos de idade foi ao hospital com história de duas semanas de infecções respiratórias. Após o tratamento com dexametasona, seus sintomas ficaram ainda piores e a cirurgia foi realizada para fins de diagnóstico. O exame histológico revelou que a lesão era inflamatória. Mais lesões apareceram na coluna vertebral (níveis T3 e T4) após dois meses, e no lobo occipital direito depois de três meses. Depois de tratamento com imunoglobulina intravenosa (IGIV) e metilprednisolona, seus sintomas melhoraram. CONCLUSÃO: Lesões progressivas podem danificar o cérebro e a medula espinhal, e prednisolona a longo prazo e terapia de IGIV são benéficas em pacientes DDIT.


Subject(s)
Humans , Male , Young Adult , Demyelinating Diseases/pathology , Encephalitis/pathology , Myelitis/pathology , Anti-Inflammatory Agents/therapeutic use , Biopsy , Demyelinating Diseases/therapy , Diagnosis, Differential , Encephalitis/therapy , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Magnetic Resonance Imaging , Methylprednisolone/therapeutic use , Myelitis/therapy
3.
Clinics (Sao Paulo) ; 66(6): 1009-13, 2011.
Article in English | MEDLINE | ID: mdl-21808867

ABSTRACT

OBJECTIVE: To explore the characteristics of seasonal distribution of active systemic lupus erythematosus (SLE) and the influences of meteorological factors including temperature and humidity on active systemic lupus erythematosus. METHODS: The characteristics of seasonal distribution of active SLE and its correlation with meteorological factors were retrospectively analyzed in 640 patients living in the city of Zhanjiang, China and had active SLE between January 1997 and December 2006. RESULTS: In winter, when there are weaker ultraviolet (UV) rays, the ratio of patients with active SLE to total inpatients was 3.89 %o, which is significantly higher than in other seasons with stronger UV rays, including 2.17 %o in spring, 1.87 0 in summer and 2.12 0 in autumn. The number of patients with active SLE had significant negative correlation with mean temperature and was not significantly related to mean humidity. CONCLUSION: Active SLE has the characteristics of seasonal distribution and is associated with temperature. The mechanism remains to be further studied.


Subject(s)
Lupus Erythematosus, Systemic/epidemiology , Meteorological Concepts , Seasons , Adolescent , Adult , Aged , Child , Child, Preschool , China/epidemiology , Female , Humans , Lupus Erythematosus, Systemic/etiology , Male , Middle Aged , Retrospective Studies , Statistics, Nonparametric , Time Factors , Ultraviolet Rays/adverse effects , Young Adult
4.
Clinics ; Clinics;66(6): 1009-1013, 2011. graf, tab
Article in English | LILACS | ID: lil-594370

ABSTRACT

OBJECTIVE: To explore the characteristics of seasonal distribution of active systemic lupus erythematosus (SLE) and the influences of meteorological factors including temperature and humidity on active systemic lupus erythematosus. METHODS: The characteristics of seasonal distribution of active SLE and its correlation with meteorological factors were retrospectively analyzed in 640 patients living in the city of Zhanjiang, China and had active SLE between January 1997 and December 2006. RESULTS: In winter, when there are weaker ultraviolet (UV) rays, the ratio of patients with active SLE to total inpatients was 3.89 percento, which is significantly higher than in other seasons with stronger UV rays, including 2.17 percento in spring, 1.87 0 in summer and 2.12 0 in autumn. The number of patients with active SLE had significant negative correlation with mean temperature and was not significantly related to mean humidity. CONCLUSION: Active SLE has the characteristics of seasonal distribution and is associated with temperature. The mechanism remains to be further studied.


Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Lupus Erythematosus, Systemic/epidemiology , Meteorological Concepts , Seasons , China/epidemiology , Lupus Erythematosus, Systemic/etiology , Retrospective Studies , Statistics, Nonparametric , Time Factors , Ultraviolet Rays/adverse effects
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